{ "resourceType": "StructureDefinition", "id": "access-diagnosticreport-gen-pat", "text": { "status": "generated", "div": "
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\"DiagnosticReportACCESS DiagnosticReport General Lab (Patient) Profile
\".\"\".\"\".\"identifierIdentifierBusiness identifier for report
\".\"\".\"\".\"statusScoderegistered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required)
\".\"\".\"\".\"categorySCodeableConceptService Category
Slice: Unordered, Open by value:pattern
Binding: DiagnosticServiceSectionCodes (example)
\".\"\".\"\".\"\".\"labS1..1CodeableConceptRequired Pattern: {\"coding\":[{\"system\":\"http://terminology.hl7.org/CodeSystem/v2-0074\",\"code\":\"LAB\"}]}
\".\"\".\"\".\"codeSCodeableConceptName/Code for this diagnostic report
Binding: LOINCDiagnosticReportCodes (preferred)
\".\"\".\"\".\"subjectS1..1Reference(http://hl7.org/fhir/ca/core/StructureDefinition/profile-patient)The subject of the report
\".\"\".\"\".\"effectiveDateTimeSdateTimeClinically relevant time/time-period for report
\".\"\".\"\".\"issuedSDateTime this version was made
\".\"\".\"\".\"performerSReference(Practitioner | Organization)Responsible Diagnostic Service
Slice: Unordered, Open by value:profile
\".\"\".\"\".\"\".\"practitionerReference(http://hl7.org/fhir/ca/core/StructureDefinition/profile-practitioner)Practitioner responsible for the diagnostic report
\".\"\".\"\".\"\".\"organizationReference(http://hl7.org/fhir/ca/core/StructureDefinition/profile-organization)Organization responsible for the diagnostic report
\".\"\".\"\".\"specimenReference(Specimen)Specimens this report is based on
\".\"\".\"\".\"resultSReference(ACCESS Observation General Lab (Patient) Profile)Observations
\".\"\".\"\".\"conclusionstringClinical conclusion (interpretation) of test results
\".\"\".\"\".\"conclusionCodeCodeableConceptCodes for the clinical conclusion of test results
Binding: SNOMEDCTClinicalFindings (example)

\"doco\" Documentation for this format
" }, "url": "http://infoway-inforoute.ca/fhir/StructureDefinition/access-diagnosticreport-gen-pat", "version": "0.1.0", "name": "AccessDiagnosticReportGeneralLabPatient", "title": "ACCESS DiagnosticReport General Lab (Patient) Profile", "status": "draft", "experimental": false, "date": "2019-03-21T04:00:00+00:00", "publisher": "Canada Health Infoway", "contact": [ { "telecom": [ { "system": "url", "value": "http://infoway-inforoute.ca" } ] } ], "description": "Constraints on the DiagnosticReport resource to reflect source data mappings for the ACCESS Health project. Focus of this profile is on display of general Diagnostic Report result information to citizen/patient viewers.", "fhirVersion": "4.0.0", "mapping": [ { "identity": "vendor-agnostic-v2", "uri": "http://unknown.org/Vendor Agnostic v2", "name": "Vendor Agnostic v2" }, { "identity": "ontario--olis", "uri": "http://unknown.org/Ontario- OLIS", "name": "Ontario- OLIS" }, { "identity": "prince-edward-island--cerner-millennium", "uri": "http://unknown.org/Prince Edward Island- Cerner Millennium", "name": "Prince Edward Island- Cerner Millennium" }, { "identity": "nova-scotia--meditech-magic", "uri": "http://unknown.org/Nova Scotia- Meditech Magic", "name": "Nova Scotia- Meditech Magic" }, { "identity": "nove-scotia--cerner-millennium", "uri": "http://unknown.org/Nove Scotia- Cerner Millennium", "name": "Nove Scotia- Cerner Millennium" }, { "identity": "nova-scotia--meditech-c/s", "uri": "http://unknown.org/Nova Scotia- Meditech C/S", "name": "Nova Scotia- Meditech C/S" }, { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" } ], "kind": "resource", "abstract": false, "type": "DiagnosticReport", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "derivation": "constraint", "differential": { "element": [ { "id": "DiagnosticReport", "path": "DiagnosticReport", "short": "ACCESS DiagnosticReport General Lab (Patient) Profile", "definition": "Expected requirements for the DiagnosticReport resource when reflecting general lab result data based on existing source mappings.", "comment": "Note for implementors: This profile focuses on general lab results. It excludes pathology, microbiology, serotology, etc for two reasons: 1) The density and content of information in the various lab types are dramatically different from each other, these differences drive different information and interaction requirements from patients, and 2) there is a large degree of variance in how general lab results are formatted (more structured) and how other types of labs like pathology are structured (largely text based). Additional analysis required for microbiology, serotology, and pathology lab result types to determine level of structured data available.", "mustSupport": false, "isModifier": false }, { "id": "DiagnosticReport.identifier", "path": "DiagnosticReport.identifier", "short": "Business identifier for report", "type": [ { "code": "Identifier" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-51 \nOther suggested options if OBR-51 is not available: OBR-2 + OBR-3 + OBR-4" }, { "identity": "ontario--olis", "map": "OBR-3 + ORC-4" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-2 + OBR-3" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-2 + OBR-3" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-2 + OBR-20" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-2 + OBR-3" } ] }, { "id": "DiagnosticReport.status", "path": "DiagnosticReport.status", "short": "registered | partial | preliminary | final +", "comment": "Mapping Note: See the notes in the mapping document discussing the need to map the HL7 v2 codes used by the LIS (shorthand often single-digit codes) to the codes used by the FHIR value set (usually full word code).", "type": [ { "code": "code" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "required", "description": "Diagnostic Report Status", "valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-report-status" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-25 (not 1:1 mapping)" }, { "identity": "ontario--olis", "map": "OBR-25 (Codes supported: P, F, C, N, W, X, Z)" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-25 (Codes supported: P, F, C, D, R, S, D, U, I) Could also receive codes from Cerner Millennium Code Set 8 (UNAUTH, TRANSCRIBED, C_TRANSCRIBED, INPROGRESS, AUTH, ALTERED, MODIFIED, INERROR, INERRNOMUT, INERRNOVIEW, CANCELLED, NOT DONE)" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-25 (Codes supported: P, F, D, A*)" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-25 (Codes supported: P, F, C)" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-25 (Codes supported: P, F, C, D, A*, FOUT*)" } ] }, { "id": "DiagnosticReport.category", "path": "DiagnosticReport.category", "slicing": { "discriminator": [ { "type": "value", "path": "pattern" } ], "rules": "open" }, "short": "Service Category", "comment": "Laboratory should be the default code used in this diagnostic report profile. Other profiles may support other codes.", "min": 1, "max": "*", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "example", "description": "Diagnostic Service Section Codes", "valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-service-sections" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-24" }, { "identity": "ontario--olis", "map": "?" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-24" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-24" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-24" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-24" } ] }, { "id": "DiagnosticReport.category.lab", "path": "DiagnosticReport.category.lab", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" } ], "patternCodeableConcept": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v2-0074", "code": "LAB" } ] }, "mustSupport": true, "isModifier": false }, { "id": "DiagnosticReport.code", "path": "DiagnosticReport.code", "short": "Name/Code for this diagnostic report", "comment": "Implementor Note: US Core uses a value set that pulls from the LOINC Diagnostic Report codes but does not fix a certain value. OLIS pulls from LOINC but requires a fixed value of 11502-2 to identify the lab report. Keeping the LOINC value set as an example is intended to strike a balance between both profiles, but further investigation with jurisdictional end-users/LIS is recommended to determine if a fixed value should be pursued to reduce confusion and inconsistency for patients.", "type": [ { "code": "CodeableConcept" } ], "mustSupport": true, "isModifier": false, "binding": { "strength": "preferred", "description": "LOINC Diagnostic Report Codes", "valueSet": "http://hl7.org/fhir/ValueSet/report-codes" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)" }, { "identity": "ontario--olis", "map": "OBX-3" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-4" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-4" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-4" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-4" } ] }, { "id": "DiagnosticReport.subject", "path": "DiagnosticReport.subject", "short": "The subject of the report", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/ca/core/StructureDefinition/profile-patient" ] } ], "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "PID-3(MRN) , PID-2 (primary insurance policy number) should also be considered\nOther suggested options if PID-3 is not available or the patient resource is tied to provincial identifiers: PID-2 OR PID-4 (Depending on if HL7 v2.3 or lower)" }, { "identity": "ontario--olis", "map": "PID-3" }, { "identity": "prince-edward-island--cerner-millennium", "map": "PID-3 (if v2.3.1 and above), PID-4 (if v2.3 or below)" }, { "identity": "nova-scotia--meditech-magic", "map": "PID-3" }, { "identity": "nove-scotia--cerner-millennium", "map": "PID-3" }, { "identity": "nova-scotia--meditech-c/s", "map": "PID-3" } ] }, { "id": "DiagnosticReport.effectiveDateTime", "path": "DiagnosticReport.effectiveDateTime", "short": "Clinically relevant time/time-period for report", "type": [ { "code": "dateTime" } ], "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-7 (Observation Date/Time)" }, { "identity": "ontario--olis", "map": "OBR-7" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-7" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-7" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-7" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-7" } ] }, { "id": "DiagnosticReport.issued", "path": "DiagnosticReport.issued", "short": "DateTime this version was made", "comment": "Mapping note: Keep in mind that the instant data type requires seconds and time zone to be reported and the HL7 v2 ORU messages that are the source of the conversions are likely to only include