FHIR Genomics Implementation Guide

Notice

Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.

StructureDefinition NHSEngland-DiagnosticReport-GenomicReport

The requirements of a specific Genomics DiagnosticReport is currently under review.

The draft profile is provided below for completeness.

Currently, only requirements for initial Pathology reports, provided with a test order, have been reviewed. DiagnosticReports containing the results of genomic testing are expected to be attached/provided as PDF documents during the alpha phase of the GMS development programme.

It is expected structured DiagnosticReports will mimic the structure proposed within the HL7 International Genomic Reporting IG, though customizations for use within the UK still need to be investigated.

Additionally, to support sharing across borders, lab reports MAY additionally be aligned to the HL7 EU Lab Implementation guide, though requirement on suppliers to conform to this structure are still under review. details of elements of interest for alignment with the EU DiagnosticReport profile are provided below.

Genomic DiagnosticReports which have been updated post submission SHALL be accompanied by Provenance resources, referencing the DiagnosticReport which detail when the resource was changed, who made the change and why.

Whilst unstructured Diagnostic Reports can also be represented by DocumentReference resources, the DiagnosticReport resource is preferred for any documents constituting actual reports, as the resource allows capture of metadata not present in DocumentReference, such as the resultsInterpreter, specimen or conclusion, which would help in searching or for analytics. The DiagnosticReport SHOULD then reference a DocumentReference e.g. registered on NRL following guidance on coding provided by the National Record Locator Service. Use of DocumentReference within the Order Management Service resources is limited to other data files or documents.

Where binary data is uploaded to the central server, or made available via a national service such as NRL, as in the case of unstructured reports, information cannot be redacted by the central service if a patient is marked as sensitive. It is the responsibility of source systems to redact the necessary information from binary files for sensitive patients before sending this data to the central broker, this includes information such as address and GP details in line with PDS.

Profile url	FHIR Module	Normative Status
https://fhir.nhs.uk/StructureDefinition/NHSEngland-DiagnosticReport-GenomicReport	NHS England Genomics	trial-use

Canonical_URL	Status	Current_Version	Last_Updated	Description
https://fhir.nhs.uk/StructureDefinition/NHSEngland-DiagnosticReport-GenomicReport	active	0.3.0	2026-04-16	This profile defines the Genomics constraints and extensions on the Genomics Reporting FHIR resource Genomic Report DiagnosticReport.

Tree View

NHSEngland_DiagnosticReport_GenomicReport (DiagnosticReport)

GenomicReport

There are no (further) constraints on this element

Element id

DiagnosticReport

Short description

A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports

Alternate names

Report, Test, Result, Results, Labs, Laboratory

Definition

The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.

Comments

This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.

Data type

GenomicReport

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
v2: ORU -> OBR
rim: Observation[classCode=OBS, moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

DiagnosticReport.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

Detailed Descriptions

DiagnosticReport

Short A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports

Definition

Cardinality 0..*

Alias Report, Test, Result, Results, Labs, Laboratory

Comments

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
v2: ORU -> OBR
rim: Observation[classCode=OBS, moodCode=EVN]

DiagnosticReport.id

Short Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Cardinality 0..1

Type

Summary True

Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

DiagnosticReport.meta

Short Metadata about the resource

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.

