HL7 Europe Imaging Report R5
0.1.1-build - ci-build 150

HL7 Europe Imaging Report R5, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.1-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/imaging-r5/ and changes regularly. See the Directory of published versions

Resource Profile: EEHRxF MHD DocumentReference Profile for unstructured imaging reports

Official URL: http://hl7.eu/fhir/imaging-r5/StructureDefinition/DocumentReferenceUnstructuredImagingReport Version: 0.1.1-build
Standards status: Draft Draft as of 2026-02-23 Maturity Level: 1 Computable Name: DocumentReferenceUnstructuredImagingReport

Copyright/Legal: Copyright HL7 Europe. Licensed under Creative Commons public domain (CC0 1.0).

Profile for DocumentReference resources used in the EEHRxF context, based on the IHE MHD Minimal DocumentReference profile. This profile is used for the DocumentReference resources that represent imaging reports in the EEHRxF context. It includes additional constraints and extensions specific to imaging reports, such as the type of report, the clinical specialty, and the anatomical region of interest. It is intended for unstructured reports needed to support legacy reports, where the content is provided as an attachment without a specific structure or format.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DocumentReference C 0..* DocumentReference A reference to a document
Constraints: docRef-1, docRef-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... type Σ 1..1 CodeableConcept Type of Imaging Diagnostic Report
Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document.
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:imaging-report Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85430-7
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... coding:imaging-report-type Σ 0..* Coding Code defined by a terminology system
Binding: ValueSet: Radiology Report Types (preferred)
... category Σ 1..1 CodeableConcept Categorization of document
Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:priority-area Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: Medical-Imaging
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
... subject Σ 1..1 Reference(Patient (EU core)) Who/what is the subject of the document
... context C 0..* Reference(Appointment | Encounter | EpisodeOfCare) Context of the document content
... bodySite Σ 0..* CodeableReference(BodyStructure) The anatomical region of the patient that is the focus of the imaging manifest, concept field is required.
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
.... concept Σ 1..1 CodeableConcept Reference to a concept (by class)
..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:concept
...... coding:anatomical-region Σ 1..* Coding Code defined by a terminology system
Binding: ValueSet: Anatomical Region (extensible)
... practiceSetting C 0..1 CodeableConcept Clinical specialty (e.g., radiology, laboratory) - SHOULD be used for lab vs imaging differentiation
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
... date Σ 1..1 instant When this document reference was created
... custodian 0..1 Reference(Organization (EU base)) Organization that manages the Imaging Report
... content Σ 1..* BackboneElement Document referenced
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment Σ 1..1 Attachment Where to access the document

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.status Base required DocumentReferenceStatus 📍5.0.0 FHIR Std.
DocumentReference.type Base preferred FHIR Document Type Codes 📍5.0.0 FHIR Std.
DocumentReference.type.​coding:imaging-report-type Base preferred ValueSet: Radiology Report Types 📦0.1.1-build This IG
DocumentReference.category Base example Referenced Item Category Value Set 📍5.0.0 FHIR Std.
DocumentReference.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
DocumentReference.bodySite.​concept.coding:anatomical-region Base extensible ValueSet: Anatomical Region 📦0.1.1-build This IG
DocumentReference.practiceSetting Base example Practice Setting Code Value Set 📍5.0.0 FHIR Std.

Constraints

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DocumentReference 0..* DocumentReference A reference to a document
... type 1..1 CodeableConcept Type of Imaging Diagnostic Report
.... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:imaging-report 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85430-7
..... coding:imaging-report-type 0..* Coding Code defined by a terminology system
Binding: ValueSet: Radiology Report Types (preferred)
... category 1..1 CodeableConcept Categorization of document
.... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:priority-area 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: Medical-Imaging
... subject 1..1 Reference(Patient (EU core)) Who/what is the subject of the document
.... concept 1..1 CodeableConcept Reference to a concept (by class)
..... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:concept
...... coding:anatomical-region 1..* Coding Code defined by a terminology system
Binding: ValueSet: Anatomical Region (extensible)
... practiceSetting 0..1 CodeableConcept Clinical specialty (e.g., radiology, laboratory) - SHOULD be used for lab vs imaging differentiation
... date 1..1 instant When this document reference was created
... custodian 0..1 Reference(Organization (EU base)) Organization that manages the Imaging Report

