SIL HIE Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

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• Mappings
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• XML
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Resource Profile: HIE DiagnosticReport

R4B DiagnosticReport constrained for HIE capture and exchange.

Usages:

• Refer to this Profile: HIE ServiceRequest
• Examples for this Profile: DiagnosticReport/HIEDiagnosticReport-example

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
DiagnosticReport.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
DiagnosticReport.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
DiagnosticReport.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Business identifier for report
DiagnosticReport.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
DiagnosticReport.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
DiagnosticReport.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
DiagnosticReport.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
DiagnosticReport.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
DiagnosticReport.basedOn		0..*	HIEReference(ServiceRequest)	What was requested
DiagnosticReport.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
DiagnosticReport.category	S This element must be supported. Σ This element is included in summaries. C	0..*	HIECodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): HL7 V2 table 0074 Constraints: cc-text-or-code
DiagnosticReport.code	S This element must be supported. Σ This element is included in summaries. C	1..1	HIECodeableConcept	Name/Code for this diagnostic report Binding: http://loinc.org (extensible) Constraints: cc-text-or-code
DiagnosticReport.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the report - usually, but not always, the patient
DiagnosticReport.encounter	Σ This element is included in summaries.	1..1	HIEReference(HIE Encounter)	Health care event when test ordered
DiagnosticReport.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Clinically relevant time/time-period for report
DiagnosticReport.effective[x].effectiveDateTime			dateTime
DiagnosticReport.effective[x].effectivePeriod			Period
DiagnosticReport.issued	S This element must be supported. Σ This element is included in summaries.	0..1	instant	DateTime this version was made
DiagnosticReport.performer	S This element must be supported. Σ This element is included in summaries.	1..*	HIEReference(HIE Organization | HIE Practitioner | PractitionerRole)	Responsible Diagnostic Service
DiagnosticReport.resultsInterpreter	Σ This element is included in summaries.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Primary result interpreter
DiagnosticReport.specimen		0..*	HIEReference(Specimen)	Specimens this report is based on
DiagnosticReport.result	S This element must be supported.	0..*	HIEReference(Observation)	Observations
DiagnosticReport.imagingStudy		0..*	HIEReference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
DiagnosticReport.conclusion		1..1	string	Clinical conclusion (interpretation) of test results
DiagnosticReport.conclusionCode	C	0..*	HIECodeableConcept	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): SNOMED CT Clinical Findings Constraints: cc-text-or-code
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
DiagnosticReport.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
DiagnosticReport.status	Base	required	DiagnosticReportStatus	📍4.3.0	FHIR Std.
DiagnosticReport.category	Base	example	Diagnostic Service Section Codes	📍4.3.0	FHIR Std.
DiagnosticReport.code	Base	extensible	http://loinc.org	Not State	Unknown
DiagnosticReport.conclusionCode	Base	example	SNOMED CT Clinical Findings	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	DiagnosticReport.identifier.type, DiagnosticReport.category, DiagnosticReport.code, DiagnosticReport.conclusionCode	Text is optional, coding is required	coding.exists()
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.exists() and ('#'+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(uri) = '#').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()

