Scope and usage

The MedComHomeCareDiagnosticReport profile contains references to all observation results performed and produced by the municipal acute care team, with the purpose of sending the HomeCareObservation to citizens genereal practitioner. The MedComHomeCareDiagnosticReport is sent as a HomeCareObservation message.

Status

In a DiagnosticRepport resource, it is required to specify the status of the repport. When all results from performeded observations by the acute care team are typed ind then the HomeCareDiagnosticRepport.status shall be #final.

Comments

In the MedComHomeCareDiagnosticReport it is possible to send comments regarding the performed and produced observation results by the municipal acute care team. There are two types of comments that can be send; analysis comments about individual analysis and results, and a clinical comment (overall nursing assessment) about the entire report.

Analysis comment about an individual observation

Analysis comment (Danish: Analysekommentar) is a comment that the user can choose to add, if relevant, to an individual observation result. The element Observation.note in HomeCareObservation profile shall be used when adding a analysis comment about the observation. The analysis comment shall not exceed 1 MB (1024 x 1024 characters) in size.

Clinical comment (overall nursing assessment)

The clinical comment (Danish: Klinisk kommentar) is a comment to the etntire report. This comment shall contain information that is necessary to provide an overall assessment of the citizen in the acute situation. It is recommended that the municipal acute careteam send the relevant clinical observations (nursing assessment) that are necessary in order to understand and interpret the citizens overall results and health status. When adding a clinical comment the element DiagnosticReport.conclusion shall be used. The clinical comment shall not exceed 1 MB (1024 x 1024 characters) in size.

Performer

In the MedComHomeCareDiagnosticReport it is required to describe the performer of the MedComHomeCareDiagnosticReport. The performer is organization that is responsible for creating the HomeCareDiagnosticRepport e.g acute care team . The performer shall be described using a signature and a producer-ID.

Signature

It is required to send the siganure of the MedComHomeCareDiagnosticReport performer. The signature consist of:

• Name: of the person responsible for producing the report. The name shall be described using a MedComCorePractitioner.
• Author role: The role (Danish: stillingsbetegnelse) of the person producing the report shall be described using a MedComCorePractitionerRole
• Telephone nummer: Relevant telephone number e.g. to the department or organization where the person who is reposnible for the report works.

Producer-ID

The producer-ID consist of a three letter code and a SOR-ID for the municiplity where the acute care team is owned by. The three letter code is exhibited by MedCom and is an abbreviation for the producer (e.g. unit or organization) that is responsible for the observations results. The municipal acute care team is responsible for performig and producing the observations results in the MedCom HomeCareObservation. Therefore the code for the municiapl acute careteam is "KAF". The three letter code is exibited in code system on the terminology IG. Click here to see the code system.

Use of security labet on patient consent

If a patient not allow to share the observation results with other than the general practitioner a securety labe shall be used. This mean that the meta.security.code shall be R, and in the user interface, it shall be clearly stated that consent has been refused.

Attachements

In MedComHomeCareDiagnosticReport it is allowed to include attachments. When including an attachment to a HomeCareDiagnosticReport then the element DiagnosticReport.media.link shall be used. The DiagnosticReport.media.link reference to MedComCoreMedia resource where the atachment shall be added. It is up to the user to assess when it is relevant to send an attachment. Only an attachment of the permitted formats must be included. Click here to see the permitted formats of an attachment

The attached file shall be base64ed and added to MedComCoreMedia.content.data element. If the attached file are sent, it is a requirement that the ID and title of the attached file shall be sent. The ID of the attachment shall be expressed using Media.identifier element. The Media.content.titel element shall be used to express the titel of the attachment.

Furthermore, MedCom recommended that the name of the author, as well as the time of creation, of the attached file be signed and sent with it. To express the author of the attachemn the Media.operator shal be used. The time of creation, of the attached file shall be expressed using Media.content.creation element

