{
"description": "This CH ELM base profile constrains the DiagnosticReport resource for the purpose of laboratory test reports.",
"_filename": "StructureDefinition-ch-elm-diagnosticreport.json",
"package_name": "ch.fhir.ig.ch-elm",
"date": "2024-08-20T16:24:59+00:00",
"derivation": "constraint",
"publisher": "Federal Office of Public Health FOPH",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "CHE",
"system": "urn:iso:std:iso:3166"
} ]
} ],
"name": "ChElmDiagnosticReport",
"mapping": [ {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern",
"identity": "workflow"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
} ],
"abstract": false,
"copyright": "CC0-1.0",
"type": "DiagnosticReport",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "CH ELM DiagnosticReport: Laboratory Report",
"package_version": "1.4.0",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-imposeProfile",
"valueCanonical": "http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab"
} ],
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-3",
"human": "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",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "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()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
} ],
"expression": "text.`div`.exists()"
} ],
"path": "DiagnosticReport",
"min": 0,
"definition": "Laboratory Report DiagnosticReport",
"isModifier": false,
"short": "CH ELM DiagnosticReport: Laboratory Report",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Event",
"identity": "workflow"
}, {
"map": "ORU -> OBR",
"identity": "v2"
}, {
"map": "Observation[classCode=OBS, moodCode=EVN]",
"identity": "rim"
} ],
"alias": [ "Report", "Test", "Result", "Results", "Labs", "Laboratory" ],
"max": "*",
"id": "DiagnosticReport",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport"
},
"isSummary": false
}, {
"path": "DiagnosticReport.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
} ]
} ],
"max": "1",
"id": "DiagnosticReport.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.meta",
"min": 0,
"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.",
"isModifier": false,
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "DiagnosticReport.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.implicitRules",
"min": 0,
"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.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "DiagnosticReport.implicitRules",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "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",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
} ],
"description": "A human language."
},
"max": "1",
"id": "DiagnosticReport.language",
"comment": "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).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.text",
"min": 0,
"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.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "DiagnosticReport.text",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"path": "DiagnosticReport.contained",
"min": 0,
"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.",
"isModifier": false,
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "DiagnosticReport.contained",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.extension",
"min": 1,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "DiagnosticReport.extension",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.extension",
"min": 1,
"definition": "This extension implements the R5 composition element. It allow to link this DiagnosticReport with the Composition documenting this Laboratory Report.",
"isModifier": false,
"short": "Associated Lab Report Composition",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition" ]
} ],
"sliceName": "DiagnosticReportCompositionR5",
"max": "1",
"id": "DiagnosticReport.extension:DiagnosticReportCompositionR5",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"path": "DiagnosticReport.extension.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "DiagnosticReport.extension:DiagnosticReportCompositionR5.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.extension.extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "0",
"id": "DiagnosticReport.extension:DiagnosticReportCompositionR5.extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"path": "DiagnosticReport.extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"isModifier": false,
"short": "identifies the meaning of the extension",
"fixedUri": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "DiagnosticReport.extension:DiagnosticReportCompositionR5.url",
"comment": "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.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.extension.value[x]",
"min": 1,
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
"isModifier": false,
"short": "Value of extension",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-lab-report/StructureDefinition/ch-lab-report-composition" ]
} ],
"max": "1",
"id": "DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "DiagnosticReport.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.identifier",
"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.",
"min": 1,
"definition": "Identifiers assigned to this Laboratory Report by the performer or other systems. It shall be common to several report versions",
"isModifier": false,
"short": "Persistent, unique identifier for the diagnostic report (UUID)",
"mapping": [ {
"map": "Event.identifier",
"identity": "workflow"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": "OBR-51/ for globally unique filler ID - OBR-3 , For non-globally unique filler-id the flller/placer number must be combined with the universal service Id - OBR-2(if present)+OBR-3+OBR-4",
"identity": "v2"
}, {
"map": "id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"alias": [ "ReportID", "Filler ID", "Placer ID" ],
"max": "1",
"id": "DiagnosticReport.identifier",
"comment": "Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.identifier"
},
"isSummary": true
}, {
"path": "DiagnosticReport.identifier.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "DiagnosticReport.identifier.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.identifier.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "DiagnosticReport.identifier.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.identifier.use",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"definition": "The purpose of this identifier.",
"isModifier": true,
"short": "usual | official | temp | secondary | old (If known)",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
} ],
"description": "Identifies the purpose for this identifier, if known ."