This structure is derived from DiagnosticReport

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
DiagnosticReport.identifier	S This element must be supported.	1..*	Identifier	Business identifier for report
DiagnosticReport.identifier.use		1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
DiagnosticReport.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible)
DiagnosticReport.identifier.system		1..1	uri	The namespace for the identifier value
DiagnosticReport.identifier.value	S This element must be supported.	1..1	string	The value that is unique
DiagnosticReport.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
DiagnosticReport.basedOn		0..*	HIEReference(ServiceRequest)	What was requested
DiagnosticReport.category	S This element must be supported.	0..*	HIECodeableConcept	Service category
DiagnosticReport.code	S This element must be supported.	1..1	HIECodeableConcept	Name/Code for this diagnostic report Binding: http://loinc.org (extensible)
DiagnosticReport.subject	S This element must be supported.	1..1	HIEReference(HIE Patient)	The subject of the report - usually, but not always, the patient
DiagnosticReport.encounter		1..1	HIEReference(HIE Encounter)	Health care event when test ordered
DiagnosticReport.effective[x]	S This element must be supported.	0..1	dateTime, Period	Clinically relevant time/time-period for report
DiagnosticReport.issued	S This element must be supported.	0..1	instant	DateTime this version was made
DiagnosticReport.performer	S This element must be supported.	1..*	HIEReference(HIE Organization | HIE Practitioner | PractitionerRole)	Responsible Diagnostic Service
DiagnosticReport.resultsInterpreter		0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Primary result interpreter
DiagnosticReport.specimen		0..*	HIEReference(Specimen)	Specimens this report is based on
DiagnosticReport.result	S This element must be supported.	0..*	HIEReference(Observation)	Observations
DiagnosticReport.imagingStudy		0..*	HIEReference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
DiagnosticReport.media
DiagnosticReport.media.link		1..1	HIEReference(Media)	Reference to the image source
DiagnosticReport.conclusion		1..1	string	Clinical conclusion (interpretation) of test results
DiagnosticReport.conclusionCode		0..*	HIECodeableConcept	Codes for the clinical conclusion of test results
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
DiagnosticReport.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
DiagnosticReport.code	Base	extensible	http://loinc.org	Not State	Unknown

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
DiagnosticReport.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
DiagnosticReport.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
DiagnosticReport.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
DiagnosticReport.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
DiagnosticReport.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
DiagnosticReport.extension		0..*	Extension	Additional content defined by implementations
DiagnosticReport.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
DiagnosticReport.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Business identifier for report
DiagnosticReport.identifier.id		0..1	id	Unique id for inter-element referencing
DiagnosticReport.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
DiagnosticReport.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
DiagnosticReport.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
DiagnosticReport.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
DiagnosticReport.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
DiagnosticReport.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
DiagnosticReport.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
DiagnosticReport.basedOn		0..*	HIEReference(ServiceRequest)	What was requested
DiagnosticReport.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
DiagnosticReport.category	S This element must be supported. Σ This element is included in summaries. C	0..*	HIECodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): HL7 V2 table 0074 Constraints: cc-text-or-code
DiagnosticReport.code	S This element must be supported. Σ This element is included in summaries. C	1..1	HIECodeableConcept	Name/Code for this diagnostic report Binding: http://loinc.org (extensible) Constraints: cc-text-or-code
DiagnosticReport.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the report - usually, but not always, the patient
DiagnosticReport.encounter	Σ This element is included in summaries.	1..1	HIEReference(HIE Encounter)	Health care event when test ordered
DiagnosticReport.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Clinically relevant time/time-period for report
DiagnosticReport.effective[x].effectiveDateTime			dateTime
DiagnosticReport.effective[x].effectivePeriod			Period
DiagnosticReport.issued	S This element must be supported. Σ This element is included in summaries.	0..1	instant	DateTime this version was made
DiagnosticReport.performer	S This element must be supported. Σ This element is included in summaries.	1..*	HIEReference(HIE Organization | HIE Practitioner | PractitionerRole)	Responsible Diagnostic Service
DiagnosticReport.resultsInterpreter	Σ This element is included in summaries.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Primary result interpreter
DiagnosticReport.specimen		0..*	HIEReference(Specimen)	Specimens this report is based on
DiagnosticReport.result	S This element must be supported.	0..*	HIEReference(Observation)	Observations
DiagnosticReport.imagingStudy		0..*	HIEReference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
DiagnosticReport.media	Σ This element is included in summaries.	0..*	BackboneElement	Key images associated with this report
DiagnosticReport.media.id		0..1	string	Unique id for inter-element referencing
DiagnosticReport.media.extension		0..*	Extension	Additional content defined by implementations
DiagnosticReport.media.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
DiagnosticReport.media.comment		0..1	string	Comment about the image (e.g. explanation)
DiagnosticReport.media.link	Σ This element is included in summaries.	1..1	HIEReference(Media)	Reference to the image source
DiagnosticReport.conclusion		1..1	string	Clinical conclusion (interpretation) of test results
DiagnosticReport.conclusionCode	C	0..*	HIECodeableConcept	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): SNOMED CT Clinical Findings Constraints: cc-text-or-code
DiagnosticReport.presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
DiagnosticReport.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
DiagnosticReport.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
DiagnosticReport.status	Base	required	DiagnosticReportStatus	📍4.3.0	FHIR Std.
DiagnosticReport.category	Base	example	Diagnostic Service Section Codes	📍4.3.0	FHIR Std.
DiagnosticReport.code	Base	extensible	http://loinc.org	Not State	Unknown
DiagnosticReport.conclusionCode	Base	example	SNOMED CT Clinical Findings	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	DiagnosticReport.identifier.type, DiagnosticReport.category, DiagnosticReport.code, DiagnosticReport.conclusionCode	Text is optional, coding is required	coding.exists()
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.exists() and ('#'+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(uri) = '#').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()
dom-r4b	warning	DiagnosticReport.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()