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

This structure is derived from MedComCoreDiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	MedComCoreDiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
meta
security	S	0..1	Coding	Security Labels applied to this resource Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
code		1..1	code	Symbol in syntax defined by the system Fixed Value: R
display		1..1	string	Representation defined by the system Fixed Value: Restricted
status
value		0..1	string	Primitive value for code Required Pattern: final
Slices for performer		2..2	Reference(MedComCoreProducerOrganization | MedComCorePractitionerRole)	Performer of the observations. Shall include a name, practitioner role, relevant telephone of the producer. Slice: Unordered, Closed by profile:resolve()
performer:ProducerOrganization		1..1	Reference(MedComCoreProducerOrganization) {b}	Producer organization of the observations. Shall include a producer-ID (Danish: Producent-ID) of the producer
performer:PractitionerRole	C	1..1	Reference(MedComCorePractitionerRole) {b}	Responsible Diagnostic Service medcom-homecareReport-1: There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. medcom-homecareReport-2: There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. medcom-homecareReport-3: There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report.
result		0..*	Reference(MedComHomeCareObservation) {b}	Observations
conclusion		0..1	string	A comment relevant for all observations in the report and necessary to interpret and understand the results (Danish:Klinisk kommentar).
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-homecareReport-1	error	DiagnosticReport.performer:PractitionerRole	There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. : reference.resolve().code.coding.code.exists()
medcom-homecareReport-2	error	DiagnosticReport.performer:PractitionerRole	There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().name.exists()
medcom-homecareReport-3	error	DiagnosticReport.performer:PractitionerRole	There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().telecom.where(system = 'phone').exists()

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	MedComCoreDiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
meta	Σ	0..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
security	SΣ	0..1	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
code		1..1	code	Symbol in syntax defined by the system Fixed Value: R
display		1..1	string	Representation defined by the system Fixed Value: Restricted
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	​registered | partial | preliminary | final | corrected | cancelled | entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required) ele-1: All FHIR elements must have a @value or children
value		0..1	string	Primitive value for code Required Pattern: final
code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The subject of the report - usually, but not always, the patient ele-1: All FHIR elements must have a @value or children
issued	SΣ	1..1	instant	DateTime this version was made ele-1: All FHIR elements must have a @value or children
Slices for performer	SΣ	2..2	Reference(MedComCoreProducerOrganization | MedComCorePractitionerRole)	Performer of the observations. Shall include a name, practitioner role, relevant telephone of the producer. Slice: Unordered, Closed by profile:resolve() ele-1: All FHIR elements must have a @value or children
performer:ProducerOrganization	SΣ	1..1	Reference(MedComCoreProducerOrganization) {b}	Producer organization of the observations. Shall include a producer-ID (Danish: Producent-ID) of the producer ele-1: All FHIR elements must have a @value or children
performer:PractitionerRole	SΣC	1..1	Reference(MedComCorePractitionerRole) {b}	Responsible Diagnostic Service ele-1: All FHIR elements must have a @value or children medcom-homecareReport-1: There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. medcom-homecareReport-2: There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. medcom-homecareReport-3: There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report.
result	S	0..*	Reference(MedComHomeCareObservation) {b}	Observations ele-1: All FHIR elements must have a @value or children
media	SΣ	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
link	SΣ	1..1	Reference(MedComMedia)	Reference to the image source ele-1: All FHIR elements must have a @value or children
conclusion	S	0..1	string	A comment relevant for all observations in the report and necessary to interpret and understand the results (Danish:Klinisk kommentar). ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.meta.security	extensible	Pattern: R("Restricted") http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
DiagnosticReport.status	required	​http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset http://medcomfhir.dk/ig/terminology/ValueSet/MedComDiagnosticReportCodesValueset

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-1	error	DiagnosticReport.performer:PractitionerRole	There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. : reference.resolve().code.coding.code.exists()
medcom-homecareReport-2	error	DiagnosticReport.performer:PractitionerRole	There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().name.exists()
medcom-homecareReport-3	error	DiagnosticReport.performer:PractitionerRole	There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().telecom.where(system = 'phone').exists()

