HL7 Europe Patient Summary
1.0.0-alpha - qa-preview 150

HL7 Europe Patient Summary - Downloaded Version 1.0.0-alpha See the Directory of published versions

## Resource Profile: DiagnosticReportEuEps - Detailed Descriptions

Page standards status: Draft | Maturity Level: 1

Definitions for the diagnosticReport-eu-eps resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. DiagnosticReport
Definition | Diagnostic Report EU core The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.
Short | Diagnostic Report EU coreA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Comments | This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.
Control | 0..*
Is Modifier | false
Impose Profile | This profile also requires that the instance also conform this additional profile: DiagnosticReport (IPS)
Summary | false
Alternate Names | Report, Test, Result, Results, Labs, Laboratory
Invariants | 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
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.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DiagnosticReport.extension:DiagnosticReportCompositionR5
Slice Name | DiagnosticReportCompositionR5
Definition | This extension implements the R5 composition element. It allow to link this DiagnosticReport with the Composition documenting this Diagnostic Report.
Short | Associated Composition
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.DiagnosticReport.composition for use in FHIR R4) (Extension Type: Reference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. DiagnosticReport.extension:DiagnosticReportCompositionR5.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `DiagnosticReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
8. DiagnosticReport.extension:DiagnosticReportCompositionR5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition`
10. DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]
Definition | Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Reference to a Composition resource for the DiagnosticReport structureValue of extension
Control | 10..1
Type | Reference(Composition (EU core)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. DiagnosticReport.extension:note
Slice Name | note
Definition | This cross-version extension represents DiagnosticReport.note from http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0 for use in FHIR R4.
Short | Comments about the diagnostic report
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.DiagnosticReport.note for use in FHIR R4) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. DiagnosticReport.extension:note.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `DiagnosticReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. DiagnosticReport.extension:note.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note`
18. DiagnosticReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. DiagnosticReport.status
Definition | The status of the diagnostic report.
Short | Status of the Reportregistered | partial | preliminary | final +
Comments | DiagnosticReport.status and Composition.status shall be aligned
Control | 1..1
Binding | The codes SHALL be taken from DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1` ) The status of the diagnostic report.
Type | code
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. 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.
Short | Type of Diagnostic ReportName/Code for this diagnostic report
Control | 1..1
Binding | The codes SHOULD be taken from LOINCDiagnosticReportCodes http://hl7.org/fhir/ValueSet/report-codes|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/report-codes|4.0.1` ) Codes that describe Diagnostic Reports.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Alternate Names | Type
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. DiagnosticReport.subject
Definition | Who or what this report is about. The report can be about a human patient, a living subject, a device (e.g. a machine), a location or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure). The subject of the report. Usually, but not always, this is a patient. However, diagnostic services also perform analyses on specimens collected from a variety of other sources.
Short | Who and/or what this report is aboutThe subject of the report - usually, but not always, the patient
Control | 10..1
Type | Reference(Patient (EU core), Group, Patient, Group, Device, Location)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | SHALL know the subject context.
Alternate Names | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. DiagnosticReport.subject.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.
Short | Literal 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.
Control | 10..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. 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.
Short | Clinically 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.
Control | 10..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DiagnosticReport.effective[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
30. DiagnosticReport.effective[x]:effectiveDateTime
Slice Name | effectiveDateTime
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.
Short | Clinically 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.
Control | 0..1
Type | dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. DiagnosticReport.effective[x]:effectivePeriod
Slice Name | effectivePeriod
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.
Short | Effective period of the reportClinically 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.
Control | 0..1
Type | Period, dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. DiagnosticReport.performer
Definition | The diagnostic service that is responsible for issuing the report.
Short | Responsible Diagnostic Service.
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author. This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report.
Control | 0..*
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Organization (EU core), CareTeam, Practitioner, PractitionerRole, Organization, CareTeam)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
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 Names | Laboratory, Service, Practitioner, Department, Company, Authorized by, Director
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DiagnosticReport.performer`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this
36. DiagnosticReport.performer:organization
Slice Name | organization
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.
Short | The 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.
Control | 0..*
Type | Reference(Organization (EU core), Practitioner, PractitionerRole, Organization, CareTeam)
Is Modifier | false
Summary | true
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 Names | Laboratory, Service, Practitioner, Department, Company, Authorized by, Director
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. DiagnosticReport.resultsInterpreter
Definition | The practitioner or organization that is responsible for the report's conclusions and interpretations.