This structure is derived from DiagnosticReport

Summary

Mandatory: 9 elements
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)
• HIE Encounter (https://nshr.dha.go.ke/fhir/StructureDefinition/encounter)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
DiagnosticReport.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
DiagnosticReport.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
DiagnosticReport.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Business identifier for report
DiagnosticReport.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
DiagnosticReport.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
DiagnosticReport.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
DiagnosticReport.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
DiagnosticReport.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
DiagnosticReport.basedOn		0..*	HIEReference(ServiceRequest)	What was requested
DiagnosticReport.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
DiagnosticReport.category	S This element must be supported. Σ This element is included in summaries. C	0..*	HIECodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): HL7 V2 table 0074 Constraints: cc-text-or-code
DiagnosticReport.code	S This element must be supported. Σ This element is included in summaries. C	1..1	HIECodeableConcept	Name/Code for this diagnostic report Binding: http://loinc.org (extensible) Constraints: cc-text-or-code
DiagnosticReport.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the report - usually, but not always, the patient
DiagnosticReport.encounter	Σ This element is included in summaries.	1..1	HIEReference(HIE Encounter)	Health care event when test ordered
DiagnosticReport.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Clinically relevant time/time-period for report
DiagnosticReport.effective[x].effectiveDateTime			dateTime
DiagnosticReport.effective[x].effectivePeriod			Period
DiagnosticReport.issued	S This element must be supported. Σ This element is included in summaries.	0..1	instant	DateTime this version was made
DiagnosticReport.performer	S This element must be supported. Σ This element is included in summaries.	1..*	HIEReference(HIE Organization | HIE Practitioner | PractitionerRole)	Responsible Diagnostic Service
DiagnosticReport.resultsInterpreter	Σ This element is included in summaries.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Primary result interpreter
DiagnosticReport.specimen		0..*	HIEReference(Specimen)	Specimens this report is based on
DiagnosticReport.result	S This element must be supported.	0..*	HIEReference(Observation)	Observations
DiagnosticReport.imagingStudy		0..*	HIEReference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
DiagnosticReport.conclusion		1..1	string	Clinical conclusion (interpretation) of test results
DiagnosticReport.conclusionCode	C	0..*	HIECodeableConcept	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): SNOMED CT Clinical Findings Constraints: cc-text-or-code
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
DiagnosticReport.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
DiagnosticReport.status	Base	required	DiagnosticReportStatus	📍4.3.0	FHIR Std.
DiagnosticReport.category	Base	example	Diagnostic Service Section Codes	📍4.3.0	FHIR Std.
DiagnosticReport.code	Base	extensible	http://loinc.org	Not State	Unknown
DiagnosticReport.conclusionCode	Base	example	SNOMED CT Clinical Findings	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	DiagnosticReport.identifier.type, DiagnosticReport.category, DiagnosticReport.code, DiagnosticReport.conclusionCode	Text is optional, coding is required	coding.exists()
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.exists() and ('#'+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(uri) = '#').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()