Cardinality 0..1

Type

Table View

DiagnosticReport		0..*
DiagnosticReport.id	id	0..1
DiagnosticReport.meta	Meta	0..1
DiagnosticReport.implicitRules	uri	0..1
DiagnosticReport.language	code	0..1
DiagnosticReport.text	Narrative	0..1
DiagnosticReport.contained	Resource	0..*
DiagnosticReport.extension	Extension	0..*
DiagnosticReport.extension:recommended-action	Extension	0..*
DiagnosticReport.extension:genomic-risk-assessment	Extension	0..*
DiagnosticReport.extension:coded-note	Extension	0..*
DiagnosticReport.extension:supporting-info	Extension	0..*
DiagnosticReport.extension:genomic-study	Extension	0..*
DiagnosticReport.extension:hla-genotyping-results-allele-database	Extension	0..1
DiagnosticReport.extension:hla-genotyping-results-glstring	Extension	0..1
DiagnosticReport.extension:workflow-relatedArtifact	Extension	0..*
DiagnosticReport.extension:workflow-relatedArtifact.id	string	0..1
DiagnosticReport.extension:workflow-relatedArtifact.extension	Extension	0..0
DiagnosticReport.extension:workflow-relatedArtifact.url	uri	1..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x]	RelatedArtifact	1..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].id	string	0..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].extension	Extension	0..*
DiagnosticReport.extension:workflow-relatedArtifact.value[x].type	code	1..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].label	string	0..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].display	string	0..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].citation	markdown	0..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].url	url	0..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].document	Attachment	0..1
DiagnosticReport.extension:workflow-relatedArtifact.value[x].resource	canonical(Resource)	0..1
DiagnosticReport.extension:diagnosticReportCompositionR5	Extension	0..*
DiagnosticReport.modifierExtension	Extension	0..*
DiagnosticReport.identifier	Identifier	1..*
DiagnosticReport.identifier:identifierGMSReport	Identifier	0..1
DiagnosticReport.identifier:identifierGMSReport.id	string	0..1
DiagnosticReport.identifier:identifierGMSReport.extension	Extension	0..*
DiagnosticReport.identifier:identifierGMSReport.use	code	0..0
DiagnosticReport.identifier:identifierGMSReport.type	CodeableConcept	0..0
DiagnosticReport.identifier:identifierGMSReport.system	uri	1..1
DiagnosticReport.identifier:identifierGMSReport.value	string	1..1
DiagnosticReport.identifier:identifierGMSReport.period	Period	0..0
DiagnosticReport.identifier:identifierGMSReport.assigner	Reference(Organization)	0..0
DiagnosticReport.identifier:localIdentifier	Identifier	0..*
DiagnosticReport.identifier:localIdentifier.id	string	0..1
DiagnosticReport.identifier:localIdentifier.extension	Extension	0..*
DiagnosticReport.identifier:localIdentifier.use	code	0..1
DiagnosticReport.identifier:localIdentifier.type	CodeableConcept	0..1
DiagnosticReport.identifier:localIdentifier.system	uri	1..1
DiagnosticReport.identifier:localIdentifier.value	string	1..1
DiagnosticReport.identifier:localIdentifier.period	Period	0..1
DiagnosticReport.identifier:localIdentifier.assigner	Reference(Organization)	1..1
DiagnosticReport.identifier:localIdentifier.assigner.id	string	0..1
DiagnosticReport.identifier:localIdentifier.assigner.extension	Extension	0..*
DiagnosticReport.identifier:localIdentifier.assigner.reference	string	0..0
DiagnosticReport.identifier:localIdentifier.assigner.type	uri	0..1
DiagnosticReport.identifier:localIdentifier.assigner.identifier	Identifier	1..1
DiagnosticReport.identifier:localIdentifier.assigner.display	string	0..1
DiagnosticReport.basedOn	Reference(CarePlan \| ImmunizationRecommendation \| MedicationRequest \| NutritionOrder \| ServiceRequest \| NHSEngland_ServiceRequest_Genomics)	0..1
DiagnosticReport.status	code	1..1
DiagnosticReport.category	CodeableConcept	1..*
DiagnosticReport.category:Genetics	CodeableConcept	1..1
DiagnosticReport.category:Genetics.id	string	0..1
DiagnosticReport.category:Genetics.extension	Extension	0..*
DiagnosticReport.category:Genetics.coding	Coding	1..1
DiagnosticReport.category:Genetics.text	string	0..1
DiagnosticReport.category:GeneticsSnomedCT	CodeableConcept	0..*
DiagnosticReport.category:GeneticsSnomedCT.id	string	0..1
DiagnosticReport.category:GeneticsSnomedCT.extension	Extension	0..*
DiagnosticReport.category:GeneticsSnomedCT.coding	Coding	0..*
DiagnosticReport.category:GeneticsSnomedCT.text	string	0..1
DiagnosticReport.code	CodeableConcept	1..1
DiagnosticReport.code.id	string	0..1
DiagnosticReport.code.extension	Extension	0..*
DiagnosticReport.code.coding	Coding	0..*
DiagnosticReport.code.coding:codingSnomedCT	Coding	0..*
DiagnosticReport.code.text	string	0..1
DiagnosticReport.subject	Reference(Device \| Group \| Location \| Patient \| NHSEngland_Patient_Genomics)	1..1
DiagnosticReport.encounter	Reference(Encounter)	0..1
DiagnosticReport.effective[x]	dateTime	0..1
DiagnosticReport.issued	instant	1..1
DiagnosticReport.performer	Reference(CareTeam \| Organization \| Practitioner \| PractitionerRole \| UKCoreOrganization)	0..*
DiagnosticReport.performer.id	string	0..1
DiagnosticReport.performer.extension	Extension	0..*
DiagnosticReport.performer.reference	string	0..0
DiagnosticReport.performer.type	uri	0..1
DiagnosticReport.performer.identifier	Identifier	1..1
DiagnosticReport.performer.identifier.id	string	0..1
DiagnosticReport.performer.identifier.extension	Extension	0..*
DiagnosticReport.performer.identifier.use	code	0..1
DiagnosticReport.performer.identifier.type	CodeableConcept	0..1
DiagnosticReport.performer.identifier.system	uri	0..1
DiagnosticReport.performer.identifier.value	string	0..1
DiagnosticReport.performer.identifier.period	Period	0..1
DiagnosticReport.performer.identifier.assigner	Reference(Organization)	0..1
DiagnosticReport.performer.display	string	0..1
DiagnosticReport.resultsInterpreter	Reference(CareTeam \| Organization \| Practitioner \| PractitionerRole \| NHSEngland_PractitionerRole_Genomics)	0..*
DiagnosticReport.specimen	Reference(Specimen \| NHSEngland_Specimen_Genomics)	1..*
DiagnosticReport.result	Reference(Observation)	0..*
DiagnosticReport.result:diagnostic-implication	Reference(DiagnosticImplication)	0..*
DiagnosticReport.result:therapeutic-implication	Reference(TherapeuticImplication)	0..*
DiagnosticReport.result:molecular-consequence	Reference(MolecularConsequence)	0..*
DiagnosticReport.result:variant	Reference(Variant)	0..*
DiagnosticReport.result:sequence-phase-relation	Reference(SequencePhaseRelationship)	0..*
DiagnosticReport.result:genotype	Reference(Genotype)	0..*
DiagnosticReport.result:haplotype	Reference(Haplotype)	0..*
DiagnosticReport.result:biomarker	Reference(MolecularBiomarker)	0..*
DiagnosticReport.imagingStudy	Reference(ImagingStudy)	0..0
DiagnosticReport.media	BackboneElement	0..*
DiagnosticReport.media.id	string	0..1
DiagnosticReport.media.extension	Extension	0..*
DiagnosticReport.media.modifierExtension	Extension	0..*
DiagnosticReport.media.comment	string	0..1
DiagnosticReport.media.link	Reference(Media)	1..1
DiagnosticReport.media.link.id	string	0..1
DiagnosticReport.media.link.extension	Extension	0..*
DiagnosticReport.media.link.extension:alternateReference	Extension	0..1
DiagnosticReport.media.link.extension:alternateReference.id	string	0..1
DiagnosticReport.media.link.extension:alternateReference.extension	Extension	0..0
DiagnosticReport.media.link.extension:alternateReference.url	uri	1..1
DiagnosticReport.media.link.extension:alternateReference.value[x]	Reference(Resource \| https://fhir.nhs.uk/StructureDefinition/NHSEngland-DocumentReference-Genomics)	1..1
DiagnosticReport.media.link.reference	string	0..1
DiagnosticReport.media.link.type	uri	0..1
DiagnosticReport.media.link.identifier	Identifier	0..1
DiagnosticReport.media.link.display	string	0..1
DiagnosticReport.conclusion	string	0..1
DiagnosticReport.conclusionCode	CodeableConcept	0..*
DiagnosticReport.presentedForm	Attachment	1..*