},
"max": "1",
"id": "DiagnosticReport.identifier.use",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.use"
},
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.identifier.type",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"isModifier": false,
"short": "Description of identifier",
"mapping": [ {
"map": "CX.5",
"identity": "v2"
}, {
"map": "Role.code or implied by context",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
} ],
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."
},
"max": "1",
"id": "DiagnosticReport.identifier.type",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.identifier.system",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"isModifier": false,
"short": "The namespace for the identifier value",
"mapping": [ {
"map": "CX.4 / EI-2-4",
"identity": "v2"
}, {
"map": "II.root or Role.id.root",
"identity": "rim"
}, {
"map": "./IdentifierType",
"identity": "servd"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "DiagnosticReport.identifier.system",
"comment": "Identifier.system is always case sensitive.",
"example": [ {
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.system"
},
"patternUri": "urn:ietf:rfc:3986",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ch-elm-doc-identifier",
"human": "The identifier must be an UUID.",
"source": "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-diagnosticreport",
"severity": "error",
"expression": "startsWith('urn:uuid:')"
} ],
"path": "DiagnosticReport.identifier.value",
"min": 1,
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"isModifier": false,
"short": "The value that is unique",
"mapping": [ {
"map": "CX.1 / EI.1",
"identity": "v2"
}, {
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)",
"identity": "rim"
}, {
"map": "./Value",
"identity": "servd"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "DiagnosticReport.identifier.value",
"comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"example": [ {
"label": "General",
"valueString": "123456"
}, {
"label": "CH ELM",
"valueString": "urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f"
} ],
"base": {
"max": "1",
"min": 0,
"path": "Identifier.value"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.identifier.period",
"min": 0,
"definition": "Time period during which identifier is/was valid for use.",
"isModifier": false,
"short": "Time period when id is/was valid for use",
"mapping": [ {
"map": "CX.7 + CX.8",
"identity": "v2"
}, {
"map": "Role.effectiveTime or implied by context",
"identity": "rim"
}, {
"map": "./StartDate and ./EndDate",
"identity": "servd"
} ],
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "DiagnosticReport.identifier.period",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.period"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.identifier.assigner",
"min": 0,
"definition": "Organization that issued/manages the identifier.",
"isModifier": false,
"short": "Organization that issued id (may be just text)",
"mapping": [ {
"map": "CX.4 / (CX.4,CX.9,CX.10)",
"identity": "v2"
}, {
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper",
"identity": "rim"
}, {
"map": "./IdentifierIssuingAuthority",
"identity": "servd"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ],
"max": "1",
"id": "DiagnosticReport.identifier.assigner",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"base": {
"max": "1",
"min": 0,
"path": "Identifier.assigner"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.basedOn",
"requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
"min": 1,
"definition": "Details concerning a service requested.",
"isModifier": false,
"short": "What was requested",
"mapping": [ {
"map": "Event.basedOn",
"identity": "workflow"
}, {
"map": "ORC? OBR-2/3?",
"identity": "v2"
}, {
"map": "outboundRelationship[typeCode=FLFS].target",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-servicerequest-laboratory-order" ]
} ],
"alias": [ "Request" ],
"max": "1",
"id": "DiagnosticReport.basedOn",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.basedOn"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.status",
"requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
"min": 1,
"definition": "The status of the diagnostic report.",
"isModifier": true,
"short": "Status of the Report",
"mapping": [ {
"map": "Event.status",
"identity": "workflow"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": "OBR-25 (not 1:1 mapping)",
"identity": "v2"
}, {
"map": "statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type \"revise\"",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"patternCode": "final",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticReportStatus"
} ],
"description": "The status of the diagnostic report."
},
"max": "1",
"id": "DiagnosticReport.status",
"comment": "DiagnosticReport.status and Composition.status shall be aligned, based on the http://hl7.eu/fhir/laboratory/ConceptMap/ConceptMap-eu-diagRptStatus2CompStatus mapping",
"base": {
"max": "1",
"min": 1,
"path": "DiagnosticReport.status"
},
"isModifierReason": "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",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.category",
"min": 0,
"definition": "A code that classifies this laboratory report. Two basic categories has been selected in this guide: laboratory specialty and Study type. Laboratory specialty is characteristic of the laboratory that produced the test result while Study type is an arbitrary classificion of the test type.",
"isModifier": false,
"short": "Report Category",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": "OBR-24",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "pattern"
} ]
},
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-service-sections",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticServiceSection"
} ],
"description": "Codes for diagnostic service sections."