Short | Primary result interpreter
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author. Might not be the same entity that takes responsibility for the clinical report.
Control | 0..*
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Organization (EU core), CareTeam, Practitioner, PractitionerRole, Organization, CareTeam)
Is Modifier | false
Summary | true
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 Names | Analyzed by, Reported by
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DiagnosticReport.resultsInterpreter`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
40. DiagnosticReport.resultsInterpreter:author
Slice Name | author
Definition | The practitioner or organization that is responsible for the report's conclusions and interpretations.
Short | Primary result interpreter
Comments | Might not be the same entity that takes responsibility for the clinical report.
Control | 0..*
Type | Reference(PractitionerRole (EU core), Practitioner, PractitionerRole, Organization, CareTeam)
Is Modifier | false
Summary | true
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 Names | Analyzed by, Reported by
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. DiagnosticReport.result
Definition | Observations that are part of this diagnostic report.
Short | resultsObservations
Comments | Observations can contain observations.
Control | 0..*
Type | Reference(Observation)
Is Modifier | false
Summary | false
Requirements | Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Alternate Names | Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `DiagnosticReport.result`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
44. DiagnosticReport.result:observation-results
Slice Name | observation-results
Definition | Observations that are part of this diagnostic report.
Short | resultsObservations
Comments | Observations can contain observations.
Control | 0..*
Type | Reference(Observation: Medical Test Result (EU core), Observation)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Alternate Names | Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Invariants | ele-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
Impose Profile | This profile also requires that the instance also conform this additional profile: DiagnosticReport (IPS)
2. DiagnosticReport.code
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
4. DiagnosticReport.subject
Type | Reference(Patient (EU core), Group)
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
6. DiagnosticReport.subject.reference
Control | 1..?
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
8. DiagnosticReport.effective[x]
Control | 1..?
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
10. DiagnosticReport.effective[x]:effectiveDateTime
Slice Name | effectiveDateTime
Control | 0..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
12. DiagnosticReport.performer
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
14. DiagnosticReport.result
Slicing | This element introduces a set of slices on `DiagnosticReport.result`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
16. DiagnosticReport.result:observation-results
Slice Name | observation-results
Control | 0..*
Type | Reference(Observation: Medical Test Result (EU core))
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)

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

0. DiagnosticReport
Definition | Diagnostic Report EU core
Short | Diagnostic Report EU core
Comments | This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.
Control | 0..*
Is Modifier | false
Impose Profile | This profile also requires that the instance also conform this additional profile: DiagnosticReport (IPS)
Summary | false
Alternate Names | Report, Test, Result, Results, Labs, Laboratory
Invariants | 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. DiagnosticReport.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-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.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-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.
Short | Language of the diagnostic report 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-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.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. DiagnosticReport.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, 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.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. DiagnosticReport.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This 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:DiagnosticReportCompositionR5
Slice Name | DiagnosticReportCompositionR5
Definition | This extension implements the R5 composition element. It allow to link this DiagnosticReport with the Composition documenting this Diagnostic Report.
Short | Associated Composition
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.DiagnosticReport.composition for use in FHIR R4) (Extension Type: Reference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. DiagnosticReport.extension:DiagnosticReportCompositionR5.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
20. DiagnosticReport.extension:DiagnosticReportCompositionR5.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DiagnosticReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. DiagnosticReport.extension:DiagnosticReportCompositionR5.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition`
24. DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]
Definition | Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
Short | Reference to a Composition resource for the DiagnosticReport structure
Control | 1..1
Type | Reference(Composition (EU core))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. DiagnosticReport.extension:note
Slice Name | note
Definition | This cross-version extension represents DiagnosticReport.note from http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0 for use in FHIR R4.
Short | Comments about the diagnostic report
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.DiagnosticReport.note for use in FHIR R4) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. DiagnosticReport.extension:note.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
30. DiagnosticReport.extension:note.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DiagnosticReport.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. DiagnosticReport.extension:note.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note`
34. DiagnosticReport.extension:note.value[x]
Definition | This cross-version extension represents DiagnosticReport.note from http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0 for use in FHIR R4.
Short | Comments about the diagnostic report
Control | 0..1
Type | Annotation
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. DiagnosticReport.extension:note.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
38. DiagnosticReport.extension:note.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DiagnosticReport.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
40. DiagnosticReport.extension:note.value[x].extension:annotation-type
Slice Name | annotation-type
Definition | The type of annotation. This extension can be used to map the v2 NTE-4 comment type field.