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	MedComCoreDiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	SΣ	0..1	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: R
display		1..1	string	Representation defined by the system Fixed Value: Restricted
userSelected		0..1	boolean	If this coding was chosen directly by the user
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier for report
basedOn		0..*	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested
status	?!SΣ	1..1	code	​registered | partial | preliminary | final | corrected | cancelled | entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional content defined by implementations
value		0..1	string	Primitive value for code Required Pattern: final
category	Σ	0..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The subject of the report - usually, but not always, the patient
encounter	Σ	0..1	Reference(Encounter)	Health care event when test ordered
effective[x]	Σ	0..1		Clinically relevant time/time-period for report
effectiveDateTime			dateTime
effectivePeriod			Period
issued	SΣ	1..1	instant	DateTime this version was made
Slices for performer	SΣ	2..2	Reference(MedComCoreProducerOrganization | MedComCorePractitionerRole)	Performer of the observations. Shall include a name, practitioner role, relevant telephone of the producer. Slice: Unordered, Closed by profile:resolve()
performer:ProducerOrganization	SΣ	1..1	Reference(MedComCoreProducerOrganization) {b}	Producer organization of the observations. Shall include a producer-ID (Danish: Producent-ID) of the producer
performer:PractitionerRole	SΣC	1..1	Reference(MedComCorePractitionerRole) {b}	Responsible Diagnostic Service medcom-homecareReport-1: There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. medcom-homecareReport-2: There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. medcom-homecareReport-3: There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report.
resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
specimen		0..*	Reference(Specimen)	Specimens this report is based on
result	S	0..*	Reference(MedComHomeCareObservation) {b}	Observations
imagingStudy		0..*	Reference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
media	SΣ	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
comment		0..1	string	Comment about the image (e.g. explanation)
link	SΣ	1..1	Reference(MedComMedia)	Reference to the image source
conclusion	S	0..1	string	A comment relevant for all observations in the report and necessary to interpret and understand the results (Danish:Klinisk kommentar).
conclusionCode		0..*	CodeableConcept	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.meta.security	extensible	Pattern: R("Restricted") http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
DiagnosticReport.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.status	required	​http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset http://medcomfhir.dk/ig/terminology/ValueSet/MedComDiagnosticReportCodesValueset
DiagnosticReport.conclusionCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-1	error	DiagnosticReport.performer:PractitionerRole	There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. : reference.resolve().code.coding.code.exists()
medcom-homecareReport-2	error	DiagnosticReport.performer:PractitionerRole	There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().name.exists()
medcom-homecareReport-3	error	DiagnosticReport.performer:PractitionerRole	There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().telecom.where(system = 'phone').exists()

Differential View

This structure is derived from MedComCoreDiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	MedComCoreDiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
meta
security	S	0..1	Coding	Security Labels applied to this resource Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
code		1..1	code	Symbol in syntax defined by the system Fixed Value: R
display		1..1	string	Representation defined by the system Fixed Value: Restricted
status
value		0..1	string	Primitive value for code Required Pattern: final
Slices for performer		2..2	Reference(MedComCoreProducerOrganization | MedComCorePractitionerRole)	Performer of the observations. Shall include a name, practitioner role, relevant telephone of the producer. Slice: Unordered, Closed by profile:resolve()
performer:ProducerOrganization		1..1	Reference(MedComCoreProducerOrganization) {b}	Producer organization of the observations. Shall include a producer-ID (Danish: Producent-ID) of the producer
performer:PractitionerRole	C	1..1	Reference(MedComCorePractitionerRole) {b}	Responsible Diagnostic Service medcom-homecareReport-1: There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. medcom-homecareReport-2: There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. medcom-homecareReport-3: There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report.
result		0..*	Reference(MedComHomeCareObservation) {b}	Observations
conclusion		0..1	string	A comment relevant for all observations in the report and necessary to interpret and understand the results (Danish:Klinisk kommentar).
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-homecareReport-1	error	DiagnosticReport.performer:PractitionerRole	There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. : reference.resolve().code.coding.code.exists()
medcom-homecareReport-2	error	DiagnosticReport.performer:PractitionerRole	There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().name.exists()
medcom-homecareReport-3	error	DiagnosticReport.performer:PractitionerRole	There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().telecom.where(system = 'phone').exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	MedComCoreDiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
meta	Σ	0..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
security	SΣ	0..1	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
code		1..1	code	Symbol in syntax defined by the system Fixed Value: R
display		1..1	string	Representation defined by the system Fixed Value: Restricted
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	​registered | partial | preliminary | final | corrected | cancelled | entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required) ele-1: All FHIR elements must have a @value or children
value		0..1	string	Primitive value for code Required Pattern: final
code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The subject of the report - usually, but not always, the patient ele-1: All FHIR elements must have a @value or children
issued	SΣ	1..1	instant	DateTime this version was made ele-1: All FHIR elements must have a @value or children
Slices for performer	SΣ	2..2	Reference(MedComCoreProducerOrganization | MedComCorePractitionerRole)	Performer of the observations. Shall include a name, practitioner role, relevant telephone of the producer. Slice: Unordered, Closed by profile:resolve() ele-1: All FHIR elements must have a @value or children
performer:ProducerOrganization	SΣ	1..1	Reference(MedComCoreProducerOrganization) {b}	Producer organization of the observations. Shall include a producer-ID (Danish: Producent-ID) of the producer ele-1: All FHIR elements must have a @value or children
performer:PractitionerRole	SΣC	1..1	Reference(MedComCorePractitionerRole) {b}	Responsible Diagnostic Service ele-1: All FHIR elements must have a @value or children medcom-homecareReport-1: There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. medcom-homecareReport-2: There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. medcom-homecareReport-3: There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report.
result	S	0..*	Reference(MedComHomeCareObservation) {b}	Observations ele-1: All FHIR elements must have a @value or children
media	SΣ	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition. ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
link	SΣ	1..1	Reference(MedComMedia)	Reference to the image source ele-1: All FHIR elements must have a @value or children
conclusion	S	0..1	string	A comment relevant for all observations in the report and necessary to interpret and understand the results (Danish:Klinisk kommentar). ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.meta.security	extensible	Pattern: R("Restricted") http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
DiagnosticReport.status	required	​http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset http://medcomfhir.dk/ig/terminology/ValueSet/MedComDiagnosticReportCodesValueset