},
"alias": [ "Department", "Sub-department", "Service", "Discipline" ],
"max": "*",
"id": "DiagnosticReport.category",
"comment": "DiagnosticReport.category and Composition.category shall be aligned",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.category"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.category",
"min": 0,
"definition": "Laboratory services, i.e., results of tests performed, could be characterized using typology of services, commonly called study types. Study type could be seen as an attribute or grouping mechanism that assigns a common clinical sense to certain types of laboratory test results., e.g., Hemoglobin, Platelet count, etc. belongs to 'Hematology study'.",
"isModifier": false,
"short": "The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": "OBR-24",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "studyType",
"binding": {
"strength": "required",
"valueSet": "http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab"
},
"alias": [ "Department", "Sub-department", "Service", "Discipline" ],
"max": "*",
"id": "DiagnosticReport.category:studyType",
"comment": "In comparison to the laboratory specialty which is an attribute of laboratory, study type is a categorization of laboratory service. It needs to be mentioned that classification of test to study types in not standardized.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.category"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.category",
"min": 0,
"definition": "Laboratory specialty is an attribute of any laboratory setting representing professional qualification of the laboratory to execute certain kind of laboratory tests.",
"isModifier": false,
"short": "The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": "OBR-24",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"sliceName": "specialty",
"binding": {
"strength": "required",
"valueSet": "http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab"
},
"alias": [ "Department", "Sub-department", "Service", "Discipline" ],
"max": "*",
"id": "DiagnosticReport.category:specialty",
"comment": "Specialty could be used as parameter for searching/querying of laboratory test results.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.category"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.code",
"min": 1,
"definition": "Specifies that it refers to a Laboratory Report",
"isModifier": false,
"short": "Type of (Laboratory) Report",
"mapping": [ {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)",
"identity": "v2"
}, {
"map": "code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.eu/fhir/laboratory/ValueSet/lab-reportType-eu-lab"
},
"alias": [ "Type" ],
"max": "1",
"id": "DiagnosticReport.code",
"comment": "At least one DiagnosticReport.code.coding and Composition.type.coding SHALL be equal",
"base": {
"max": "1",
"min": 1,
"path": "DiagnosticReport.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.subject",
"requirements": "SHALL know the subject context.",
"min": 1,
"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).",
"isModifier": false,
"short": "Who and/or what this report is about",
"mapping": [ {
"map": "Event.subject",
"identity": "workflow"
}, {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "PID-3 (no HL7 v2 mapping for Group or Device)",
"identity": "v2"
}, {
"map": "participation[typeCode=SBJ]",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient" ]
} ],
"alias": [ "Patient" ],
"max": "1",
"id": "DiagnosticReport.subject",
"comment": "DiagnosticReport and Composition SHALL have the same subject",
"base": {
"max": "1",
"min": 0,
"path": "DiagnosticReport.subject"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.encounter",
"requirements": "Links the request to the Encounter context.",
"min": 0,
"definition": "The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.",
"isModifier": false,
"short": "The healthcare event which this Laboratory Report is about (when test ordered).",
"mapping": [ {
"map": "Event.encounter",
"identity": "workflow"
}, {
"map": "FiveWs.context",
"identity": "w5"
}, {
"map": "PV1-19",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
} ],
"alias": [ "Context" ],
"max": "1",
"id": "DiagnosticReport.encounter",
"comment": "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).\n\n DiagnosticReport and Composition SHALL have the same encounter.",
"base": {
"max": "1",
"min": 0,
"path": "DiagnosticReport.encounter"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.effective[x]",
"requirements": "Need to know where in the patient history to file/present this report.",
"min": 0,
"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.",
"isModifier": false,
"short": "Clinically relevant time/time-period for report.",
"mapping": [ {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "FiveWs.done[x]",
"identity": "w5"
}, {
"map": "OBR-7",
"identity": "v2"
}, {
"map": "effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
}, {
"code": "Period"
} ],
"alias": [ "Observation time", "Effective Time", "Occurrence" ],
"max": "1",
"id": "DiagnosticReport.effective[x]",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "DiagnosticReport.effective[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.issued",
"requirements": "Clinicians need to be able to check the date that the report was released.",
"min": 0,
"definition": "The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.",
"isModifier": false,
"short": "DateTime this version was made",
"mapping": [ {
"map": "FiveWs.recorded",
"identity": "w5"
}, {
"map": "OBR-22",
"identity": "v2"
}, {
"map": "participation[typeCode=VRF or AUT].time",
"identity": "rim"
} ],
"type": [ {
"code": "instant"
} ],
"alias": [ "Date published", "Date Issued", "Date Verified" ],
"max": "1",
"id": "DiagnosticReport.issued",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "DiagnosticReport.issued"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.performer",
"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.",
"min": 1,
"definition": "The diagnostic service that is responsible for issuing the report.",
"isModifier": false,
"short": "Responsible Diagnostic Service.",
"mapping": [ {
"map": "Event.performer.actor",