XML View

<id value="NHSEngland-DiagnosticReport-GenomicReport" />
<url value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-DiagnosticReport-GenomicReport" />
<version value="0.3.0" />
<name value="NHSEngland_DiagnosticReport_GenomicReport" />
<title value="NHSEngland DiagnosticReport GenomicReport" />
<status value="active" />
<date value="2026-04-16" />
<publisher value="NHS England" />
<contact>
<name value="NHS England" />
<telecom>
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="This profile defines the Genomics constraints and extensions on the Genomics Reporting FHIR resource [Genomic Report DiagnosticReport](http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report)." />
<purpose value="DiagnosticReports containing the results of genomic testing are expected to be attached/provided as PDF documents during the alpha phase of the GMS development programme.\n\nIt is expected structured DiagnosticReports will mimic the structure proposed within the HL7 International Genomic Reporting IG.\n\nAdditionally, to support sharing across borders, lab reports MAY additionally be aligned to the HL7 EU Lab Implementation guide. Details of elements of interest for alignment with the EU DiagnosticReport profile are provided below.\n\nGenomic DiagnosticReports which have been updated post submission SHALL be accompanied by Provenance resources, referencing the DiagnosticReport which detail when the resource was changed, who made the change and why.\n\nWhilst unstructured Diagnostic Reports can also be represented by DocumentReference resources, the DiagnosticReport resource is preferred for any documents constituting actual reports, as the resource allows capture of metadata not present in DocumentReference, such as the resultsInterpreter, specimen or conclusion, which would help in searching or for analytics. Use of DocumentReference resources is limited to other data files or documents.\n\nWhere binary data is uploaded to the central server, as in the case of unstructured reports, information cannot be redacted by the central service if a patient is marked as sensitive. It is the responsibility of source systems to redact the necessary information from binary files for sensitive patients before sending this data to the central broker, this includes information such as address and GP details in line with PDS." />
<copyright value="Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="DiagnosticReport" />
<baseDefinition value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report" />
<derivation value="constraint" />
<snapshot>
<element id="DiagnosticReport">
<path value="DiagnosticReport" />
<short value="A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports" />
<definition value="The findings and interpretation of diagnostic  tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports." />
<comment 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="Report" />
<alias value="Test" />
<alias value="Result" />
<alias value="Results" />
<alias value="Labs" />
<alias value="Laboratory" />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport" />
<min value="0" />
<max value="*" />
</base>
<constraint>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-3" />
<severity value="error" />
<human value="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" />
<expression value="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()" />
<xpath value="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 value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="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." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event" />
</mapping>
<mapping>
<identity value="v2" />
<map value="ORU -> OBR" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Observation[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="DiagnosticReport.id">
<path value="DiagnosticReport.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id" />
</extension>
<code value="id" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.meta">
<path value="DiagnosticReport.meta" />
<short value="Metadata about the resource" />
<definition value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Meta" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.implicitRules">
<path value="DiagnosticReport.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="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 value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.language">
<path value="DiagnosticReport.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="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)." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.text">
<path value="DiagnosticReport.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="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." />
<comment value="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." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="DiagnosticReport.contained">
<path value="DiagnosticReport.contained" />
<short value="Contained, inline Resources" />
<definition value="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." />
<comment value="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." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Resource" />
</type>
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension">
<path value="DiagnosticReport.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. 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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:recommended-action">
<path value="DiagnosticReport.extension" />
<sliceName value="recommended-action" />
<short value="Recommended Action" />
<definition value="TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Task resource indicating recommended action to take in response to the report's result/conclusion." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:genomic-risk-assessment">
<path value="DiagnosticReport.extension" />
<sliceName value="genomic-risk-assessment" />
<short value="Genomic Risk Assessment" />
<definition value="RiskAssessment delivered as part of a genomics report or observation" />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-risk-assessment" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:coded-note">
<path value="DiagnosticReport.extension" />
<sliceName value="coded-note" />
<short value="Comments about the report that also contain a coded type" />
<definition value="Adds codified notes to a report to capture additional content" />
<comment value="May include general statements about the report, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.\nThe CodedAnnotation data type, while not allowing for or intending to make the content computable, does allow the author to indicate the type of note. This does not replace the use of results or conclusion or conclusionCode.\nOne important note is that Annotation is a FHIR data type, this is **NOT** about annotations in the genomic context." />
<requirements value="Need to be able to provide free text additional information. Notes SHALL NOT contain information which can be captured in a structured way." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:supporting-info">
<path value="DiagnosticReport.extension" />
<sliceName value="supporting-info" />
<short value="Other information that may be relevant to this event." />
<definition value="TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to the genomic data files analysed as part of the test order, forming the report. Reference to DocumentReference resource which links to the binary data file." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:genomic-study">
<path value="DiagnosticReport.extension" />
<sliceName value="genomic-study" />
<short value="Reference to full details of an genomic study associated with the diagnostic report" />
<definition value="TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Procedure resources indicating the analyses performed as part the genomic test order." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:hla-genotyping-results-allele-database">
<path value="DiagnosticReport.extension" />
<sliceName value="hla-genotyping-results-allele-database" />
<short value="Allele Database" />
<definition value="Allele Database." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:hla-genotyping-results-glstring">
<path value="DiagnosticReport.extension" />
<sliceName value="hla-genotyping-results-glstring" />
<short value="glstring" />
<definition value="glstring." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact">
<path value="DiagnosticReport.extension" />
<sliceName value="workflow-relatedArtifact" />
<short value="Documentation relevant to the 'parent' resource" />
<definition value="TBC. Only relevant for structured genomic reports (included in Genomic Report Profile in the Genomics Report IG). A reference to the guidelines or other knowledge artifacts which were used to guide interpretation or recommended actions included within this DiagnosticReport.\nIf entries constitute published papers, they SHOULD be referenced using a known citation style, e.g. Vancouver/Harvard. Alternatively for online texts, these MAY be referenced via URL only.\n\nA fixed value of 'citation' is expected for the type element, though this recommendation is pending further use cases." />
<comment value="Note that in contrast this extension, the supportingInfo extension references other resources from the patient record that were used in creating the resource." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.id">
<path value="DiagnosticReport.extension.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.extension">
<path value="DiagnosticReport.extension.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="0" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.url">
<path value="DiagnosticReport.extension.url" />
<representation value="xmlAttr" />
<short value="identifies the meaning of the extension" />
<definition value="Source of the definition for the extension code - a logical name or a URL." />
<comment value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<fixedUri value="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x]">
<path value="DiagnosticReport.extension.value[x]" />
<short value="Value of extension" />
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
<min value="1" />
<max value="1" />
<base>
<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="RelatedArtifact" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].id">
<path value="DiagnosticReport.extension.value[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].extension">
<path value="DiagnosticReport.extension.value[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].type">
