HL7 Europe Imaging Report R5
1.0.0-ballot - 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 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-r5/ and changes regularly. See the Directory of published versions

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

Draft as of 2026-06-10

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

Guidance on how to interpret the contents of this table can be foundhere

0. DiagnosticReport
Definition

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

ShortA 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
Must Supportfalse
Summaryfalse
Alternate NamesReport, Test, Result, Results, Labs, Laboratory
Invariantsdgr-1: When a Composition is referenced in `Diagnostic.composition`, all Observation resources referenced in `Composition.entry` must also be referenced in `Diagnostic.entry` or in the references Observations in `Observation.hasMember` (composition.exists() implies (composition.resolve().section.entry.reference.where(resolve() is Observation) in (result.reference|result.reference.resolve().hasMember.reference)))
dom-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().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: 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())
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 its 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 its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
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 SHALL be taken from AllLanguageshttp://hl7.org/fhir/ValueSet/all-languages|5.0.0
(required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

IETF language tag for a human language

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Obligations
    ObligationsActorDocumentation
    SHOULD:able-to-populateImaging Report provider

    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.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

    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..*
    This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
    TypeResource
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    8. 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
    Must Supportfalse
    Obligations
      ObligationsActorDocumentation
      MAY:able-to-populateImaging Report provider

      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())
      10. 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
      Must Supportfalse
      Summaryfalse
      Requirements

      This field is present in order to be able to populate the MHD DocumentReference field.

      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())
      12. 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: General, ImagingSelection: General))
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActorDocumentation
        SHALL:able-to-populateImaging Report provider

        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())
        14. DiagnosticReport.extension:patientHistory
        Slice NamepatientHistory
        Definition

        May have originally been extracted from the medical record by imaging staff, automated tools, or by the radiologists themselves.

        ShortPatient history items selected by radiologist
        Control0..*
        TypeExtension(Extension: HL7IDR Patient History) (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())
        16. 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
          SHOULD:able-to-populateImaging Report provider

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

          SHALL:able-to-populateImaging Report provider

          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())
          18. 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, ImagingSelection: Key Image, DocumentReference: Key Image, 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())
          20. 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, DocumentReference: Key Image, ImagingSelection: Key Image))
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActorDocumentation
            SHALL:able-to-populateImaging Report provider

            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())
            22. 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 provider

              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())
              24. 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())
              26. 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
              Must Supportfalse
              Obligations
                ObligationsActorDocumentation
                SHOULD:able-to-populateImaging Report provider

                EHDSImagingReport.header.intendedRecipient[x]

                Summaryfalse
                Requirements

                EHDSImagingReport.header.intendedRecipient[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())
                28. 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 managable, 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
                Must Supportfalse
                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
                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.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
                Must Supportfalse
                Obligations
                  ObligationsActorDocumentation
                  SHALL:able-to-populateImaging Report provider

                  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()))
                  32. 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(CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                  Is Modifierfalse
                  Must Supportfalse
                  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
                  • 34. 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
                    Must Supportfalse
                    Obligations
                      ObligationsActorDocumentation
                      MAY:able-to-populateImaging Report provider

                      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()))
                      36. 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-2, 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()))
                      38. 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).

                      This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control10..1
                      This element is affected by the following invariants: ref-2
                      TypeIdentifier(Identifier: Accession Number)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      40. DiagnosticReport.status
                      Definition

                      The status of the diagnostic report.

                      ShortStatus of the Reportregistered | partial | preliminary | modified | final | amended | corrected | appended | cancelled | entered-in-error | unknown
                      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|5.0.0
                      (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|5.0.0)

                      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
                      Must Supportfalse
                      Obligations
                        ObligationsActorDocumentation
                        MAY:able-to-populateImaging Report provider

                        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()))
                        42. 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|5.0.0
                        (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|5.0.0)

                        HL7 V2 table 0074

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        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
                        • 44. 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|5.0.0
                          (required to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)
                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Obligations
                            ObligationsActorDocumentation
                            MAY:able-to-populateImaging Report provider

                            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()))
                            46. 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|5.0.0
                            (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|5.0.0)

                            HL7 V2 table 0074

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Alternate NamesDepartment, Sub-department, Service, Discipline
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "85430-7"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            48. 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|5.0.0
                            (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections|5.0.0)

                            HL7 V2 table 0074

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Alternate NamesDepartment, Sub-department, Service, Discipline
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs",
                                "code" : "Medical-Imaging"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            50. 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|5.0.0
                            (preferred to http://hl7.eu/fhir/imaging-r5/ValueSet/ImagingReportTypesEuVSEuImaging)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Alternate NamesType
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            52. DiagnosticReport.subject
                            Definition

                            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.

