Home > Profiles and Operations > DiagnosticReport Search - Patient Query

DiagnosticReport Search - Patient Query

DiagnosticReport search is simple RESTful interactions. It supports retrieving a lab results from OLIS for a health care practitioner by patient ID.

Scope

This transaction involves a request by the following parameters:

The mandatory parameters for the query:

• Patient Identifier(s)
• Date of Birth
• Report issued Start Date
• DiagnosticReport Type

The optional parameters for the query:

• Patient Gender
• Diagnostic Report Identifier
• Test Request Code
• Observation Code
• Observation Status
• Interpretation (filter by abnormal results)
• Report Issued End Date (this should default to either Observation Date or Last Updated Time in OLIS that the provider has chosen for the Start Date)

The usage of these parameters are as follows:

Parameter	FHIR Query Parameter	Optionality	Type	Description	Usage Note	Example
Patient Identifer(s)	patient.identifier	mandatory	token	This parameter specifies an identifier associated with the patient who is the subject of this lab report.	This can be an HCN or MRN and SHALL include both system and value.	[base]/DiangosticReport?patient.identifier=[system]|[value]
Date of Birth	patient.birthdate	mandatory	date	This parameter specifies the birth date of patient who is the subject of this lab report.	SHALL specify a FHIR date value	[base]/DiangosticReport?patient.birthdate=1950-01-01
Report issued start Date	issued	mandatory	date	This parameter specifies the report issued date.	SHALL specify a date value, and MAY contain a date specific prefix such as ge	[base]/DiangosticReport?issued=[ge]2023-01-01
DiagnosticReport Type	code	mandatory	token	This parameter specifies the LOINC code indicating a query to only lab reports.	SHALL contain a fixed LOINC code "11502-2" for "Laboratory Report"	[base]/DiangosticReport?code=http://loinc.org|11502-2
Patient Gender	patient.gender	optional	token	This parameter specifies the gender of the patient associated with the lab report.		[base]/DiangosticReport?patient.gender=male
Diagostic Report Identifier	identifier	optional	token	This parameter specifies an identifier for the report.	System and value SHALL be provided.	[base]/DiangosticReport?identifier=[system]|[value]
Test Request Code	based-on:ServiceRequest.code	optional	token	This parameter specifies the test request code associated with the lab report.	system and value SHALL be provided.
Observation Code	result.code	optional	token	This parameter specifies the lab result code associated with the lab report.	system and value SHALL be provided. When used with other observation search parameters, SHALL use one of the composite search parameters defined below	[base]/DiangosticReport?result.code=[system]|[value]
Observation Status	result.status	optional	token	This parameter specifies the lab result code associated with the lab report.	system and value SHALL be provided. When used with other observation search parameters, SHALL use one of the composite search parameters defined below	[base]/DiangosticReport?result.status=[system]|[value]
Interpretation	result.interpretation	optional	token	This parameter supports filtering of lab reports by abnormal results.	The allowed values are "AB" and "CR". See Supported Search Parameter section for how to use these values. When used with other observation search parameters, SHALL use one of the composite search parameters defined below	[base]/DiangosticReport?result.interpretation=AB

Note: As per FHIR chained search parameter methodloogy, a composite search parameter SHALL be used when multiple observation search parameters are used together. These parameters will be supported in future OLIS releases.

Name	Type	Description	Usage Note	Example
code-status	composite	code and status composite pair	SHALL be used when search includes observation code and status. The value of the parameter MUST be concatenated with "$"	[base]/DiangosticReport?result.code-status=http://loinc.org|12345$final
code-interpretation	composite	code and interpretation composite pair	SHALL be used when search includes observation code and interpretation ("AB" or "CR"). The value of the parameter MUST be concatenated with "$"	[base]/DiangosticReport?result.code-interpretation=http://loinc.org|12345$AB
status-interpretation	composite	status and interpretation composite pair	SHALL be used when search includes observation status and interpretation ("AB" or "CR"). The value of the parameter MUST be concatenated with "$"	[base]/DiangosticReport?result.status-interpretation=final$AB
code-status-interpretation	composite	code, status and interpretation used together	SHALL be used when search includes observation code, status and interpretation ("AB" or "CR"). The value of the parameter MUST be concatenated with "$"	[base]/DiangosticReport?result.code-status-interpretation=http://loinc.org|12345$final$AB

Specification

The OLIS FHIR Patient Query For Providers is based on the FHIR R4 Search interaction.