"identity": "workflow"
}, {
"map": "FiveWs.actor",
"identity": "w5"
}, {
"map": "PRT-8 (where this PRT-4-Participation = \"PO\")",
"identity": "v2"
}, {
"map": ".participation[typeCode=PRF]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab" ]
} ],
"alias": [ "Laboratory", "Service", "Practitioner", "Department", "Company", "Authorized by", "Director" ],
"max": "1",
"id": "DiagnosticReport.performer",
"comment": "If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.performer"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.resultsInterpreter",
"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.",
"min": 0,
"definition": "The practitioner or organization that is responsible for the report's conclusions and interpretations.",
"isModifier": false,
"short": "Primary result interpreter",
"mapping": [ {
"map": "Event.performer.actor",
"identity": "workflow"
}, {
"map": "FiveWs.actor",
"identity": "w5"
}, {
"map": "OBR-32, PRT-8 (where this PRT-4-Participation = \"PI\")",
"identity": "v2"
}, {
"map": ".participation[typeCode=PRF]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/CareTeam" ]
} ],
"alias": [ "Analyzed by", "Reported by" ],
"max": "*",
"id": "DiagnosticReport.resultsInterpreter",
"comment": "If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.resultsInterpreter"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.specimen",
"requirements": "Need to be able to report information about the collected specimens on which the report is based.",
"min": 1,
"definition": "Details about the specimens on which this diagnostic report is based.",
"isModifier": false,
"short": "Specimens this report is based on.",
"mapping": [ {
"map": "SPM",
"identity": "v2"
}, {
"map": "participation[typeCode=SBJ]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen" ]
} ],
"max": "1",
"id": "DiagnosticReport.specimen",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.specimen"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.result",
"requirements": "Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.",
"min": 1,
"definition": "[Observations](http://hl7.org/fhir/R4/observation.html) that are part of this diagnostic report.",
"isModifier": false,
"short": "results",
"mapping": [ {
"map": "OBXs",
"identity": "v2"
}, {
"map": "outboundRelationship[typeCode=COMP].target",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory" ]
} ],
"alias": [ "Data", "Atomic Value", "Result", "Atomic result", "Data", "Test", "Analyte", "Battery", "Organizer" ],
"max": "1",
"id": "DiagnosticReport.result",
"comment": "Observations can contain observations.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.result"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.imagingStudy",
"min": 0,
"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.",
"isModifier": false,
"short": "Reference to full details of imaging associated with the diagnostic report",
"mapping": [ {
"map": "outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/ImagingStudy" ]
} ],
"max": "0",
"id": "DiagnosticReport.imagingStudy",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.imagingStudy"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.media",
"requirements": "Many diagnostic services include images in the report as part of their service.",
"min": 0,
"definition": "A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).",
"isModifier": false,
"short": "Key images associated with this report",
"mapping": [ {
"map": "OBX?",
"identity": "v2"
}, {
"map": "outboundRelationship[typeCode=COMP].target",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"alias": [ "DICOM", "Slides", "Scans" ],
"max": "*",
"id": "DiagnosticReport.media",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.media"
},
"isSummary": true
}, {
"path": "DiagnosticReport.media.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "DiagnosticReport.media.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.media.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "DiagnosticReport.media.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "DiagnosticReport.media.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "DiagnosticReport.media.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.media.comment",
"requirements": "The provider of the report should make a comment about each image included in the report.",
"min": 0,
"definition": "A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.",
"isModifier": false,
"short": "Comment about the image (e.g. explanation)",
"mapping": [ {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "DiagnosticReport.media.comment",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "DiagnosticReport.media.comment"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.media.link",
"min": 1,
"definition": "Reference to the image source.",
"isModifier": false,
"short": "Reference to the image source",
"mapping": [ {
"map": ".value.reference",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Media" ]
} ],
"max": "1",
"id": "DiagnosticReport.media.link",
"base": {
"max": "1",
"min": 1,
"path": "DiagnosticReport.media.link"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.conclusion",
"requirements": "Need to be able to provide a conclusion that is not lost among the basic result data.",
"min": 0,
"definition": "Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.",
"isModifier": false,
"short": "Clinical conclusion (interpretation) of test results",
"mapping": [ {
"map": "OBX",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=\"SPRT\"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "Report" ],
"max": "1",
"id": "DiagnosticReport.conclusion",
"base": {
"max": "1",
"min": 0,
"path": "DiagnosticReport.conclusion"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.conclusionCode",
"min": 0,
"definition": "One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.",
"isModifier": false,
"short": "Codes for the clinical conclusion of test results",
"mapping": [ {
"map": "OBX",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/clinical-findings",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdjunctDiagnosis"
} ],
"description": "Diagnosis codes provided as adjuncts to the report."