                            ShortThe subject of the report - usually, but not always, the patient
                            Control10..1
                            TypeReference(Patient (EU core), Patient, Group, Device, Location, Organization, Practitioner, Medication, Substance, BiologicallyDerivedProduct)
                            Is Modifierfalse
                            Must Supportfalse
                            Obligations
                              ObligationsActorDocumentation
                              SHALL:able-to-populateImaging Report provider

                              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()))
                              54. 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
                              Must Supportfalse
                              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 Open, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 56. 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
                                Must Supportfalse
                                Obligations
                                  ObligationsActorDocumentation
                                  SHOULD:able-to-populateImaging Report provider

                                  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()))
                                  58. 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
                                  Must Supportfalse
                                  Obligations
                                    ObligationsActorDocumentation
                                    SHALL:able-to-populateImaging Report provider

                                    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()))
                                    60. DiagnosticReport.performer
                                    Definition

                                    The diagnostic service that is responsible for issuing the report.

                                    ShortResponsible 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(Practitioner, PractitionerRole, Organization, CareTeam)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    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
                                    • 62. 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
                                      Must Supportfalse
                                      Obligations
                                        ObligationsActorDocumentation
                                        SHALL:able-to-populateImaging Report provider

                                        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()))
                                        64. DiagnosticReport.resultsInterpreter
                                        Definition

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

                                        ShortPrimary result interpreter
                                        Comments

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

                                        Control0..*
                                        TypeReference(Practitioner, PractitionerRole, Organization, CareTeam)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        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()
                                        • 66. DiagnosticReport.resultsInterpreter:author
                                          Slice Nameauthor
                                          Definition

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

                                          ShortPrimary result interpreter
                                          Comments

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

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

                                            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()))
                                            68. DiagnosticReport.result
                                            Definition

                                            R5 requires a .result element to be present if .composition is present. This mandatory cardinality fills that gap for the model in which no Observations are part of the report.


                                            Observations that are part of this diagnostic report.

                                            ShortFindingsObservations
                                            Comments

                                            Observations can contain observations.

                                            Control10..*
                                            This element is affected by the following invariants: dgr-1
                                            TypeReference(Observation: Imaging Finding, Observation)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            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()))
                                            70. DiagnosticReport.note
                                            Definition

                                            Comments about the diagnostic report.

                                            ShortComments about the diagnostic report
                                            Comments

                                            May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.

                                            Control0..*
                                            TypeAnnotation
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Obligations
                                              ObligationsActorDocumentation
                                              SHALL:able-to-populateImaging Report provider

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

                                              Summaryfalse
                                              Requirements

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


                                              Need to be able to provide free text additional information.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              72. DiagnosticReport.note.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())
                                              74. DiagnosticReport.note.extension:annotation-type.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 managable, 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())
                                              SlicingThis element introduces a set of slices on DiagnosticReport.note.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 76. DiagnosticReport.note.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 Valuehttp://hl7.org/fhir/StructureDefinition/annotationType
                                                78. DiagnosticReport.note.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).

                                                ShortValue of extension
                                                Control10..1
                                                This element is affected by the following invariants: ext-1
                                                BindingThe codes SHOULD be taken from For codes, see ValueSet: Section codes used to label annotations.
                                                (preferred to http://hl7.eu/fhir/imaging-r5/ValueSet/valueset-diagnosticreport-notes)
                                                TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, RatioRange, Coding, SampledData, id, positiveInt, Distance, Availability, integer64, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ExtendedContactDetail, ParameterDefinition, dateTime, code, string, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, CodeableReference, 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()))
                                                80. DiagnosticReport.note.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()))
                                                82. DiagnosticReport.media
                                                Definition

                                                A list of key images or data associated with this report. The images or data are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).