Short | The type of annotation
Comments | This is used to identify the type of annotation.
Control | 0..*
Type | Extension(Annotation type) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
42. DiagnosticReport.extension:note.value[x].extension:annotation-type.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
44. DiagnosticReport.extension:note.value[x].extension:annotation-type.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DiagnosticReport.extension.value[x].extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. DiagnosticReport.extension:note.value[x].extension:annotation-type.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies 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.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/annotationType`
48. DiagnosticReport.extension:note.value[x].extension:annotation-type.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Type of note
Control | 1..1 This element is affected by the following invariants: ext-1
Binding | For example codes, see hl7VS-commentType (example to `http://terminology.hl7.org/ValueSet/v2-0364` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. DiagnosticReport.extension:note.value[x].author[x]
Definition | The individual responsible for making the annotation.
Short | Individual responsible for the annotation
Comments | Organization is used when there's no need for specific attribution as to who made the comment.
Control | 0..1
Type | Choice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. DiagnosticReport.extension:note.value[x].time
Definition | Indicates when this particular annotation was made.
Short | When the annotation was made
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. DiagnosticReport.extension:note.value[x].text
Definition | The text of the annotation in markdown format.
Short | The annotation - text content (as markdown)
Control | 1..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. DiagnosticReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
58. DiagnosticReport.identifier
Definition | Identifiers assigned to this report by the performer or other systems.
Short | Business identifier for report
Comments | Usually assigned by the Information System of the diagnostic service provider for facilitating the Report search. The order id can be used as one of the Report identifier if only one report is produced for that order.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | 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 Names | ReportID, Filler ID, Placer ID
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. DiagnosticReport.basedOn
Definition | Details concerning a service requested.
Short | What 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.
Control | 0..*
Type | Reference(CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
Is Modifier | false
Summary | false
Requirements | This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.
Alternate Names | Request
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. DiagnosticReport.status
Definition | The status of the diagnostic report.
Short | Status of the Report
Comments | DiagnosticReport.status and Composition.status shall be aligned
Control | 1..1
Binding | The codes SHALL be taken from DiagnosticReportStatus (required to `http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1` ) The status of the diagnostic report.
Type | code
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. 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.
Short | Service 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.
Control | 0..*
Binding | For example codes, see DiagnosticServiceSectionCodes (example to `http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1` ) Codes for diagnostic service sections.
Type | CodeableConcept
Is Modifier | false
Summary | true
Alternate Names | Department, Sub-department, Service, Discipline
Invariants | ele-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.
Short | Type of Diagnostic Report
Control | 1..1
Binding | The codes SHOULD be taken from LOINCDiagnosticReportCodes (preferred to `http://hl7.org/fhir/ValueSet/report-codes|4.0.1` ) Codes that describe Diagnostic Reports.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Alternate Names | Type
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. DiagnosticReport.subject
Definition | Who or what this report is about. The report can be about a human patient, a living subject, a device (e.g. a machine), a location or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).
Short | Who and/or what this report is about
Control | 1..1
Type | Reference(Patient (EU core), Group)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | SHALL know the subject context.
Alternate Names | Patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. DiagnosticReport.subject.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
72. DiagnosticReport.subject.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `DiagnosticReport.subject.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
74. DiagnosticReport.subject.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.
Short | Literal 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.
Control | 1..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. DiagnosticReport.subject.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).
Short | Type the reference refers to (e.g. "Patient")
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. DiagnosticReport.subject.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.
Short | Logical 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).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. DiagnosticReport.subject.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text 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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. DiagnosticReport.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Short | The healthcare event which this Diagnostic Report is about (when test ordered).
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Requirements | Links the request to the Encounter context.
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. 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.
Short | Clinically 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.
Control | 1..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `DiagnosticReport.effective[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
86. DiagnosticReport.effective[x]:effectiveDateTime
Slice Name | effectiveDateTime
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.
Short | Clinically 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.
Control | 0..1
Type | dateTime
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHOULD:able-to-populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. DiagnosticReport.effective[x]:effectivePeriod
Slice Name | effectivePeriod
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.
Short | Effective period of the 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.
Control | 0..1
Type | Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | Need to know where in the patient history to file/present this report.