Differential View

This structure is derived from DiagnosticReport

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
DiagnosticReport.identifier	S This element must be supported.	1..*	Identifier	Business identifier for report
DiagnosticReport.identifier.use		1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
DiagnosticReport.identifier.type		1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible)
DiagnosticReport.identifier.system		1..1	uri	The namespace for the identifier value
DiagnosticReport.identifier.value	S This element must be supported.	1..1	string	The value that is unique
DiagnosticReport.identifier.assigner	S This element must be supported.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
DiagnosticReport.basedOn		0..*	HIEReference(ServiceRequest)	What was requested
DiagnosticReport.category	S This element must be supported.	0..*	HIECodeableConcept	Service category
DiagnosticReport.code	S This element must be supported.	1..1	HIECodeableConcept	Name/Code for this diagnostic report Binding: http://loinc.org (extensible)
DiagnosticReport.subject	S This element must be supported.	1..1	HIEReference(HIE Patient)	The subject of the report - usually, but not always, the patient
DiagnosticReport.encounter		1..1	HIEReference(HIE Encounter)	Health care event when test ordered
DiagnosticReport.effective[x]	S This element must be supported.	0..1	dateTime, Period	Clinically relevant time/time-period for report
DiagnosticReport.issued	S This element must be supported.	0..1	instant	DateTime this version was made
DiagnosticReport.performer	S This element must be supported.	1..*	HIEReference(HIE Organization | HIE Practitioner | PractitionerRole)	Responsible Diagnostic Service
DiagnosticReport.resultsInterpreter		0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Primary result interpreter
DiagnosticReport.specimen		0..*	HIEReference(Specimen)	Specimens this report is based on
DiagnosticReport.result	S This element must be supported.	0..*	HIEReference(Observation)	Observations
DiagnosticReport.imagingStudy		0..*	HIEReference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
DiagnosticReport.media
DiagnosticReport.media.link		1..1	HIEReference(Media)	Reference to the image source
DiagnosticReport.conclusion		1..1	string	Clinical conclusion (interpretation) of test results
DiagnosticReport.conclusionCode		0..*	HIECodeableConcept	Codes for the clinical conclusion of test results
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
DiagnosticReport.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
DiagnosticReport.code	Base	extensible	http://loinc.org	Not State	Unknown