<path value="DiagnosticReport.extension.value[x].type" />
<short value="documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of" />
<definition value="The type of relationship to the related artifact." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="1" />
<max value="1" />
<base>
<path value="RelatedArtifact.type" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<fixedCode value="citation" />
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="RelatedArtifactType" />
</extension>
<strength value="required" />
<description value="The type of relationship to the related artifact." />
<valueSet value="http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].label">
<path value="DiagnosticReport.extension.value[x].label" />
<short value="Short label" />
<definition value="A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="1" />
<base>
<path value="RelatedArtifact.label" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].display">
<path value="DiagnosticReport.extension.value[x].display" />
<short value="Brief description of the related artifact" />
<definition value="A brief description of the document or knowledge resource being referenced, suitable for display to a consumer." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="1" />
<base>
<path value="RelatedArtifact.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].citation">
<path value="DiagnosticReport.extension.value[x].citation" />
<short value="Bibliographic citation for the artifact" />
<definition value="A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format." />
<comment value="Additional structured information about citations should be captured as extensions." />
<min value="0" />
<max value="1" />
<base>
<path value="RelatedArtifact.citation" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="markdown" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].url">
<path value="DiagnosticReport.extension.value[x].url" />
<short value="Where the artifact can be accessed" />
<definition value="A url for the artifact that can be followed to access the actual content." />
<comment value="If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference)." />
<min value="0" />
<max value="1" />
<base>
<path value="RelatedArtifact.url" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="url" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].document">
<path value="DiagnosticReport.extension.value[x].document" />
<short value="What document is being referenced" />
<definition value="The document being referenced, represented as an attachment. This is exclusive with the resource element." />
<comment value="When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent"." />
<min value="0" />
<max value="1" />
<base>
<path value="RelatedArtifact.document" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Attachment" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="att-1" />
<severity value="error" />
<human value="If the Attachment has data, it SHALL have a contentType" />
<expression value="data.empty() or contentType.exists()" />
<xpath value="not(exists(f:data)) or exists(f:contentType)" />
<source value="http://hl7.org/fhir/StructureDefinition/Attachment" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="ED/RP" />
</mapping>
<mapping>
<identity value="rim" />
<map value="ED" />
</mapping>
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].resource">
<path value="DiagnosticReport.extension.value[x].resource" />
<short value="What resource is being referenced" />
<definition value="The related resource, such as a library, value set, profile, or other knowledge resource." />
<comment value="If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource." />
<min value="0" />
<max value="1" />
<base>
<path value="RelatedArtifact.resource" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="canonical" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.extension:diagnosticReportCompositionR5">
<path value="DiagnosticReport.extension" />
<sliceName value="diagnosticReportCompositionR5" />
<short value="A Composition reference for a DiagnosticReport." />
<definition value="TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: DiagnosticReport Profile). A reference to the Composition which wraps this report for data sharing." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.modifierExtension">
<path value="DiagnosticReport.modifierExtension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Extensions that cannot be ignored" />
<definition value="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)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.identifier">
<path value="DiagnosticReport.identifier" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Business identifier for report" />
<definition value="Identifiers assigned to this report by the performer or other systems." />
<comment value="Usually assigned by the Information System of the diagnostic service provider (filler id)." />
<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" />
<alias value="Filler ID" />
<alias value="Placer ID" />
<min value="1" />
<max value="*" />
<base>
<path value="DiagnosticReport.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="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" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport">
<path value="DiagnosticReport.identifier" />
<sliceName value="identifierGMSReport" />
<short value="Business identifier for report" />
<definition value="Identifiers assigned to this report by the performer or other systems." />
<comment value="Usually assigned by the Information System of the diagnostic service provider (filler id)." />
<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" />
<alias value="Filler ID" />
<alias value="Placer ID" />
<min value="0" />
<max value="1" />
<base>
<path value="DiagnosticReport.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="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" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.id">
<path value="DiagnosticReport.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.extension">
<path value="DiagnosticReport.identifier.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.use">
<path value="DiagnosticReport.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="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="0" />
<max value="0" />
<base>
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.type">
<path value="DiagnosticReport.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="0" />
<base>
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.system">
<path value="DiagnosticReport.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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 value="1" />
<max value="1" />
<base>
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/Id/GMSReport" />
<example>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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 id="DiagnosticReport.identifier:identifierGMSReport.value">
<path value="DiagnosticReport.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](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." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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 id="DiagnosticReport.identifier:identifierGMSReport.period">
<path value="DiagnosticReport.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="0" />
<base>
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.assigner">
<path value="DiagnosticReport.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="0" />
<base>
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier">
<path value="DiagnosticReport.identifier" />
<sliceName value="localIdentifier" />
<short value="Business identifier for report" />
<definition value="Identifiers assigned to this report by the performer or other systems." />
<comment value="Usually assigned by the Information System of the diagnostic service provider (filler id)." />
<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" />
<alias value="Filler ID" />
<alias value="Placer ID" />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="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" />
</mapping>
<mapping>
<identity value="rim" />
<map value="id" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.id">
<path value="DiagnosticReport.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.extension">
<path value="DiagnosticReport.identifier.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.use">
<path value="DiagnosticReport.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="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="0" />
<max value="1" />
<base>
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.type">
<path value="DiagnosticReport.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.system">
<path value="DiagnosticReport.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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 value="1" />
<max value="1" />
<base>
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/local-identifier/diagnosticreport" />
<example>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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 id="DiagnosticReport.identifier:localIdentifier.value">
<path value="DiagnosticReport.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](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." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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 id="DiagnosticReport.identifier:localIdentifier.period">
<path value="DiagnosticReport.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner">
<path value="DiagnosticReport.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.id">
<path value="DiagnosticReport.identifier.assigner.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.extension">
<path value="DiagnosticReport.identifier.assigner.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.reference">
<path value="DiagnosticReport.identifier.assigner.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." />
<min value="0" />
<max value="0" />
<base>
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.type">
<path value="DiagnosticReport.identifier.assigner.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
<comment value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.identifier">
<path value="DiagnosticReport.identifier.assigner.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)." />
<min value="1" />
<max value="1" />
<base>
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Identifier" />
</type>
<fixedIdentifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