Alternate Names | Observation time, Effective Time, Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. DiagnosticReport.issued
Definition | The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.
Short | Date and time this report was issued
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.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Clinicians need to be able to check the date that the report was released.
Alternate Names | Date published, Date Issued, Date Verified
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. DiagnosticReport.performer
Definition | The diagnostic service that is responsible for issuing the report.
Short | Responsible Diagnostic Service.
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.
Control | 0..*
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Organization (EU core), CareTeam)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
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 Names | Laboratory, Service, Practitioner, Department, Company, Authorized by, Director
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `DiagnosticReport.performer`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ $this
94. DiagnosticReport.performer:organization
Slice Name | organization
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.
Short | The 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.
Control | 0..*
Type | Reference(Organization (EU core))
Is Modifier | false
Summary | true
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 Names | Laboratory, Service, Practitioner, Department, Company, Authorized by, Director
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. DiagnosticReport.resultsInterpreter
Definition | The practitioner or organization that is responsible for the report's conclusions and interpretations.
Short | Primary result interpreter
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.
Control | 0..*
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Organization (EU core), CareTeam)
Is Modifier | false
Summary | true
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 Names | Analyzed by, Reported by
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `DiagnosticReport.resultsInterpreter`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
98. DiagnosticReport.resultsInterpreter:author
Slice Name | author
Definition | The practitioner or organization that is responsible for the report's conclusions and interpretations.
Short | Primary result interpreter
Comments | Might not be the same entity that takes responsibility for the clinical report.
Control | 0..*
Type | Reference(PractitionerRole (EU core))
Is Modifier | false
Summary | true
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 Names | Analyzed by, Reported by
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. DiagnosticReport.specimen
Definition | Details about the specimens on which this diagnostic report is based.
Short | Specimens 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.
Control | 0..*
Type | Reference(Specimen)
Is Modifier | false
Summary | false
Requirements | Need to be able to report information about the collected specimens on which the report is based.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. DiagnosticReport.result
Definition | Observations that are part of this diagnostic report.
Short | results
Comments | Observations can contain observations.
Control | 0..*
Type | Reference(Observation)
Is Modifier | false
Summary | false
Requirements | Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Alternate Names | Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `DiagnosticReport.result`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
104. DiagnosticReport.result:observation-results
Slice Name | observation-results
Definition | Observations that are part of this diagnostic report.
Short | results
Comments | Observations can contain observations.
Control | 0..*
Type | Reference(Observation: Medical Test Result (EU core))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Alternate Names | Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. DiagnosticReport.imagingStudy
Definition | One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.
Short | Study subject to this report
Comments | ImagingStudy and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However, each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.
Control | 0..*
Type | Reference(ImagingStudy)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. DiagnosticReport.media
Definition | A list of additional data, other then presented form of the report, associated with this report. This data is generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).
Short | Additional data (like images, diagrams or documents) associated with this report
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Some diagnostic reports may include additional data such as images, diagrams or documents that are relevant to the report. This additional information can provide further context and support for the findings presented in the report.
Alternate Names | DICOM, Slides, Scans, DICOM; Slides; Scans; Pictures; Documents; Diagrams
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
112. DiagnosticReport.media.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. DiagnosticReport.media.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
116. DiagnosticReport.media.comment
Definition | Allows for a comment about the image or data, such as an explanation of its significance or context within the diagnostic report.
Short | Comment about the image or data (e.g. explanation)
Comments | The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | The provider of the report should make a comment about each image or data included in the report. This comment can provide valuable context and help the reader understand the significance of the image or data in relation to the overall findings of the report.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. DiagnosticReport.media.link
Definition | A reference to the image or data associated with this report.
Short | Reference to the image or data
Control | 1..1
Type | Reference(Media)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. DiagnosticReport.conclusion
Definition | Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.
Short | Clinical conclusion (interpretation) of test results
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Need to be able to provide a conclusion that is not lost among the basic result data.
Alternate Names | Report
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. DiagnosticReport.conclusionCode
Definition | One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.
Short | Codes for the clinical conclusion of test results
Control | 0..*
Binding | For example codes, see SNOMEDCTClinicalFindings (example to `http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1` ) Diagnosis codes provided as adjuncts to the report.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. 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.
Short | Entire report as issued (pdf recommended)
Comments | "application/pdf" is recommended as the most reliable and interoperable in this context.
Control | 0..*
Type | Attachment
Is Modifier | false
Summary | false
Requirements | Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)