                                                ShortKey images or data associated with this report
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Obligations
                                                  ObligationsActorDocumentation
                                                  SHOULD:able-to-populateImaging Report provider

                                                  EHDSImagingReport.attachments

                                                  Summarytrue
                                                  Requirements

                                                  EHDSImagingReport.attachments


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

                                                  Alternate NamesDICOM, Slides, Scans
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  84. 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 managable, 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())
                                                  86. DiagnosticReport.media.link
                                                  Definition

                                                  Reference to the image or data source.

                                                  ShortReference to the image or data source
                                                  Control1..1
                                                  TypeReference(DocumentReference)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  88. DiagnosticReport.composition
                                                  Definition

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

                                                  ShortImaging Diagnostic ReportReference to a Composition resource for the DiagnosticReport structure
                                                  Comments

                                                  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.

                                                  Control10..1
                                                  This element is affected by the following invariants: dgr-1
                                                  TypeReference(Composition: Imaging Report, Composition)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Obligations
                                                    ObligationsActorDocumentation
                                                    SHALL:able-to-populateImaging Report provider

                                                    EHDSImagingReport.

                                                    Summaryfalse
                                                    Requirements

                                                    EHDSImagingReport.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    90. 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
                                                    Comments

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

                                                    Control0..*
                                                    TypeAttachment
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Obligations
                                                      ObligationsActorDocumentation
                                                      SHOULD:able-to-populateImaging Report provider

                                                      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()))

                                                      Guidance on how to interpret the contents of this table can be foundhere

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

                                                        EHDSImagingReport.header.language

                                                        Requirements

                                                        EHDSImagingReport.header.language

                                                        4. DiagnosticReport.extension:artifactVersion
                                                        Slice NameartifactVersion
                                                        Obligations
                                                          ObligationsActorDocumentation
                                                          MAY:able-to-populateImaging Report provider

                                                          EHDSImagingReport.header.version

                                                          Requirements

                                                          EHDSImagingReport.header.version

                                                          6. DiagnosticReport.extension:comparison
                                                          Slice Namecomparison
                                                          Obligations
                                                            ObligationsActorDocumentation
                                                            SHALL:able-to-populateImaging Report provider

                                                            EHDSImagingReport.body.comparisonStudy

                                                            Requirements

                                                            EHDSImagingReport.body.comparisonStudy

                                                            8. DiagnosticReport.extension:procedure
                                                            Slice Nameprocedure
                                                            Obligations
                                                              ObligationsActorDocumentation
                                                              SHOULD:able-to-populateImaging Report provider

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

                                                              SHALL:able-to-populateImaging Report provider

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

                                                              Requirements

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

                                                              10. DiagnosticReport.extension:impression
                                                              Slice Nameimpression
                                                              Obligations
                                                                ObligationsActorDocumentation
                                                                SHALL:able-to-populateImaging Report provider

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

                                                                Requirements

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

                                                                12. DiagnosticReport.extension:recommendation
                                                                Slice Namerecommendation
                                                                Obligations
                                                                  ObligationsActorDocumentation
                                                                  SHOULD:able-to-populateImaging Report provider

                                                                  EHDSImagingReport.body.recommendation

                                                                  Requirements

                                                                  EHDSImagingReport.body.recommendation

                                                                  14. DiagnosticReport.extension:informationRecipient
                                                                  Slice NameinformationRecipient
                                                                  Obligations
                                                                    ObligationsActorDocumentation
                                                                    SHOULD:able-to-populateImaging Report provider

                                                                    EHDSImagingReport.header.intendedRecipient[x]

                                                                    Requirements

                                                                    EHDSImagingReport.header.intendedRecipient[x]

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

                                                                      EHDSImagingReport.header.identifier

                                                                      Requirements

                                                                      EHDSImagingReport.header.identifier

                                                                      18. DiagnosticReport.basedOn:ServiceRequestOrderEuImagingaccession
                                                                      Slice NameServiceRequestOrderEuImagingaccession
                                                                      Obligations
                                                                        ObligationsActorDocumentation
                                                                        MAY:able-to-populateImaging Report provider

                                                                        EHDSImagingReport.body.orderInformation.orderId

                                                                        Requirements

                                                                        EHDSImagingReport.body.orderInformation.orderId

                                                                        20. DiagnosticReport.status
                                                                        Obligations
                                                                          ObligationsActorDocumentation
                                                                          MAY:able-to-populateImaging Report provider