</fixedIdentifier>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="DiagnosticReport.identifier.assigner.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.basedOn">
<path value="DiagnosticReport.basedOn" />
<short value="What was requested" />
<definition value="SHOULD reference the originating ServiceRequest if this is an instance of a genomic diagnostic report resulting from a GMS test order." />
<comment 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="This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon." />
<alias value="Request" />
<min value="0" />
<max value="1" />
<base>
<path value="DiagnosticReport.basedOn" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
<aggregation value="referenced" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.basedOn" />
</mapping>
<mapping>
<identity value="v2" />
<map value="ORC? OBR-2/3?" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=FLFS].target" />
</mapping>
</element>
<element id="DiagnosticReport.status">
<path value="DiagnosticReport.status" />
<short value="registered | partial | preliminary | final +" />
<definition value="SHALL use base HL7 codes for DiagnosticReport.status. A DiagnosticReport SHOULD only be marked as final if the report is complete and verified by an authorised person." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports." />
<min value="1" />
<max value="1" />
<base>
<path value="DiagnosticReport.status" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="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 value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DiagnosticReportStatus" />
</extension>
<strength value="required" />
<description value="The status of the diagnostic report." />
<valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.status" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<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 "revise"" />
</mapping>
</element>
<element id="DiagnosticReport.category">
<path value="DiagnosticReport.category" />
<slicing>
<discriminator>
<type value="value" />
<path value="coding" />
</discriminator>
<description value="Slice based on the category code pattern" />
<rules value="open" />
</slicing>
<short value="Service category" />
<definition value="Potentially multiple categories to specify the specialty the report is relevant for. Different codings are expected by the Genomic Report and EU Lab profiles." />
<comment value="Multiple categories are allowed using various categorization schemes.   The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code." />
<alias value="Department" />
<alias value="Sub-department" />
<alias value="Service" />
<alias value="Discipline" />
<min value="1" />
<max value="*" />
<base>
<path value="DiagnosticReport.category" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DiagnosticServiceSection" />
</extension>
<strength value="example" />
<description value="Codes for diagnostic service sections." />
<valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-24" />
</mapping>
<mapping>
<identity value="rim" />
<map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code" />
</mapping>
</element>
<element id="DiagnosticReport.category:Genetics">
<path value="DiagnosticReport.category" />
<sliceName value="Genetics" />
<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." />
<comment value="Multiple categories are allowed using various categorization schemes.   The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code." />
<alias value="Department" />
<alias value="Sub-department" />
<alias value="Service" />
<alias value="Discipline" />
<min value="1" />
<max value="1" />
<base>
<path value="DiagnosticReport.category" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DiagnosticServiceSection" />
</extension>
<strength value="example" />
<description value="Codes for diagnostic service sections." />
<valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-24" />
</mapping>
<mapping>
<identity value="rim" />
<map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code" />
</mapping>
</element>
<element id="DiagnosticReport.category:Genetics.id">
<path value="DiagnosticReport.category.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.category:Genetics.extension">
<path value="DiagnosticReport.category.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.category:Genetics.coding">
<path value="DiagnosticReport.category.coding" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment 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 labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="1" />
<max value="1" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<patternCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074" />
<code value="GE" />
</patternCoding>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<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 id="DiagnosticReport.category:Genetics.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="DiagnosticReport.category.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="DiagnosticReport.category:GeneticsSnomedCT">
<path value="DiagnosticReport.category" />
<sliceName value="GeneticsSnomedCT" />
<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." />
<comment value="Multiple categories are allowed using various categorization schemes.   The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code." />
<alias value="Department" />
<alias value="Sub-department" />
<alias value="Service" />
<alias value="Discipline" />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport.category" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DiagnosticServiceSection" />
</extension>
<strength value="example" />
<description value="Codes for diagnostic service sections." />
<valueSet value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-24" />
</mapping>
<mapping>
<identity value="rim" />
<map value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code" />
</mapping>
</element>
<element id="DiagnosticReport.category:GeneticsSnomedCT.id">
<path value="DiagnosticReport.category.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.category:GeneticsSnomedCT.extension">
<path value="DiagnosticReport.category.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.category:GeneticsSnomedCT.coding">
<path value="DiagnosticReport.category.coding" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment 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 labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<patternCoding>
<system value="http://snomed.info/sct" />
<code value="1236877003" />
<display value="Genetic pathology" />
</patternCoding>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<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 id="DiagnosticReport.category:GeneticsSnomedCT.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="DiagnosticReport.category.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="DiagnosticReport.code">
<path value="DiagnosticReport.code" />
<short value="Name/Code for this diagnostic report" />
<definition value="SHOULD use a record artifact concept from SNOMED CT where an appropriate code exists, else text is preferred to indicate the document type." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<alias value="Type" />
<min value="1" />
<max value="1" />
<base>
<path value="DiagnosticReport.code" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<patternCodeableConcept>
<coding>
<system value="http://loinc.org" />
<code value="51969-4" />
</coding>
</patternCodeableConcept>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DiagnosticReportCodes" />
</extension>
<strength value="preferred" />
<description value="Codes that describe Diagnostic Reports." />
<valueSet value="http://hl7.org/fhir/ValueSet/report-codes" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<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>
</element>
<element id="DiagnosticReport.code.id">
<path value="DiagnosticReport.code.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.code.extension">
<path value="DiagnosticReport.code.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.code.coding">
<path value="DiagnosticReport.code.coding" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="$this" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment 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 labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<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 id="DiagnosticReport.code.coding:codingSnomedCT">
<path value="DiagnosticReport.code.coding" />
<sliceName value="codingSnomedCT" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment 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 labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<base>
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Coding" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<strength value="preferred" />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<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 id="DiagnosticReport.code.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="DiagnosticReport.code.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<base>
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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="text/plain"]/data" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="DiagnosticReport.subject">
<path value="DiagnosticReport.subject" />
<short value="The subject of the report - usually, but not always, the patient" />
<definition value="SHALL be present. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS" />
<comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
<requirements value="SHALL know the subject context." />
<alias value="Patient" />
<min value="1" />
<max value="1" />
<base>
<path value="DiagnosticReport.subject" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" />
<aggregation value="referenced" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.subject" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<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="FiveWs.subject" />
</mapping>
</element>
<element id="DiagnosticReport.encounter">
<path value="DiagnosticReport.encounter" />
<short value="Health care event when test ordered" />
<definition value="The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about." />
<comment value="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)." />
<requirements value="Links the request to the Encounter context." />
<alias value="Context" />
<min value="0" />
<max value="1" />
<base>
<path value="DiagnosticReport.encounter" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.encounter" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.context" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PV1-19" />
