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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="spark1701" />
  <meta>
    <versionId value="spark2094" />
    <lastUpdated value="2015-12-14T18:17:40.491+00:00" />
  </meta>
  <url value="http://premierinc.com/fhir/StructureDefinition/tdaf-diagnosticreport" />
  <version value="TWTW10" />
  <name value="TheraDocData Access Framework (DAF) DiagnosticReport Profile" />
  <display value="TDAF-DiagnosticReport" />
  <status value="draft" />
  <publisher value="Health Level Seven International (Infrastructure and Messaging - Data Access Framework)" />
  <contact>
    <telecom>
      <system value="other" />
      <value value="http://www.healthit.gov" />
    </telecom>
  </contact>
  <date value="2014-11-19" />
  <description value="TDAF Diagnostic Report" />
  <fhirVersion value="1.0.1" />
  <kind value="resource" />
  <constrainedType value="DiagnosticReport" />
  <abstract value="false" />
  <base value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
  <differential>
    <element>
      <path value="DiagnosticReport" />
      <name value="DAF-DiagnosticReport" />
      <short value="TDAF Diagnostic Report" />
      <definition value="The scope is accessing a diagnostic report." />
      <comments value="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." />
      <alias value="Lab Result" />
      <alias value="Lab Report" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="DiagnosticReport" />
      </type>
      <mapping>
        <identity value="v2" />
        <map value="ORU -&gt; OBR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Observation[classCode=OBS, moodCode=EVN]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.diagnostics" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.identifier" />
      <short value="Id for external references to this report" />
      <definition value="The local ID assigned to the report by the order filler, usually by the Information System of the diagnostic service provider." />
      <requirements value="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." />
      <alias value="ReportID" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Identifier" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBR-51" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="id" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.identifier.use" />
      <short value="usual | official | temp | secondary (If known)" />
      <definition value="The purpose of this identifier." />
      <comments value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
      <requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
      <mustSupport value="true" />
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="Identifies the purpose for this identifier, if known ." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/identifier-use" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role.code or implied by context" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.identifier.system" />
      <short value="Lab URI" />
      <definition value="The URI for the laboratory Issuing the report.  This establishes the namespace in which set of possible id values is unique." />
      <requirements value="There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="uri" />
      </type>
      <exampleUri value="http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri" />
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.4 / EI-2-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.root or Role.id.root" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./IdentifierType" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.identifier.value" />
      <short value="The value that is unique" />
      <definition value="The portion of the identifier typically displayed to the user and which is unique within the context of the system." />
      <comments value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <exampleString value="123456" />
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="CX.1 / EI.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="./Value" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.status" />
      <short value="registered | partial | final | corrected | appended | cancelled | entered-in-error" />
      <definition value="The status of the diagnostic report as a whole." />
      <comments value="This is labeled as &quot;Is Modifier&quot; because applications need to take appropriate action if a report is withdrawn." />
      <requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
      <mustSupport value="true" />
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="required" />
        <description value="The status of the diagnostic report as a whole." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-report-status" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBR-25 (not 1:1 mapping)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="statusCode  Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type &quot;revise&quot;" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.category" />
      <short value="Service category" />
      <definition value="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." />
      <comments value="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." />
      <alias value="Department" />
      <alias value="Sub-department" />
      <alias value="service" />
      <alias value="discipline" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="example" />
        <description value="Codes for diagnostic service sections." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBR-24" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code &lt; LabService].code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="class" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.code" />
      <short value="US Realm Laboratory Report Order Code" />
      <definition value="The test, panel or battery that was ordered." />
      <comments value="UsageNote= The typical patterns for codes are:  1)  a LOINC code either as a  translation from a &quot;local&quot; code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <binding>
        <strength value="extensible" />
        <description value="LOINC codes" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/uslab-obs-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.code.coding" />
      <name value="USLabLOINCCoding" />
      <short value="Standard and local codes may be included here by repeating the coding element with a different coding.system." />
      <definition value="Standard and local codes may be included here by repeating the coding element with a different coding.system." />
      <comments value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true." />
      <requirements value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Coding" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1-8, C*E.10-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="union(., ./translation)" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.code.coding.system" />
      <short value="Identity of the terminology system" />
      <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
      <comments value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously." />
      <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="uri" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./codeSystem" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.code.coding.code" />
      <short value="Symbol in syntax defined by the system" />
      <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
      <comments value="Logical Observation Identifiers Names and Codes (LOINC) is a database and universal standard for identifying medical laboratory observations." />
      <requirements value="Need to refer to a particular code in the system." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="code" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./code" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.code.coding.display" />
      <short value="Representation defined by the system" />
      <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
      <comments value="When using LOINC  'long common name' is preferred although the LOINC 'short name' or the LOINC 'fully-specified name can also be used.  ( http://lionc.org.terms-of-use)." />