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
DocumentReference.type.​coding:imaging-report-type Base preferred ValueSet: Radiology Report Types 📦0.1.1-build This IG
DocumentReference.bodySite.​concept.coding:anatomical-region Base extensible ValueSet: Anatomical Region 📦0.1.1-build This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DocumentReference C 0..* DocumentReference A reference to a document
Constraints: docRef-1, docRef-2
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifiers for the document
... version Σ 0..1 string An explicitly assigned identifer of a variation of the content in the DocumentReference
... basedOn 0..* Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) Procedure that caused this media to be created
... status ?!Σ 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
... docStatus Σ 0..1 code registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
Binding: CompositionStatus (required): Status of the underlying document.
... modality Σ 0..* CodeableConcept Imaging modality used
Binding: Modality (extensible): Type of acquired data in the instance.
... type Σ 1..1 CodeableConcept Type of Imaging Diagnostic Report
Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document.
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:imaging-report Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85430-7
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... coding:imaging-report-type Σ 0..* Coding Code defined by a terminology system
Binding: ValueSet: Radiology Report Types (preferred)
.... text Σ 0..1 string Plain text representation of the concept
... category Σ 1..1 CodeableConcept Categorization of document
Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:priority-area Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: Medical-Imaging
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(Patient (EU core)) Who/what is the subject of the document
... context C 0..* Reference(Appointment | Encounter | EpisodeOfCare) Context of the document content
... event 0..* CodeableReference() Main clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
... bodySite Σ 0..* CodeableReference(BodyStructure) The anatomical region of the patient that is the focus of the imaging manifest, concept field is required.
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... concept Σ 1..1 CodeableConcept Reference to a concept (by class)
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:concept
...... coding:anatomical-region Σ 1..* Coding Code defined by a terminology system
Binding: ValueSet: Anatomical Region (extensible)
..... text Σ 0..1 string Plain text representation of the concept
.... reference Σ 0..1 Reference() Reference to a resource (by instance)
... facilityType C 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
... practiceSetting C 0..1 CodeableConcept Clinical specialty (e.g., radiology, laboratory) - SHOULD be used for lab vs imaging differentiation
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
... period Σ 0..1 Period Time of service that is being documented
... date Σ 1..1 instant When this document reference was created
... author Σ 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) Who and/or what authored the document
... attester 0..* BackboneElement Attests to accuracy of the document
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... mode 1..1 CodeableConcept personal | professional | legal | official
Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document.
.... time 0..1 dateTime When the document was attested
.... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the document
... custodian 0..1 Reference(Organization (EU base)) Organization that manages the Imaging Report
... relatesTo Σ 0..* BackboneElement Relationships to other documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept The relationship type with another document
Binding: DocumentRelationshipType (extensible): The type of relationship between the documents.
.... target Σ 1..1 Reference(DocumentReference) Target of the relationship
... description Σ 0..1 markdown Human-readable description
... securityLabel Σ 0..* CodeableConcept Document security-tags
Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System.
... content Σ 1..* BackboneElement Document referenced
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment Σ 1..1 Attachment Where to access the document
.... profile Σ 0..* BackboneElement Content profile rules for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... value[x] Σ 1..1 Code|uri|canonical
Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
...... valueCoding Coding
...... valueUri uri
...... valueCanonical canonical(Any)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.language Base required All Languages 📍5.0.0 FHIR Std.
DocumentReference.status Base required DocumentReferenceStatus 📍5.0.0 FHIR Std.
DocumentReference.docStatus Base required Composition Status 📍5.0.0 FHIR Std.
DocumentReference.modality Base extensible Modality 📦2025.3.20250714 DICOM v2025c
DocumentReference.type Base preferred FHIR Document Type Codes 📍5.0.0 FHIR Std.
DocumentReference.type.​coding:imaging-report-type Base preferred ValueSet: Radiology Report Types 📦0.1.1-build This IG
DocumentReference.category Base example Referenced Item Category Value Set 📍5.0.0 FHIR Std.
DocumentReference.event Base example v3 Code System ActCode 📦3.0.0 THO v7.0
DocumentReference.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
DocumentReference.bodySite.​concept.coding:anatomical-region Base extensible ValueSet: Anatomical Region 📦0.1.1-build This IG
DocumentReference.facilityType Base example Facility Type Code Value Set 📍5.0.0 FHIR Std.
DocumentReference.practiceSetting Base example Practice Setting Code Value Set 📍5.0.0 FHIR Std.
DocumentReference.attester.​mode Base preferred Composition Attestation Mode 📍5.0.0 FHIR Std.
DocumentReference.relatesTo.​code Base extensible Document Relationship Type 📍5.0.0 FHIR Std.
DocumentReference.securityLabel Base example Example set of Security Labels 📍5.0.0 FHIR Std.
DocumentReference.content.​profile.value[x] Base preferred HL7 ValueSet of Format Codes for use with Document Sharing 📦2.1.0 THO v7.0