</mapping>
<mapping>
<identity value="rim" />
<map value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" />
</mapping>
</element>
<element id="DiagnosticReport.effective[x]">
<path value="DiagnosticReport.effective[x]" />
<short value="Clinically relevant time/time-period for report" />
<definition value="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." />
<comment 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" />
<alias value="Occurrence" />
<min value="0" />
<max value="1" />
<base>
<path value="DiagnosticReport.effective[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value="effectiveTime" />
</mapping>
</element>
<element id="DiagnosticReport.issued">
<path value="DiagnosticReport.issued" />
<short value="DateTime this version was made" />
<definition value="The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified." />
<comment 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 published" />
<alias value="Date Issued" />
<alias value="Date Verified" />
<min value="1" />
<max value="1" />
<base>
<path value="DiagnosticReport.issued" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="instant" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.recorded" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-22" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=VRF or AUT].time" />
</mapping>
</element>
<element id="DiagnosticReport.performer">
<path value="DiagnosticReport.performer" />
<short value="Responsible Diagnostic Service" />
<definition value="SHOULD reference the organization responsible for the testing, preferably by ODS code." />
<comment value="This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report." />
<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" />
<alias value="Authorized by" />
<alias value="Director" />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport.performer" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.performer.actor" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PRT-8 (where this PRT-4-Participation = "PO")" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=PRF]" />
</mapping>
</element>
<element id="DiagnosticReport.performer.id">
<path value="DiagnosticReport.performer.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.performer.extension">
<path value="DiagnosticReport.performer.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.performer.reference">
<path value="DiagnosticReport.performer.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." />
<min value="0" />
<max value="0" />
<base>
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.performer.type">
<path value="DiagnosticReport.performer.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
<comment value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier">
<path value="DiagnosticReport.performer.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)." />
<min value="1" />
<max value="1" />
<base>
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier.id">
<path value="DiagnosticReport.performer.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier.extension">
<path value="DiagnosticReport.performer.identifier.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier.use">
<path value="DiagnosticReport.performer.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="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="0" />
<max value="1" />
<base>
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier.type">
<path value="DiagnosticReport.performer.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier.system">
<path value="DiagnosticReport.performer.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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 value="0" />
<max value="1" />
<base>
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/Id/ods-organisation-code" />
<example>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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 id="DiagnosticReport.performer.identifier.value">
<path value="DiagnosticReport.performer.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](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." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<example>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<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 id="DiagnosticReport.performer.identifier.period">
<path value="DiagnosticReport.performer.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="DiagnosticReport.performer.identifier.assigner">
<path value="DiagnosticReport.performer.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper" />
</mapping>
<mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="DiagnosticReport.performer.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="DiagnosticReport.performer.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.resultsInterpreter">
<path value="DiagnosticReport.resultsInterpreter" />
<short value="Primary result interpreter" />
<definition value="SHOULD reference the person responsible for interpreting the raw results, preferably by a recognised NHS identifier, such as SDS code." />
<comment value="Might not be the same 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="Analyzed by" />
<alias value="Reported by" />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport.resultsInterpreter" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.performer.actor" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-32, PRT-8 (where this PRT-4-Participation = "PI")" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=PRF]" />
</mapping>
</element>
<element id="DiagnosticReport.specimen">
<path value="DiagnosticReport.specimen" />
<short value="Specimens this report is based on" />
<definition value="SHOULD reference the specimen used during testing to generate the report, if the document is a Genomic report." />
<comment value="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." />
<requirements value="Need to be able to report information about the collected specimens on which the report is based." />
<min value="1" />
<max value="*" />
<base>
<path value="DiagnosticReport.specimen" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" />
<aggregation value="referenced" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="SPM" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=SBJ]" />
</mapping>
</element>
<element id="DiagnosticReport.result">
<path value="DiagnosticReport.result" />
<slicing>
<discriminator>
<type value="profile" />
<path value="resolve()" />
</discriminator>
<description value="Slice based on the reference profile and code pattern" />
<rules value="open" />
</slicing>
<short value="Observations" />
<definition value="Raw results included within the report, to aid interpretation. These SHOULD take the form of Observation references, if providing a structured report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:diagnostic-implication">
<path value="DiagnosticReport.result" />
<sliceName value="diagnostic-implication" />
<short value="Diagnostic Implication" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:therapeutic-implication">
<path value="DiagnosticReport.result" />
<sliceName value="therapeutic-implication" />
<short value="Therapeutic Implication" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:molecular-consequence">
<path value="DiagnosticReport.result" />
<sliceName value="molecular-consequence" />
<short value="Molecular Consequence" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-consequence" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:variant">
<path value="DiagnosticReport.result" />
<sliceName value="variant" />
<short value="Variant" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:sequence-phase-relation">
<path value="DiagnosticReport.result" />
<sliceName value="sequence-phase-relation" />
<short value="Sequence Phase Relationship" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/sequence-phase-relationship" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:genotype">
<path value="DiagnosticReport.result" />
<sliceName value="genotype" />
<short value="Genotype" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genotype" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:haplotype">
<path value="DiagnosticReport.result" />
<sliceName value="haplotype" />
<short value="Haplotype" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/haplotype" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.result:biomarker">
<path value="DiagnosticReport.result" />
<sliceName value="biomarker" />
<short value="MolecularBiomarker" />
<definition value="[Observations](observation.html)  that are part of this diagnostic report." />
<comment value="Observations can contain observations." />
<requirements value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful." />
<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="*" />
<base>
<path value="DiagnosticReport.result" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-biomarker" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBXs" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.imagingStudy">
<path value="DiagnosticReport.imagingStudy" />
<short value="Reference to full details of imaging associated with the diagnostic report" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="0" />
<base>
<path value="DiagnosticReport.imagingStudy" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ImagingStudy" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]" />
</mapping>
</element>
<element id="DiagnosticReport.media">
<path value="DiagnosticReport.media" />
<short value="Key images associated with this report" />
<definition value="TBC. Only relevant for structured genomic reports. Uses the extension:alternate-reference extension to reference DocumentReference resources pointing to the Genomic Data Files used as the basis for the report. Usage of this field over extension:supporting-info is pending further investigation." />
<requirements value="Many diagnostic services include images in the report as part of their service." />
<alias value="DICOM" />
<alias value="Slides" />
<alias value="Scans" />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport.media" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX?" />
</mapping>
<mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
</element>
<element id="DiagnosticReport.media.id">
<path value="DiagnosticReport.media.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.media.extension">
<path value="DiagnosticReport.media.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.modifierExtension">