                                                                          EHDSImagingReport.header.status

                                                                          Requirements

                                                                          EHDSImagingReport.header.status

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

                                                                            EHDSImagingReport.header.serviceSpecialty

                                                                            Requirements

                                                                            EHDSImagingReport.header.serviceSpecialty

                                                                            24. DiagnosticReport.subject
                                                                            Obligations
                                                                              ObligationsActorDocumentation
                                                                              SHALL:able-to-populateImaging Report provider

                                                                              EHDSImagingReport.header.subject

                                                                              Requirements

                                                                              EHDSImagingReport.header.subject

                                                                              26. 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
                                                                              • 28. 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 provider

                                                                                  EHDSImagingReport.header.period

                                                                                  Requirements

                                                                                  EHDSImagingReport.header.period

                                                                                  30. DiagnosticReport.issued
                                                                                  Obligations
                                                                                    ObligationsActorDocumentation
                                                                                    SHALL:able-to-populateImaging Report provider

                                                                                    EHDSImagingReport.header.date

                                                                                    Requirements

                                                                                    EHDSImagingReport.header.date

                                                                                    32. DiagnosticReport.performer:organization
                                                                                    Slice Nameorganization
                                                                                    Obligations
                                                                                      ObligationsActorDocumentation
                                                                                      SHALL:able-to-populateImaging Report provider

                                                                                      EHDSImagingReport.header.author[x]

                                                                                      Requirements

                                                                                      EHDSImagingReport.header.author[x]

                                                                                      34. DiagnosticReport.resultsInterpreter:author
                                                                                      Slice Nameauthor
                                                                                      Obligations
                                                                                        ObligationsActorDocumentation
                                                                                        SHALL:able-to-populateImaging Report provider

                                                                                        EHDSImagingReport.header.author[x]

                                                                                        Requirements

                                                                                        EHDSImagingReport.header.author[x]

                                                                                        36. DiagnosticReport.note
                                                                                        Obligations
                                                                                          ObligationsActorDocumentation
                                                                                          SHALL:able-to-populateImaging Report provider

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

                                                                                          Requirements

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

                                                                                          38. DiagnosticReport.media
                                                                                          Obligations
                                                                                            ObligationsActorDocumentation
                                                                                            SHOULD:able-to-populateImaging Report provider

                                                                                            EHDSImagingReport.attachments

                                                                                            Requirements

                                                                                            EHDSImagingReport.attachments

                                                                                            40. DiagnosticReport.composition
                                                                                            Obligations
                                                                                              ObligationsActorDocumentation
                                                                                              SHALL:able-to-populateImaging Report provider

                                                                                              EHDSImagingReport.

                                                                                              Requirements

                                                                                              EHDSImagingReport.

                                                                                              42. DiagnosticReport.presentedForm
                                                                                              Obligations
                                                                                                ObligationsActorDocumentation
                                                                                                SHOULD:able-to-populateImaging Report provider

                                                                                                EHDSImagingReport.presentedForm

                                                                                                Requirements

                                                                                                EHDSImagingReport.presentedForm

                                                                                                Guidance on how to interpret the contents of this table can be foundhere

                                                                                                0. DiagnosticReport
                                                                                                Definition

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

                                                                                                ShortA 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
                                                                                                Must Supportfalse
                                                                                                Summaryfalse
                                                                                                Alternate NamesReport, Test, Result, Results, Labs, Laboratory
                                                                                                Invariantsdgr-1: When a Composition is referenced in `Diagnostic.composition`, all Observation resources referenced in `Composition.entry` must also be referenced in `Diagnostic.entry` or in the references Observations in `Observation.hasMember` (composition.exists() implies (composition.resolve().section.entry.reference.where(resolve() is Observation) in (result.reference|result.reference.resolve().hasMember.reference)))
                                                                                                dom-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().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: 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())
                                                                                                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

                                                                                                Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

                                                                                                Control0..1
                                                                                                Typeid
                                                                                                Is Modifierfalse
                                                                                                Must Supportfalse
                                                                                                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
                                                                                                Must Supportfalse
                                                                                                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 its 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 its meaning or interpretation
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supportfalse
                                                                                                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 SHALL be taken from AllLanguages
                                                                                                (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                                                                                                IETF language tag for a human language