},
"max": "*",
"id": "DiagnosticReport.conclusionCode",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.conclusionCode"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "DiagnosticReport.presentedForm",
"requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
"min": 0,
"definition": "Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.",
"isModifier": false,
"short": "Entire report as issued (pdf recommended)",
"mapping": [ {
"map": "OBX",
"identity": "v2"
}, {
"map": "text (type=ED)",
"identity": "rim"
} ],
"type": [ {
"code": "Attachment"
} ],
"max": "*",
"id": "DiagnosticReport.presentedForm",
"comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
"base": {
"max": "*",
"min": 0,
"path": "DiagnosticReport.presentedForm"
},
"isSummary": false
} ]
},
"status": "active",
"id": "b0c221cb-b520-40f2-9d9e-f30cd803c7ff",
"kind": "resource",
"url": "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-diagnosticreport",
"version": "1.4.0",
"differential": {
"element": [ {
"id": "DiagnosticReport",
"path": "DiagnosticReport",
"short": "CH ELM DiagnosticReport: Laboratory Report"
}, {
"id": "DiagnosticReport.identifier",
"max": "1",
"min": 1,
"path": "DiagnosticReport.identifier",
"short": "Persistent, unique identifier for the diagnostic report (UUID)"
}, {
"id": "DiagnosticReport.identifier.system",
"min": 1,
"path": "DiagnosticReport.identifier.system",
"patternUri": "urn:ietf:rfc:3986"
}, {
"id": "DiagnosticReport.identifier.value",
"min": 1,
"path": "DiagnosticReport.identifier.value",
"example": [ {
"label": "CH ELM",
"valueString": "urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f"
} ],
"constraint": [ {
"key": "ch-elm-doc-identifier",
"human": "The identifier must be an UUID.",
"source": "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-diagnosticreport",
"severity": "error",
"expression": "startsWith('urn:uuid:')"
} ]
}, {
"id": "DiagnosticReport.basedOn",
"max": "1",
"min": 1,
"path": "DiagnosticReport.basedOn",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-servicerequest-laboratory-order" ]
} ]
}, {
"id": "DiagnosticReport.status",
"path": "DiagnosticReport.status",
"patternCode": "final"
}, {
"id": "DiagnosticReport.subject",
"path": "DiagnosticReport.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient" ]
} ]
}, {
"id": "DiagnosticReport.performer",
"max": "1",
"min": 1,
"path": "DiagnosticReport.performer",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-lab" ]
} ]
}, {
"id": "DiagnosticReport.specimen",
"max": "1",
"min": 1,
"path": "DiagnosticReport.specimen",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-specimen" ]
} ]
}, {
"id": "DiagnosticReport.result",
"max": "1",
"min": 1,
"path": "DiagnosticReport.result",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory" ]
} ]
} ]
},
"contact": [ {
"name": "Federal Office of Public Health FOPH",
"telecom": [ {
"value": "https://www.bag.admin.ch/bag/en/home/das-bag/kontakt-standort.html",
"system": "url"
} ]
} ],
"baseDefinition": "http://fhir.ch/ig/ch-lab-report/StructureDefinition/ch-lab-diagnosticreport"
}