Constraints

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

Summary

Mandatory: 8 elements(3 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DocumentReference.type.coding
  • The element 1 is sliced based on the value of DocumentReference.category.coding
  • The element 1 is sliced based on the value of DocumentReference.bodySite.concept.coding

Maturity: 1

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DocumentReference C 0..* DocumentReference A reference to a document
Constraints: docRef-1, docRef-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... type Σ 1..1 CodeableConcept Type of Imaging Diagnostic Report
Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document.
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:imaging-report Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85430-7
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... coding:imaging-report-type Σ 0..* Coding Code defined by a terminology system
Binding: ValueSet: Radiology Report Types (preferred)
... category Σ 1..1 CodeableConcept Categorization of document
Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:priority-area Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: Medical-Imaging
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
... subject Σ 1..1 Reference(Patient (EU core)) Who/what is the subject of the document
... context C 0..* Reference(Appointment | Encounter | EpisodeOfCare) Context of the document content
... bodySite Σ 0..* CodeableReference(BodyStructure) The anatomical region of the patient that is the focus of the imaging manifest, concept field is required.
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
.... concept Σ 1..1 CodeableConcept Reference to a concept (by class)
..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:concept
...... coding:anatomical-region Σ 1..* Coding Code defined by a terminology system
Binding: ValueSet: Anatomical Region (extensible)
... practiceSetting C 0..1 CodeableConcept Clinical specialty (e.g., radiology, laboratory) - SHOULD be used for lab vs imaging differentiation
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
... date Σ 1..1 instant When this document reference was created
... custodian 0..1 Reference(Organization (EU base)) Organization that manages the Imaging Report
... content Σ 1..* BackboneElement Document referenced
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment Σ 1..1 Attachment Where to access the document

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.status Base required DocumentReferenceStatus 📍5.0.0 FHIR Std.
DocumentReference.type Base preferred FHIR Document Type Codes 📍5.0.0 FHIR Std.
DocumentReference.type.​coding:imaging-report-type Base preferred ValueSet: Radiology Report Types 📦0.1.1-build This IG
DocumentReference.category Base example Referenced Item Category Value Set 📍5.0.0 FHIR Std.
DocumentReference.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
DocumentReference.bodySite.​concept.coding:anatomical-region Base extensible ValueSet: Anatomical Region 📦0.1.1-build This IG
DocumentReference.practiceSetting Base example Practice Setting Code Value Set 📍5.0.0 FHIR Std.

Constraints

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

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DocumentReference 0..* DocumentReference A reference to a document
... type 1..1 CodeableConcept Type of Imaging Diagnostic Report
.... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:imaging-report 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85430-7
..... coding:imaging-report-type 0..* Coding Code defined by a terminology system
Binding: ValueSet: Radiology Report Types (preferred)
... category 1..1 CodeableConcept Categorization of document
.... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:priority-area 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: Medical-Imaging
... subject 1..1 Reference(Patient (EU core)) Who/what is the subject of the document
.... concept 1..1 CodeableConcept Reference to a concept (by class)
..... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:concept
...... coding:anatomical-region 1..* Coding Code defined by a terminology system
Binding: ValueSet: Anatomical Region (extensible)
... practiceSetting 0..1 CodeableConcept Clinical specialty (e.g., radiology, laboratory) - SHOULD be used for lab vs imaging differentiation
... date 1..1 instant When this document reference was created
... custodian 0..1 Reference(Organization (EU base)) Organization that manages the Imaging Report

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
DocumentReference.type.​coding:imaging-report-type Base preferred ValueSet: Radiology Report Types 📦0.1.1-build This IG
DocumentReference.bodySite.​concept.coding:anatomical-region Base extensible ValueSet: Anatomical Region 📦0.1.1-build This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DocumentReference C 0..* DocumentReference A reference to a document
Constraints: docRef-1, docRef-2
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifiers for the document
... version Σ 0..1 string An explicitly assigned identifer of a variation of the content in the DocumentReference
... basedOn 0..* Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription) Procedure that caused this media to be created
... status ?!Σ 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
... docStatus Σ 0..1 code registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown
Binding: CompositionStatus (required): Status of the underlying document.
... modality Σ 0..* CodeableConcept Imaging modality used
Binding: Modality (extensible): Type of acquired data in the instance.
... type Σ 1..1 CodeableConcept Type of Imaging Diagnostic Report
Binding: FHIRDocumentTypeCodes (preferred): Precise type of clinical document.
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:imaging-report Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 85430-7
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... coding:imaging-report-type Σ 0..* Coding Code defined by a terminology system
Binding: ValueSet: Radiology Report Types (preferred)
.... text Σ 0..1 string Plain text representation of the concept
... category Σ 1..1 CodeableConcept Categorization of document
Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:$this
..... coding:priority-area Σ 1..1 Coding Code defined by a terminology system