                                                                                                Typecode
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supportfalse
                                                                                                Obligations
                                                                                                  ObligationsActorDocumentation
                                                                                                  SHOULD:able-to-populateImaging Report provider

                                                                                                  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 a 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
                                                                                                  This element is affected by the following invariants: dom-6
                                                                                                  TypeNarrative
                                                                                                  Is Modifierfalse
                                                                                                  Must Supportfalse
                                                                                                  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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                                                                                                  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..*
                                                                                                  This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                                                                                                  TypeResource
                                                                                                  Is Modifierfalse
                                                                                                  Must Supportfalse
                                                                                                  Summaryfalse
                                                                                                  Alternate Namesinline resources, anonymous resources, contained resources
                                                                                                  14. DiagnosticReport.extension
                                                                                                  Definition

                                                                                                  An Extension

                                                                                                  ShortExtension
                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Must Supportfalse
                                                                                                  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
                                                                                                  • 16. 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
                                                                                                    Must Supportfalse
                                                                                                    Obligations
                                                                                                      ObligationsActorDocumentation
                                                                                                      MAY:able-to-populateImaging Report provider

                                                                                                      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())
                                                                                                      18. 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
                                                                                                      Must Supportfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      This field is present in order to be able to populate the MHD DocumentReference field.

                                                                                                      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())
                                                                                                      20. 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: General, ImagingSelection: General))
                                                                                                      Is Modifierfalse
                                                                                                      Must Supporttrue
                                                                                                      Obligations
                                                                                                        ObligationsActorDocumentation
                                                                                                        SHALL:able-to-populateImaging Report provider

                                                                                                        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())
                                                                                                        22. DiagnosticReport.extension:patientHistory
                                                                                                        Slice NamepatientHistory
                                                                                                        Definition

                                                                                                        May have originally been extracted from the medical record by imaging staff, automated tools, or by the radiologists themselves.

                                                                                                        ShortPatient history items selected by radiologist
                                                                                                        Control0..*
                                                                                                        TypeExtension(Extension: HL7IDR Patient History) (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())
                                                                                                        24. 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
                                                                                                          SHOULD:able-to-populateImaging Report provider

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

                                                                                                          SHALL:able-to-populateImaging Report provider

                                                                                                          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())
                                                                                                          26. 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, ImagingSelection: Key Image, DocumentReference: Key Image, 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())
                                                                                                          28. 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, DocumentReference: Key Image, ImagingSelection: Key Image))
                                                                                                          Is Modifierfalse
                                                                                                          Must Supporttrue
                                                                                                          Obligations
                                                                                                            ObligationsActorDocumentation
                                                                                                            SHALL:able-to-populateImaging Report provider

                                                                                                            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())
                                                                                                            30. 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 provider

                                                                                                              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())
                                                                                                              32. 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())
                                                                                                              34. 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
                                                                                                              Must Supportfalse
                                                                                                              Obligations
                                                                                                                ObligationsActorDocumentation
                                                                                                                SHOULD:able-to-populateImaging Report provider

                                                                                                                EHDSImagingReport.header.intendedRecipient[x]

                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                EHDSImagingReport.header.intendedRecipient[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.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 managable, 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
                                                                                                                Must Supportfalse
                                                                                                                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
                                                                                                                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.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
                                                                                                                Must Supportfalse
                                                                                                                Obligations
                                                                                                                  ObligationsActorDocumentation
                                                                                                                  SHALL:able-to-populateImaging Report provider

                                                                                                                  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()))
                                                                                                                  40. 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(CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                                                                                                                  Is Modifierfalse
                                                                                                                  Must Supportfalse
                                                                                                                  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
                                                                                                                  • 42. 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
                                                                                                                    Must Supportfalse
                                                                                                                    Obligations
                                                                                                                      ObligationsActorDocumentation
                                                                                                                      MAY:able-to-populateImaging Report provider

                                                                                                                      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()))
                                                                                                                      44. 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
                                                                                                                      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
                                                                                                                      46. 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 managable, 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
                                                                                                                      • 48. 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-2, 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()))
                                                                                                                        50. 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") - must be a resource in resources
                                                                                                                        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 known RESTful URL) or by resolving the target of the reference.

                                                                                                                        Control0..1
                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

                                                                                                                        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()))
                                                                                                                        52. 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).