Diagnostic Report Search Request

The Diagnostic Report Search Request is an HTTP GET operation with multiple query parameters specified in Supported Search Parameters section below. The syntax of the request is

GET [base]/DiagnosticReport?patient.identifier=[system]|[value]&&patient.birthdate=[date]&issued=[le|ge][date]&code=http://loinc.org|11502-2

Note: For the more details please reference to Supported Search Parameters and Diagnostic Report Search Examples sections

Diagnostic Report Search Response

The relationship between the resources used in DiagnosticReport Search response is below:

• DiagnosticReport

• ServiceRequest

• Observation

• Specimen

• Patient

• Practitioner(Ordering, Performing and Reporting)

• PractitionerRole

• Location

• Organization(Ordering Facility, Performing Lab, Reporting Lab, Test Request Placer, Specimen Collector, Destination Lab, Identifier Assigner, Requesting Lab)

• Encounter

• OperationOutcome

• Bundle

Extensions

• EN Qualifier

• Healthcard Version Code

• ObservationValueAttachment

• PointOfCareTestID

• TestRequestPlacer

• ServiceRequestBlockIndicator

• TestRequestRecipient

• SortKey

• SourceOfNote

• Notes (for DiagnosticReport)

• specimen-numberSampleContainer

Supported Search Parameters

GET DiagnosticReport (query by Patient ID)

Patient identifier parameter: patient.identifier

The patient identifier can be an Ontario health card number, or a medical record number (MRN).

• Example of Ontario HCN: patient.identifier=[id-system-global-base]/ca-on-patient-hcn|12345678

• Example of MRN: patient.identifier= http://ehealthontario.ca/fhir/NamingSystem/lab/patient-id-lab-license-4004|1234

Note that MRN system URI is a local identifier that contains the ID of the assigning authority (e.g. lab, hospital, specimen collection centre). For the list of possible MRN system values, please refer to Identifiers page. The patient identifiers are listed in the "Local Identifiers" table marked by "OLIS Patient Identifier generated by xxx".

Patient Gender parameter: patient.gender

• Example: patient.gender=male

Patient Date of Birth parameter: patient.birthdate

• Example: patient.birthdate=1929-11-29

Dates parameter: issued

• Example 1 (report issue start date) : issued=ge2016-01-02

• Example 2 (report issue start date and end date): issued=ge2015-02-25&issued=le2016-02-27

Dates parameter: specimen.collected

• Example : specimen.collected =ge2016-01-02

Test Request code: result.based-on:ServiceRequest.code

• Example: result.based-on:ServiceRequest.code= [code-system-local-base] /lab/test-request-codes|TR11663-2

Interpretation parameter:result.interpretation

• Example 1: result.intepretation=AB
• Example 2: result.intepretation=CR

Note: This parameter allows the requestor to further restrict the search criteria to retrieve all abnormal results (AB) or critically abnormal only (CR). The meaning of these values are as follows:

• If the abnormal result flag parameter contained “AB”, the query result set is further restricted to orders containing test requests having a test result with an abnormal flag containing (L, H, A, LL, HH, AA) field.
• If the abnormal result flag parameter contained “CR”, the query result set is further restricted to orders containing test requests having a test result with an abnormal flag containing (LL, HH, AA) field.

Observation status: result.status

• Example: result.status=final

Note: This parameter maps to OLIS result status as below. Since OLIS does not support "registered" and "unknown", query with these values will return 110 error.

- "final" maps to OLIS status value "F" and "Z"
- "preliminary" maps to "P"
- "cancelled" maps to "X" and "N"
- "entered-in-error" maps to "W"

Observation code: result.code

• Example: result.code= http://loinc.org|2028-9

Diagnostic report identifier: identifier

• Example: identifier= [id-system-local-base] /lab/report-id-lab-license-4004|543321

Size limit (for response paging):_count

• Example: _count=10

If there is no _count in the search request, the server will return all matching records in one response.

Server will generate and return an additional parameter search-id as per Server Conformance section above.

• Example: search-id= 017-11-16T20:37:03.0000000X128987

Format: JSON (default) or XML

• Example: format=[mime-type]:_format=application/fhir+json or _format=application/fhir+xml

Example

Diagnostic Report Search Example

GET [base]/DiagnosticReport?patient.identifier=[id-system-global-base]/ca-on-patient-hcn|1008624486&patient.gender=male&patient.birthdate=1929-11-29&issued=ge2016-01-02&code=http://loinc.org|11502-2&_count=10

In the returned header:

[base]/DiagnosticReport?patient.identifier=[id-system-global-base]/ca-on-patient-hcn|1008624486&patient.gender=male&patient.birthdate=1929-11-29&issued=ge2016-01-02&code=http://loinc.org|11502-2&_count=10&search-id=017-11-16T20:37:03.0000000X128987

Examples of a search response can be found below

Resource	Example
Search result containing a simple chemistry report	XML / JSON
Search result containing a panel test report	XML / JSON
Search result containing a microbiology report with 2 organisms and 2 sensitivity panels	XML / JSON
DiagnosticReport with Contained Resources	XML / JSON
ServiceRequest	XML / JSON
Observation	XML / JSON
Specimen	XML / JSON
Patient	XML / JSON
Practitioner	XML / JSON
Organization	XML / JSON
OperationOutcome	XML / JSON
OperationOutcome when request has invalid fhirVersion	XML / JSON