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-1	error	DiagnosticReport.performer:PractitionerRole	There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. : reference.resolve().code.coding.code.exists()
medcom-homecareReport-2	error	DiagnosticReport.performer:PractitionerRole	There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().name.exists()
medcom-homecareReport-3	error	DiagnosticReport.performer:PractitionerRole	There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().telecom.where(system = 'phone').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	MedComCoreDiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	SΣ	0..1	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-Confidentiality
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: R
display		1..1	string	Representation defined by the system Fixed Value: Restricted
userSelected		0..1	boolean	If this coding was chosen directly by the user
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business identifier for report
basedOn		0..*	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested
status	?!SΣ	1..1	code	​registered | partial | preliminary | final | corrected | cancelled | entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional content defined by implementations
value		0..1	string	Primitive value for code Required Pattern: final
category	Σ	0..*	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The subject of the report - usually, but not always, the patient
encounter	Σ	0..1	Reference(Encounter)	Health care event when test ordered
effective[x]	Σ	0..1		Clinically relevant time/time-period for report
effectiveDateTime			dateTime
effectivePeriod			Period
issued	SΣ	1..1	instant	DateTime this version was made
Slices for performer	SΣ	2..2	Reference(MedComCoreProducerOrganization | MedComCorePractitionerRole)	Performer of the observations. Shall include a name, practitioner role, relevant telephone of the producer. Slice: Unordered, Closed by profile:resolve()
performer:ProducerOrganization	SΣ	1..1	Reference(MedComCoreProducerOrganization) {b}	Producer organization of the observations. Shall include a producer-ID (Danish: Producent-ID) of the producer
performer:PractitionerRole	SΣC	1..1	Reference(MedComCorePractitionerRole) {b}	Responsible Diagnostic Service medcom-homecareReport-1: There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. medcom-homecareReport-2: There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. medcom-homecareReport-3: There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report.
resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
specimen		0..*	Reference(Specimen)	Specimens this report is based on
result	S	0..*	Reference(MedComHomeCareObservation) {b}	Observations
imagingStudy		0..*	Reference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
media	SΣ	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
comment		0..1	string	Comment about the image (e.g. explanation)
link	SΣ	1..1	Reference(MedComMedia)	Reference to the image source
conclusion	S	0..1	string	A comment relevant for all observations in the report and necessary to interpret and understand the results (Danish:Klinisk kommentar).
conclusionCode		0..*	CodeableConcept	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.meta.security	extensible	Pattern: R("Restricted") http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
DiagnosticReport.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.status	required	​http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset http://medcomfhir.dk/ig/terminology/ValueSet/MedComDiagnosticReportCodesValueset
DiagnosticReport.conclusionCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-homecareReport-1	error	DiagnosticReport.performer:PractitionerRole	There shall exist a practitioner role when using a PractitionerRole as author in a HomeCare Report. : reference.resolve().code.coding.code.exists()
medcom-homecareReport-2	error	DiagnosticReport.performer:PractitionerRole	There shall exist a name of the healtcare worker that performed the observations, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().name.exists()
medcom-homecareReport-3	error	DiagnosticReport.performer:PractitionerRole	There shall exist a telecom to the organization form the healthcare worker is part of, as author in a HomeCare Report. : reference.resolve().practitioner.resolve().telecom.where(system = 'phone').exists()

This structure is derived from MedComCoreDiagnosticReport

Summary

Mandatory: 2 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• MedComCoreProducerOrganization (http://medcomfhir.dk/ig/messaging/StructureDefinition/medcom-producer-organization)
• MedComCorePractitionerRole (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitionerrole)
• MedComHomeCareObservation (http://medcomfhir.dk/ig/homecareobservation/StructureDefinition/medcom-homeCare-observation)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DiagnosticReport.performer (Closed)