                                                                                                                        This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

                                                                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                        Control1..1
                                                                                                                        This element is affected by the following invariants: ref-2
                                                                                                                        TypeIdentifier(Identifier: Accession Number)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summarytrue
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        54. 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
                                                                                                                        This element is affected by the following invariants: ref-2
                                                                                                                        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()))
                                                                                                                        56. 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|5.0.0)

                                                                                                                        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
                                                                                                                        Must Supportfalse
                                                                                                                        Obligations
                                                                                                                          ObligationsActorDocumentation
                                                                                                                          MAY:able-to-populateImaging Report provider

                                                                                                                          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()))
                                                                                                                          58. 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|5.0.0)

                                                                                                                          HL7 V2 table 0074

                                                                                                                          TypeCodeableConcept
                                                                                                                          Is Modifierfalse
                                                                                                                          Must Supportfalse
                                                                                                                          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
                                                                                                                          • 60. 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
                                                                                                                            Must Supportfalse
                                                                                                                            Obligations
                                                                                                                              ObligationsActorDocumentation
                                                                                                                              MAY:able-to-populateImaging Report provider

                                                                                                                              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()))
                                                                                                                              62. 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|5.0.0)

                                                                                                                              HL7 V2 table 0074

                                                                                                                              TypeCodeableConcept
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supportfalse
                                                                                                                              Summarytrue
                                                                                                                              Alternate NamesDepartment, Sub-department, Service, Discipline
                                                                                                                              Pattern Value{
                                                                                                                                "coding" : [{
                                                                                                                                  "system" : "http://loinc.org",
                                                                                                                                  "code" : "85430-7"
                                                                                                                                }]
                                                                                                                              }
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              64. 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|5.0.0)

                                                                                                                              HL7 V2 table 0074

                                                                                                                              TypeCodeableConcept
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supportfalse
                                                                                                                              Summarytrue
                                                                                                                              Alternate NamesDepartment, Sub-department, Service, Discipline
                                                                                                                              Pattern Value{
                                                                                                                                "coding" : [{
                                                                                                                                  "system" : "http://hl7.eu/fhir/eu-health-data-api/CodeSystem/eehrxf-document-priority-category-cs",
                                                                                                                                  "code" : "Medical-Imaging"
                                                                                                                                }]
                                                                                                                              }
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              66. 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-r5/ValueSet/ImagingReportTypesEuVSEuImaging)
                                                                                                                              TypeCodeableConcept
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supportfalse
                                                                                                                              Summarytrue
                                                                                                                              Alternate NamesType
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              68. DiagnosticReport.subject
                                                                                                                              Definition

                                                                                                                              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.

                                                                                                                              ShortThe subject of the report - usually, but not always, the patient
                                                                                                                              Control1..1
                                                                                                                              TypeReference(Patient (EU core))
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supportfalse
                                                                                                                              Obligations
                                                                                                                                ObligationsActorDocumentation
                                                                                                                                SHALL:able-to-populateImaging Report provider

                                                                                                                                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()))
                                                                                                                                70. DiagnosticReport.encounter
                                                                                                                                Definition

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

                                                                                                                                ShortHealth care event 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
                                                                                                                                Must Supportfalse
                                                                                                                                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()))
                                                                                                                                72. 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
                                                                                                                                Must Supportfalse
                                                                                                                                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 Open, and can be differentiated using the following discriminators:
                                                                                                                                • type @ $this
                                                                                                                                • 74. 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
                                                                                                                                  Must Supportfalse
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActorDocumentation
                                                                                                                                    SHOULD:able-to-populateImaging Report provider

                                                                                                                                    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()))
                                                                                                                                    76. 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
                                                                                                                                    Must Supportfalse
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActorDocumentation
                                                                                                                                      SHALL:able-to-populateImaging Report provider

                                                                                                                                      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()))
                                                                                                                                      78. DiagnosticReport.performer
                                                                                                                                      Definition

                                                                                                                                      The diagnostic service that is responsible for issuing the report.