      <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.2 - but note this is not well followed" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV.displayName" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.code.text" />
      <short value="Display text" />
      <definition value="This is the laboratory defined display text for the report if different from the code display text(s)." />
      <comments value="If this exists, this is the text to be used for display." />
      <requirements value="Used when the laboratory define how the dsplay text if different from the code display text." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="C*E.9. But note many systems use C*E.2 for this" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.subject" />
      <short value="The subject of the report, usually, but not always, the patient" />
      <definition value="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." />
      <requirements value="SHALL know the subject context." />
      <alias value="Patient" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/daf-patient" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="PID-3 (no HL7 v2 mapping for Group or Device)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=SBJ]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.focus" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.encounter" />
      <short value="Health care event when test ordered" />
      <definition value="The link to the health care event (encounter) when the order was made." />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/daf-encounter" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="PV1-19" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="context" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.effective[x]" />
      <short value="Specimen Collection Datetime or Period" />
      <definition value="This is the Specimen Collection Datetime or Period which is the physically relevent dateTime for laboratory tests." />
      <comments value="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." />
      <requirements value="Need to know where in the patient history to file/present this report." />
      <alias value="Observation time" />
      <alias value="Effective Time" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBR-7" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="effectiveTime" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.done" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.issued" />
      <short value="DateTime this version was released" />
      <definition value="The date and time that this version of the report was released from the source diagnostic service." />
      <comments value="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." />
      <requirements value="Clinicians need to be able to check the date that the report was released." />
      <alias value="Date Created" />
      <alias value="Date published" />
      <alias value="Date Issued" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="instant" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBR-22" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=VRF or AUT].time" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.recorded" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.performer" />
      <short value="Responsible Diagnostic Service" />
      <definition value="The diagnostic service that is responsible for issuing the report." />
      <comments value="This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report." />
      <requirements value="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." />
      <alias value="Laboratory" />
      <alias value="Service" />
      <alias value="Practitioner" />
      <alias value="Department" />
      <alias value="Company" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/daf-pract" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/daf-organization" />
      </type>
      <mustSupport value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="v2" />
        <map value="PRT-8 (where this PRT-4-Participation = &quot;PO&quot;)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="participation[typeCode=AUT].role[classCode=ASSIGN].scoper" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.witness" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.request" />
      <short value="What was requested" />
      <definition value="Details concerning a test or procedure requested." />
      <comments value="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." />
      <requirements value="Need to be able to track completion of requests based on reports issued and also to report what diagnostic tests were requested (not always the same as what is delivered)." />
      <min value="1" />
      <max value="*" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/daf-diagnosticorder" />
      </type>
      <mustSupport value="true" />
      <mapping>
        <identity value="v2" />
        <map value="ORC? OBR-2/3?" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="outboundRelationship[typeCode=FLFS].target" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.result" />
      <short value="Observations - simple, or complex nested groups" />
      <definition value="Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. &quot;atomic&quot; results), or they can be grouping observations that include references to other members of the group (e.g. &quot;panels&quot;)." />
      <requirements value="Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations." />
      <alias value="Data" />
      <alias value="Atomic Value" />
      <alias value="Result" />
      <alias value="Atomic result" />
      <alias value="Data" />
      <alias value="Test" />
      <alias value="Analyte" />
      <alias value="Battery" />
      <alias value="Organizer" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/daf-resultobs" />
      </type>
      <mustSupport value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBXs" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="outboundRelationship[typeCode=COMP].target" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.conclusion" />
      <short value="Clinical Interpretation of test results" />
      <definition value="Concise and clinically contextualized narrative interpretation of the diagnostic report." />
      <comments value="Typically, a report is either [all data, no narrative (e.g. Core lab)] or [a mix of data with some concluding narrative (e.g. Structured Pathology Report, Bone Density)], or [all narrative (e.g. typical imaging report, histopathology)]. In all of these cases, the narrative goes in &quot;text&quot;." />
      <requirements value="Need to be able to provide a conclusion that is not lost among the basic result data." />
      <alias value="Report" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="inboundRelationship[typeCode=&quot;SPRT&quot;].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.codedDiagnosis" />
      <short value="Codes for the conclusion" />
      <definition value="Codes for the conclusion." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <binding>
        <strength value="preferred" />
        <description value="SNOMED CT findings codes provided as adjunct diagnosis to the report" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/clinical-findings" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2" />
        <map value="OBX" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)" />
      </mapping>
    </element>
    <element>
      <path value="DiagnosticReport.presentedForm" />
      <short value="Entire report as issued" />
      <definition value="Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent." />
      <comments value="&quot;application/pdf&quot; is recommended as the most reliable and interoperable in this context." />
      <requirements value="Gives Laboratory the ability to provide its own fully formatted report for clinical fidelity." />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Attachment" />
      </type>
      <mustSupport value="true" />
      <mapping>
        <identity value="v2" />
        <map value="OBX" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="text (type=ED)" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>

name : TheraDocData Access Framework (DAF) DiagnosticReport Profile

{

}

<name value="TheraDocData Access Framework (DAF) DiagnosticReport Profile" />