<path value="DiagnosticReport.media.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="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)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.comment">
<path value="DiagnosticReport.media.comment" />
<short value="Comment about the image (e.g. explanation)" />
<definition value="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." />
<comment value="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." />
<requirements value="The provider of the report should make a comment about each image included in the report." />
<min value="0" />
<max value="1" />
<base>
<path value="DiagnosticReport.media.comment" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value" />
</mapping>
</element>
<element id="DiagnosticReport.media.link">
<path value="DiagnosticReport.media.link" />
<short value="Reference to the image source" />
<definition value="Reference to the image source." />
<comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
<min value="1" />
<max value="1" />
<base>
<path value="DiagnosticReport.media.link" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Media" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".value.reference" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.id">
<path value="DiagnosticReport.media.link.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.extension">
<path value="DiagnosticReport.media.link.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference">
<path value="DiagnosticReport.media.link.extension" />
<sliceName value="alternateReference" />
<short value="Alternative reference (target type is wrong)" />
<definition value="Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions." />
<comment value="Given that a reference SHALL have a display or reference, using this extension implies that there's a display present." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/alternate-reference" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference.id">
<path value="DiagnosticReport.media.link.extension.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference.extension">
<path value="DiagnosticReport.media.link.extension.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="0" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference.url">
<path value="DiagnosticReport.media.link.extension.url" />
<representation value="xmlAttr" />
<short value="identifies the meaning of the extension" />
<definition value="Source of the definition for the extension code - a logical name or a URL." />
<comment value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<fixedUri value="http://hl7.org/fhir/StructureDefinition/alternate-reference" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference.value[x]">
<path value="DiagnosticReport.media.link.extension.value[x]" />
<short value="Value of extension" />
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
<min value="1" />
<max value="1" />
<base>
<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-DocumentReference-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.reference">
<path value="DiagnosticReport.media.link.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.type">
<path value="DiagnosticReport.media.link.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
<comment value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.identifier">
<path value="DiagnosticReport.media.link.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="DiagnosticReport.media.link.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="DiagnosticReport.media.link.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it." />
<min value="0" />
<max value="1" />
<base>
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="DiagnosticReport.conclusion">
<path value="DiagnosticReport.conclusion" />
<short value="Assessment of overall results" />
<definition value="Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<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" />
<base>
<path value="DiagnosticReport.conclusion" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="string" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX" />
</mapping>
<mapping>
<identity value="rim" />
<map value="inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)" />
</mapping>
</element>
<element id="DiagnosticReport.conclusionCode">
<path value="DiagnosticReport.conclusionCode" />
<short value="Coarse overall interpretation of the genomic results" />
<definition value="If possible, unstructured reports wrapped within DiagnosticReports, SHOULD contain a conclusionCode element indicating the coded finding from the report, to aid analytics." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<min value="0" />
<max value="*" />
<base>
<path value="DiagnosticReport.conclusionCode" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="AdjunctDiagnosis" />
</extension>
<strength value="example" />
<description value="Diagnosis codes provided as adjuncts to the report." />
<valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<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 id="DiagnosticReport.presentedForm">
<path value="DiagnosticReport.presentedForm" />
<short value="Entire report as issued" />
<definition value="Genomic reports SHALL include a presentedForm element either referencing the location of the PDF report (located and accessible on either the source/client system or via NRL using appropriate authentication) or include the PDF report as a base64 encoded attachment within the message payload.\nNote: this guidance may change in the future as work on Structured Reporting matures" />
<comment value=""application/pdf" 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="1" />
<max value="*" />
<base>
<path value="DiagnosticReport.presentedForm" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Attachment" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="att-1" />
<severity value="error" />
<human value="If the Attachment has data, it SHALL have a contentType" />
<expression value="data.empty() or contentType.exists()" />
<xpath value="not(exists(f:data)) or exists(f:contentType)" />
<source value="http://hl7.org/fhir/StructureDefinition/Attachment" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="ED/RP" />
</mapping>
<mapping>
<identity value="rim" />
<map value="ED" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX" />
</mapping>
<mapping>
<identity value="rim" />
<map value="text (type=ED)" />
</mapping>
</element>
</snapshot>
<differential>
<element id="DiagnosticReport.extension:recommended-action">
<path value="DiagnosticReport.extension" />
<sliceName value="recommended-action" />
<definition value="TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Task resource indicating recommended action to take in response to the report's result/conclusion." />
</element>
<element id="DiagnosticReport.extension:supporting-info">
<path value="DiagnosticReport.extension" />
<sliceName value="supporting-info" />
<definition value="TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to the genomic data files analysed as part of the test order, forming the report. Reference to DocumentReference resource which links to the binary data file." />
</element>
<element id="DiagnosticReport.extension:genomic-study">
<path value="DiagnosticReport.extension" />
<sliceName value="genomic-study" />
<definition value="TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Procedure resources indicating the analyses performed as part the genomic test order." />
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact">
<path value="DiagnosticReport.extension" />
<sliceName value="workflow-relatedArtifact" />
<definition value="TBC. Only relevant for structured genomic reports (included in Genomic Report Profile in the Genomics Report IG). A reference to the guidelines or other knowledge artifacts which were used to guide interpretation or recommended actions included within this DiagnosticReport.\nIf entries constitute published papers, they SHOULD be referenced using a known citation style, e.g. Vancouver/Harvard. Alternatively for online texts, these MAY be referenced via URL only.\n\nA fixed value of 'citation' is expected for the type element, though this recommendation is pending further use cases." />
</element>
<element id="DiagnosticReport.extension:workflow-relatedArtifact.value[x].type">
<path value="DiagnosticReport.extension.value[x].type" />
<fixedCode value="citation" />
</element>
<element id="DiagnosticReport.extension:diagnosticReportCompositionR5">
<path value="DiagnosticReport.extension" />
<sliceName value="diagnosticReportCompositionR5" />
<definition value="TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: DiagnosticReport Profile). A reference to the Composition which wraps this report for data sharing." />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition" />
</type>
<isModifier value="false" />
</element>
<element id="DiagnosticReport.identifier">
<path value="DiagnosticReport.identifier" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<min value="1" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport">
<path value="DiagnosticReport.identifier" />
<sliceName value="identifierGMSReport" />
<max value="1" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.use">
<path value="DiagnosticReport.identifier.use" />
<max value="0" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.type">
<path value="DiagnosticReport.identifier.type" />
<max value="0" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.system">
<path value="DiagnosticReport.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/Id/GMSReport" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.value">
<path value="DiagnosticReport.identifier.value" />
<min value="1" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.period">
<path value="DiagnosticReport.identifier.period" />
<max value="0" />
</element>
<element id="DiagnosticReport.identifier:identifierGMSReport.assigner">
<path value="DiagnosticReport.identifier.assigner" />
<max value="0" />
</element>
<element id="DiagnosticReport.identifier:localIdentifier">
<path value="DiagnosticReport.identifier" />
<sliceName value="localIdentifier" />
</element>
<element id="DiagnosticReport.identifier:localIdentifier.system">
<path value="DiagnosticReport.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/local-identifier/diagnosticreport" />
</element>
<element id="DiagnosticReport.identifier:localIdentifier.value">
<path value="DiagnosticReport.identifier.value" />
<min value="1" />
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner">
<path value="DiagnosticReport.identifier.assigner" />
<min value="1" />
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.reference">
<path value="DiagnosticReport.identifier.assigner.reference" />