                                                                                                                                      ShortResponsible 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(Practitioner, PractitionerRole, Organization, CareTeam)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supportfalse
                                                                                                                                      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
                                                                                                                                      • 80. 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
                                                                                                                                        Must Supportfalse
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActorDocumentation
                                                                                                                                          SHALL:able-to-populateImaging Report provider

                                                                                                                                          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()))
                                                                                                                                          82. DiagnosticReport.resultsInterpreter
                                                                                                                                          Definition

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

                                                                                                                                          ShortPrimary result interpreter
                                                                                                                                          Comments

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

                                                                                                                                          Control0..*
                                                                                                                                          TypeReference(Practitioner, PractitionerRole, Organization, CareTeam)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Must Supportfalse
                                                                                                                                          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()
                                                                                                                                          • 84. DiagnosticReport.resultsInterpreter:author
                                                                                                                                            Slice Nameauthor
                                                                                                                                            Definition

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

                                                                                                                                            ShortPrimary result interpreter
                                                                                                                                            Comments

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

                                                                                                                                            Control0..*
                                                                                                                                            TypeReference(Practitioner (EU core), PractitionerRole (EU core))
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Must Supportfalse
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActorDocumentation
                                                                                                                                              SHALL:able-to-populateImaging Report provider

                                                                                                                                              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()))
                                                                                                                                              86. 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
                                                                                                                                              Must Supportfalse
                                                                                                                                              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()))
                                                                                                                                              88. DiagnosticReport.result
                                                                                                                                              Definition

                                                                                                                                              R5 requires a .result element to be present if .composition is present. This mandatory cardinality fills that gap for the model in which no Observations are part of the report.

                                                                                                                                              ShortFindings
                                                                                                                                              Comments

                                                                                                                                              Observations can contain observations.

                                                                                                                                              Control1..*
                                                                                                                                              This element is affected by the following invariants: dgr-1
                                                                                                                                              TypeReference(Observation: Imaging Finding)
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Must Supporttrue
                                                                                                                                              Summaryfalse
                                                                                                                                              Requirements

                                                                                                                                              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()))
                                                                                                                                              90. DiagnosticReport.note
                                                                                                                                              Definition

                                                                                                                                              Comments about the diagnostic report.

                                                                                                                                              ShortComments about the diagnostic report
                                                                                                                                              Comments

                                                                                                                                              May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.

                                                                                                                                              Control0..*
                                                                                                                                              TypeAnnotation
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Must Supportfalse
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActorDocumentation
                                                                                                                                                SHALL:able-to-populateImaging Report provider

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

                                                                                                                                                Summaryfalse
                                                                                                                                                Requirements

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

                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                92. DiagnosticReport.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
                                                                                                                                                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
                                                                                                                                                94. DiagnosticReport.note.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 managable, 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.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                • value @ url
                                                                                                                                                • 96. DiagnosticReport.note.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())
                                                                                                                                                  98. DiagnosticReport.note.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
                                                                                                                                                  100. DiagnosticReport.note.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.note.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                  • value @ url
                                                                                                                                                  • 102. DiagnosticReport.note.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 Valuehttp://hl7.org/fhir/StructureDefinition/annotationType
                                                                                                                                                    104. DiagnosticReport.note.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).

                                                                                                                                                    ShortValue of extension
                                                                                                                                                    Control1..1
                                                                                                                                                    This element is affected by the following invariants: ext-1
                                                                                                                                                    BindingThe codes SHOULD be taken from ValueSet: Section codes used to label annotations.
                                                                                                                                                    (preferred to http://hl7.eu/fhir/imaging-r5/ValueSet/valueset-diagnosticreport-notes)
                                                                                                                                                    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()))
                                                                                                                                                    106. DiagnosticReport.note.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, PractitionerRole, 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()))
                                                                                                                                                    108. DiagnosticReport.note.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()))
                                                                                                                                                    110. DiagnosticReport.note.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()))
                                                                                                                                                    112. DiagnosticReport.study
                                                                                                                                                    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

                                                                                                                                                    For laboratory-type studies like GenomeStudy, type resources will be used for tracking additional metadata and workflow aspects of complex studies. ImagingStudy and the media element are somewhat overlapping - typically, the list of image references in the media 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: General)
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supportfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    114. DiagnosticReport.supportingInfo
                                                                                                                                                    Definition

                                                                                                                                                    This backbone element contains supporting information that was used in the creation of the report not included in the results already included in the report.