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: Medical-Imaging
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject Σ 1..1 Reference(Patient (EU core)) Who/what is the subject of the document
... context C 0..* Reference(Appointment | Encounter | EpisodeOfCare) Context of the document content
... event 0..* CodeableReference() Main clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
... bodySite Σ 0..* CodeableReference(BodyStructure) The anatomical region of the patient that is the focus of the imaging manifest, concept field is required.
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... concept Σ 1..1 CodeableConcept Reference to a concept (by class)
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:concept
...... coding:anatomical-region Σ 1..* Coding Code defined by a terminology system
Binding: ValueSet: Anatomical Region (extensible)
..... text Σ 0..1 string Plain text representation of the concept
.... reference Σ 0..1 Reference() Reference to a resource (by instance)
... facilityType C 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
... practiceSetting C 0..1 CodeableConcept Clinical specialty (e.g., radiology, laboratory) - SHOULD be used for lab vs imaging differentiation
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
... period Σ 0..1 Period Time of service that is being documented
... date Σ 1..1 instant When this document reference was created
... author Σ 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam) Who and/or what authored the document
... attester 0..* BackboneElement Attests to accuracy of the document
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... mode 1..1 CodeableConcept personal | professional | legal | official
Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document.
.... time 0..1 dateTime When the document was attested
.... party 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) Who attested the document
... custodian 0..1 Reference(Organization (EU base)) Organization that manages the Imaging Report
... relatesTo Σ 0..* BackboneElement Relationships to other documents
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code Σ 1..1 CodeableConcept The relationship type with another document
Binding: DocumentRelationshipType (extensible): The type of relationship between the documents.
.... target Σ 1..1 Reference(DocumentReference) Target of the relationship
... description Σ 0..1 markdown Human-readable description
... securityLabel Σ 0..* CodeableConcept Document security-tags
Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System.
... content Σ 1..* BackboneElement Document referenced
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment Σ 1..1 Attachment Where to access the document
.... profile Σ 0..* BackboneElement Content profile rules for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... value[x] Σ 1..1 Code|uri|canonical
Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
...... valueCoding Coding
...... valueUri uri
...... valueCanonical canonical(Any)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.language Base required All Languages 📍5.0.0 FHIR Std.
DocumentReference.status Base required DocumentReferenceStatus 📍5.0.0 FHIR Std.
DocumentReference.docStatus Base required Composition Status 📍5.0.0 FHIR Std.
DocumentReference.modality Base extensible Modality 📦2025.3.20250714 DICOM v2025c
DocumentReference.type Base preferred FHIR Document Type Codes 📍5.0.0 FHIR Std.
DocumentReference.type.​coding:imaging-report-type Base preferred ValueSet: Radiology Report Types 📦0.1.1-build This IG
DocumentReference.category Base example Referenced Item Category Value Set 📍5.0.0 FHIR Std.
DocumentReference.event Base example v3 Code System ActCode 📦3.0.0 THO v7.0
DocumentReference.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
DocumentReference.bodySite.​concept.coding:anatomical-region Base extensible ValueSet: Anatomical Region 📦0.1.1-build This IG
DocumentReference.facilityType Base example Facility Type Code Value Set 📍5.0.0 FHIR Std.
DocumentReference.practiceSetting Base example Practice Setting Code Value Set 📍5.0.0 FHIR Std.
DocumentReference.attester.​mode Base preferred Composition Attestation Mode 📍5.0.0 FHIR Std.
DocumentReference.relatesTo.​code Base extensible Document Relationship Type 📍5.0.0 FHIR Std.
DocumentReference.securityLabel Base example Example set of Security Labels 📍5.0.0 FHIR Std.
DocumentReference.content.​profile.value[x] Base preferred HL7 ValueSet of Format Codes for use with Document Sharing 📦2.1.0 THO v7.0

Constraints

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

Summary

Mandatory: 8 elements(3 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DocumentReference.type.coding
  • The element 1 is sliced based on the value of DocumentReference.category.coding
  • The element 1 is sliced based on the value of DocumentReference.bodySite.concept.coding

Maturity: 1

 

Other representations of profile: CSV, Excel, Schematron