YYYY-MM-DD-HH-DD. If hour and minute are unknown, the Meditech NS LIS append \"UNK\". Additional work will be required on behalf of the converter to add in zeros for seconds and time zone to be conformant to the FHIR Data type. There are no limitations from the base HL7 spec or NS implementation guides for time stamp that would prevent bi-directional conversion.", "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-22 (Results Rpt/Status Chng – Date/Time)\nOther suggested options if OBR-22 is not available: OBR-7 or OBX-19 can be used if interface is HL7 v2.4 or higher" }, { "identity": "ontario--olis", "map": "ZBX-1 (Test Result Release Date/Time)" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-22" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-22" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-22" } ] }, { "id": "DiagnosticReport.performer", "path": "DiagnosticReport.performer", "slicing": { "discriminator": [ { "type": "value", "path": "profile" } ], "rules": "open" }, "short": "Responsible Diagnostic Service", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization" ] } ], "mustSupport": true, "isModifier": false }, { "id": "DiagnosticReport.performer.practitioner", "path": "DiagnosticReport.performer.practitioner", "short": "Practitioner responsible for the diagnostic report", "comment": "SME Note: Rare in general labs to have physicians that sign the lab result. Lab performing practitioner is usually internal information that gets stored by LIS for operational purposes, but not likely of value to patients or clinicians. \n\nImplementor Note: Included for alignment with existing Canadian & International profiles, kept as optional until reviewal by end-users determines removal or must-support flag.", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/ca/core/StructureDefinition/profile-practitioner" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-32 (Principal Result Interpreter) or OBX-16 (Responsible Observer)" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-32" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBX-16 (not sent for all results)" } ] }, { "id": "DiagnosticReport.performer.organization", "path": "DiagnosticReport.performer.organization", "short": "Organization responsible for the diagnostic report", "comment": "SME Note: Most commonly, performing organization will be available (more frequently than performing practitioner).", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/ca/core/StructureDefinition/profile-organization" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-15 (Producer ID), OBX-23 (Performing Organization Name) if interface is HL7 2.5.1 and higher" }, { "identity": "ontario--olis", "map": "ZBR-6 (Performing Laboratory)" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBX-23" }, { "identity": "nova-scotia--meditech-magic", "map": "ZPS-2 (Meditech performing lab site mnemonic) / ZPS-3 (Meditech performing lab site name)" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBX-15" } ] }, { "id": "DiagnosticReport.specimen", "path": "DiagnosticReport.specimen", "short": "Specimens this report is based on", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Specimen" ] } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBR-3.1 (Filler Order Number ID) SPM-2 (Specimen ID) can be used in interfaces that are HL7 v2.5.1 and higher" }, { "identity": "ontario--olis", "map": "OBR-3.1" }, { "identity": "prince-edward-island--cerner-millennium", "map": "SPM-2.2" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-3.1" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-20 (Filler Field 1+ Unformatted Millennium accession number)" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-3.1" } ] }, { "id": "DiagnosticReport.result", "path": "DiagnosticReport.result", "short": "Observations", "type": [ { "code": "Reference", "targetProfile": [ "http://infoway-inforoute.ca/fhir/StructureDefinition/access-observation-gen-pat" ] } ], "mustSupport": true, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX-21 (Observation Instance Identifier)\nOther suggested options if OBX-21 is not available: OBR-2 (Placer Order Number) + OBR-3(Filler Order Number) + OBX-3 (Observation Identifier)" }, { "identity": "ontario--olis", "map": "OBR-3.1" }, { "identity": "prince-edward-island--cerner-millennium", "map": "OBR-3.1 + OBR-4.1" }, { "identity": "nova-scotia--meditech-magic", "map": "OBR-3.1 + OBR-4.1" }, { "identity": "nove-scotia--cerner-millennium", "map": "OBR-20 + OBR-4.1" }, { "identity": "nova-scotia--meditech-c/s", "map": "OBR-3.1 + OBR-4.1" } ] }, { "id": "DiagnosticReport.conclusion", "path": "DiagnosticReport.conclusion", "short": "Clinical conclusion (interpretation) of test results", "type": [ { "code": "string" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX. Or NTE-3 when NTE-2 data type is interpretive data" } ] }, { "id": "DiagnosticReport.conclusionCode", "path": "DiagnosticReport.conclusionCode", "short": "Codes for the clinical conclusion of test results", "type": [ { "code": "CodeableConcept" } ], "mustSupport": false, "isModifier": false, "binding": { "strength": "example", "description": "SNOMED CT Clinical Findings", "valueSet": "http://hl7.org/fhir/ValueSet/clinical-findings" }, "mapping": [ { "identity": "vendor-agnostic-v2", "map": "OBX. Or NTE-3 when NTE-2 data type is interpretive data" } ] } ] } }