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
DiagnosticReport.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
DiagnosticReport.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
DiagnosticReport.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
DiagnosticReport.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): IETF language tag Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
DiagnosticReport.contained		0..*	Resource	Contained, inline Resources Constraints: dom-r4b
DiagnosticReport.extension		0..*	Extension	Additional content defined by implementations
DiagnosticReport.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
DiagnosticReport.identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Business identifier for report
DiagnosticReport.identifier.id		0..1	id	Unique id for inter-element referencing
DiagnosticReport.identifier.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
DiagnosticReport.identifier.use	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
DiagnosticReport.identifier.type	Σ This element is included in summaries. C	1..1	HIECodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible) Constraints: cc-text-or-code
DiagnosticReport.identifier.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
DiagnosticReport.identifier.value	S This element must be supported. Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
DiagnosticReport.identifier.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
DiagnosticReport.identifier.assigner	S This element must be supported. Σ This element is included in summaries.	0..1	HIEReference(HIE Organization)	Organization that issued id (may be just text)
DiagnosticReport.basedOn		0..*	HIEReference(ServiceRequest)	What was requested
DiagnosticReport.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
DiagnosticReport.category	S This element must be supported. Σ This element is included in summaries. C	0..*	HIECodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): HL7 V2 table 0074 Constraints: cc-text-or-code
DiagnosticReport.code	S This element must be supported. Σ This element is included in summaries. C	1..1	HIECodeableConcept	Name/Code for this diagnostic report Binding: http://loinc.org (extensible) Constraints: cc-text-or-code
DiagnosticReport.subject	S This element must be supported. Σ This element is included in summaries.	1..1	HIEReference(HIE Patient)	The subject of the report - usually, but not always, the patient
DiagnosticReport.encounter	Σ This element is included in summaries.	1..1	HIEReference(HIE Encounter)	Health care event when test ordered
DiagnosticReport.effective[x]	S This element must be supported. Σ This element is included in summaries.	0..1		Clinically relevant time/time-period for report
DiagnosticReport.effective[x].effectiveDateTime			dateTime
DiagnosticReport.effective[x].effectivePeriod			Period
DiagnosticReport.issued	S This element must be supported. Σ This element is included in summaries.	0..1	instant	DateTime this version was made
DiagnosticReport.performer	S This element must be supported. Σ This element is included in summaries.	1..*	HIEReference(HIE Organization | HIE Practitioner | PractitionerRole)	Responsible Diagnostic Service
DiagnosticReport.resultsInterpreter	Σ This element is included in summaries.	0..*	HIEReference(HIE Practitioner | PractitionerRole | HIE Organization)	Primary result interpreter
DiagnosticReport.specimen		0..*	HIEReference(Specimen)	Specimens this report is based on
DiagnosticReport.result	S This element must be supported.	0..*	HIEReference(Observation)	Observations
DiagnosticReport.imagingStudy		0..*	HIEReference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
DiagnosticReport.media	Σ This element is included in summaries.	0..*	BackboneElement	Key images associated with this report
DiagnosticReport.media.id		0..1	string	Unique id for inter-element referencing
DiagnosticReport.media.extension		0..*	Extension	Additional content defined by implementations
DiagnosticReport.media.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
DiagnosticReport.media.comment		0..1	string	Comment about the image (e.g. explanation)
DiagnosticReport.media.link	Σ This element is included in summaries.	1..1	HIEReference(Media)	Reference to the image source
DiagnosticReport.conclusion		1..1	string	Clinical conclusion (interpretation) of test results
DiagnosticReport.conclusionCode	C	0..*	HIECodeableConcept	Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): SNOMED CT Clinical Findings Constraints: cc-text-or-code
DiagnosticReport.presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
DiagnosticReport.identifier.​use	Base	required	IdentifierUse	📦4.3.0	FHIR Std.
DiagnosticReport.identifier.​type	Base	extensible	IdentifierType	📦4.3.0	FHIR Std.
DiagnosticReport.status	Base	required	DiagnosticReportStatus	📍4.3.0	FHIR Std.
DiagnosticReport.category	Base	example	Diagnostic Service Section Codes	📍4.3.0	FHIR Std.
DiagnosticReport.code	Base	extensible	http://loinc.org	Not State	Unknown
DiagnosticReport.conclusionCode	Base	example	SNOMED CT Clinical Findings	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
cc-text-or-code	warning	DiagnosticReport.identifier.type, DiagnosticReport.category, DiagnosticReport.code, DiagnosticReport.conclusionCode	Text is optional, coding is required	coding.exists()
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.exists() and ('#'+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(uri) = '#').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()
dom-r4b	warning	DiagnosticReport.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()

This structure is derived from DiagnosticReport

Summary

Mandatory: 9 elements
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• HIE CodeableConcept (https://nshr.dha.go.ke/fhir/StructureDefinition/codeable-concept)
• HIE Reference (https://nshr.dha.go.ke/fhir/StructureDefinition/reference)
• HIE Organization (https://nshr.dha.go.ke/fhir/StructureDefinition/organization)
• HIE Patient (https://nshr.dha.go.ke/fhir/StructureDefinition/patient)
• HIE Encounter (https://nshr.dha.go.ke/fhir/StructureDefinition/encounter)
• HIE Practitioner (https://nshr.dha.go.ke/fhir/StructureDefinition/practitioner)

Other representations of profile: CSV, Excel, Schematron