                                                                                                                                                    ShortAdditional information supporting the diagnostic report
                                                                                                                                                    Control0..*
                                                                                                                                                    TypeBackboneElement
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supportfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    116. DiagnosticReport.supportingInfo.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
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                    Summaryfalse
                                                                                                                                                    118. DiagnosticReport.supportingInfo.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 managable, 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())
                                                                                                                                                    120. DiagnosticReport.supportingInfo.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 managable, 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())
                                                                                                                                                    122. DiagnosticReport.supportingInfo.type
                                                                                                                                                    Definition

                                                                                                                                                    The code value for the role of the supporting information in the diagnostic report.

                                                                                                                                                    ShortSupporting information role code
                                                                                                                                                    Control1..1
                                                                                                                                                    BindingFor example codes, see hl7VS-VS-observationType
                                                                                                                                                    (example to http://terminology.hl7.org/ValueSet/v2-0936)

                                                                                                                                                    The code value for the role of the supporting information in the diagnostic report.

                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supportfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    124. DiagnosticReport.supportingInfo.reference
                                                                                                                                                    Definition

                                                                                                                                                    The reference for the supporting information in the diagnostic report.

                                                                                                                                                    ShortSupporting information reference
                                                                                                                                                    Control1..1
                                                                                                                                                    TypeReference(Procedure, Observation, DiagnosticReport, Citation)
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supportfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    126. DiagnosticReport.media
                                                                                                                                                    Definition

                                                                                                                                                    A list of key images or data associated with this report. The images or data are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).

                                                                                                                                                    ShortKey images or data associated with this report
                                                                                                                                                    Control0..*
                                                                                                                                                    TypeBackboneElement
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supportfalse
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActorDocumentation
                                                                                                                                                      SHOULD:able-to-populateImaging Report provider

                                                                                                                                                      EHDSImagingReport.attachments

                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      EHDSImagingReport.attachments

                                                                                                                                                      Alternate NamesDICOM, Slides, Scans
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      128. 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
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                      Summaryfalse
                                                                                                                                                      130. 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 managable, 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())
                                                                                                                                                      132. 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 managable, 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())
                                                                                                                                                      134. DiagnosticReport.media.comment
                                                                                                                                                      Definition

                                                                                                                                                      A comment about the image or data. Typically, this is used to provide an explanation for why the image or data is included, or to draw the viewer's attention to important features.

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

                                                                                                                                                      The comment should be displayed with the image or data. It would be common for the report to include additional discussion of the image or data contents or 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
                                                                                                                                                      Must Supportfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Requirements

                                                                                                                                                      The provider of the report should make a comment about each image or data included in the report.

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

                                                                                                                                                      Reference to the image or data source.

                                                                                                                                                      ShortReference to the image or data source
                                                                                                                                                      Control1..1
                                                                                                                                                      TypeReference(DocumentReference)
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supportfalse
                                                                                                                                                      Summarytrue
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      138. DiagnosticReport.composition
                                                                                                                                                      Definition

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

                                                                                                                                                      ShortImaging Diagnostic Report
                                                                                                                                                      Comments

                                                                                                                                                      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: dgr-1
                                                                                                                                                      TypeReference(Composition: Imaging Report)
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supportfalse
                                                                                                                                                      Obligations
                                                                                                                                                        ObligationsActorDocumentation
                                                                                                                                                        SHALL:able-to-populateImaging Report provider

                                                                                                                                                        EHDSImagingReport.

                                                                                                                                                        Summaryfalse
                                                                                                                                                        Requirements

                                                                                                                                                        EHDSImagingReport.

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

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

                                                                                                                                                        ShortClinical conclusion (interpretation) of test results
                                                                                                                                                        Control0..1
                                                                                                                                                        Typemarkdown
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Must Supportfalse
                                                                                                                                                        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()))
                                                                                                                                                        142. 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|5.0.0)

                                                                                                                                                        SNOMED CT Clinical Findings

                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Must Supportfalse
                                                                                                                                                        Summaryfalse
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        144. 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
                                                                                                                                                        Comments

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

                                                                                                                                                        Control0..*
                                                                                                                                                        TypeAttachment
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Must Supportfalse
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActorDocumentation
                                                                                                                                                          SHOULD:able-to-populateImaging Report provider

                                                                                                                                                          EHDSImagingReport.presentedForm

                                                                                                                                                          Summaryfalse
                                                                                                                                                          Requirements

                                                                                                                                                          EHDSImagingReport.presentedForm

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