<max value="0" />
</element>
<element id="DiagnosticReport.identifier:localIdentifier.assigner.identifier">
<path value="DiagnosticReport.identifier.assigner.identifier" />
<min value="1" />
<fixedIdentifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
</fixedIdentifier>
</element>
<element id="DiagnosticReport.basedOn">
<path value="DiagnosticReport.basedOn" />
<definition value="SHOULD reference the originating ServiceRequest if this is an instance of a genomic diagnostic report resulting from a GMS test order." />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
<aggregation value="referenced" />
</type>
</element>
<element id="DiagnosticReport.status">
<path value="DiagnosticReport.status" />
<definition value="SHALL use base HL7 codes for DiagnosticReport.status. A DiagnosticReport SHOULD only be marked as final if the report is complete and verified by an authorised person." />
</element>
<element id="DiagnosticReport.category">
<path value="DiagnosticReport.category" />
<definition value="Potentially multiple categories to specify the specialty the report is relevant for. Different codings are expected by the Genomic Report and EU Lab profiles." />
</element>
<element id="DiagnosticReport.category:GeneticsSnomedCT">
<path value="DiagnosticReport.category" />
<sliceName value="GeneticsSnomedCT" />
</element>
<element id="DiagnosticReport.category:GeneticsSnomedCT.coding">
<path value="DiagnosticReport.category.coding" />
<patternCoding>
<system value="http://snomed.info/sct" />
<code value="1236877003" />
<display value="Genetic pathology" />
</patternCoding>
</element>
<element id="DiagnosticReport.code">
<path value="DiagnosticReport.code" />
<definition value="SHOULD use a record artifact concept from SNOMED CT where an appropriate code exists, else text is preferred to indicate the document type." />
</element>
<element id="DiagnosticReport.code.coding">
<path value="DiagnosticReport.code.coding" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="$this" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="DiagnosticReport.code.coding:codingSnomedCT">
<path value="DiagnosticReport.code.coding" />
<sliceName value="codingSnomedCT" />
<binding>
<strength value="preferred" />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode" />
</binding>
</element>
<element id="DiagnosticReport.subject">
<path value="DiagnosticReport.subject" />
<definition value="SHALL be present. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS" />
<min value="1" />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" />
<aggregation value="referenced" />
</type>
</element>
<element id="DiagnosticReport.issued">
<path value="DiagnosticReport.issued" />
<min value="1" />
</element>
<element id="DiagnosticReport.performer">
<path value="DiagnosticReport.performer" />
<definition value="SHOULD reference the organization responsible for the testing, preferably by ODS code." />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="DiagnosticReport.performer.reference">
<path value="DiagnosticReport.performer.reference" />
<max value="0" />
</element>
<element id="DiagnosticReport.performer.identifier">
<path value="DiagnosticReport.performer.identifier" />
<min value="1" />
</element>
<element id="DiagnosticReport.performer.identifier.system">
<path value="DiagnosticReport.performer.identifier.system" />
<fixedUri value="https://fhir.nhs.uk/Id/ods-organisation-code" />
</element>
<element id="DiagnosticReport.resultsInterpreter">
<path value="DiagnosticReport.resultsInterpreter" />
<definition value="SHOULD reference the person responsible for interpreting the raw results, preferably by a recognised NHS identifier, such as SDS code." />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="DiagnosticReport.specimen">
<path value="DiagnosticReport.specimen" />
<definition value="SHOULD reference the specimen used during testing to generate the report, if the document is a Genomic report." />
<min value="1" />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" />
<aggregation value="referenced" />
</type>
</element>
<element id="DiagnosticReport.result">
<path value="DiagnosticReport.result" />
<definition value="Raw results included within the report, to aid interpretation. These SHOULD take the form of Observation references, if providing a structured report." />
</element>
<element id="DiagnosticReport.imagingStudy">
<path value="DiagnosticReport.imagingStudy" />
<max value="0" />
</element>
<element id="DiagnosticReport.media">
<path value="DiagnosticReport.media" />
<definition value="TBC. Only relevant for structured genomic reports. Uses the extension:alternate-reference extension to reference DocumentReference resources pointing to the Genomic Data Files used as the basis for the report. Usage of this field over extension:supporting-info is pending further investigation." />
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference">
<path value="DiagnosticReport.media.link.extension" />
<sliceName value="alternateReference" />
<type>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/alternate-reference" />
</type>
<isModifier value="false" />
</element>
<element id="DiagnosticReport.media.link.extension:alternateReference.value[x]">
<path value="DiagnosticReport.media.link.extension.value[x]" />
<type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-DocumentReference-Genomics" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="DiagnosticReport.conclusionCode">
<path value="DiagnosticReport.conclusionCode" />
<definition value="If possible, unstructured reports wrapped within DiagnosticReports, SHOULD contain a conclusionCode element indicating the coded finding from the report, to aid analytics." />
</element>
<element id="DiagnosticReport.presentedForm">
<path value="DiagnosticReport.presentedForm" />
<definition value="Genomic reports SHALL include a presentedForm element either referencing the location of the PDF report (located and accessible on either the source/client system or via NRL using appropriate authentication) or include the PDF report as a base64 encoded attachment within the message payload.\nNote: this guidance may change in the future as work on Structured Reporting matures" />
<min value="1" />
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "NHSEngland-DiagnosticReport-GenomicReport",
"url": "https://fhir.nhs.uk/StructureDefinition/NHSEngland-DiagnosticReport-GenomicReport",
"version": "0.3.0",
"name": "NHSEngland_DiagnosticReport_GenomicReport",
"title": "NHSEngland DiagnosticReport GenomicReport",
"status": "active",
"date": "2026-04-16",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work",
"rank": 1
}
]
}
],
"description": "This profile defines the Genomics constraints and extensions on the Genomics Reporting FHIR resource [Genomic Report DiagnosticReport](http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report).",
"purpose": "DiagnosticReports containing the results of genomic testing are expected to be attached/provided as PDF documents during the alpha phase of the GMS development programme.\n\nIt is expected structured DiagnosticReports will mimic the structure proposed within the HL7 International Genomic Reporting IG.\n\nAdditionally, to support sharing across borders, lab reports MAY additionally be aligned to the HL7 EU Lab Implementation guide. Details of elements of interest for alignment with the EU DiagnosticReport profile are provided below.\n\nGenomic DiagnosticReports which have been updated post submission SHALL be accompanied by Provenance resources, referencing the DiagnosticReport which detail when the resource was changed, who made the change and why.\n\nWhilst unstructured Diagnostic Reports can also be represented by DocumentReference resources, the DiagnosticReport resource is preferred for any documents constituting actual reports, as the resource allows capture of metadata not present in DocumentReference, such as the resultsInterpreter, specimen or conclusion, which would help in searching or for analytics. Use of DocumentReference resources is limited to other data files or documents.\n\nWhere binary data is uploaded to the central server, as in the case of unstructured reports, information cannot be redacted by the central service if a patient is marked as sensitive. It is the responsibility of source systems to redact the necessary information from binary files for sensitive patients before sending this data to the central broker, this includes information such as address and GP details in line with PDS.",
"copyright": "Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\\\\\"License\\\\\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\\\\\"AS IS\\\\\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "DiagnosticReport",
"baseDefinition": "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "DiagnosticReport",
"path": "DiagnosticReport",
"short": "A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports",
"definition": "The findings and interpretation of diagnostic  tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.",
"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.",
"alias": [
"Report",
"Test",
"Result",
"Results",
"Labs",
"Laboratory"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"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"
},
{
"key": "dom-3",
"severity": "error",
"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",
"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()",
"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"
},
{
"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."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "v2",
"map": "ORU -> OBR"
},
{
"identity": "rim",
"map": "Observation[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "DiagnosticReport.id",
"path": "DiagnosticReport.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
}
],
"code": "id"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.meta",
"path": "DiagnosticReport.meta",
"short": "Metadata about the resource",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.implicitRules",
"path": "DiagnosticReport.implicitRules",
"short": "A set of rules under which this content was created",
"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.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"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,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.language",
"path": "DiagnosticReport.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"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).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"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"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.text",
"path": "DiagnosticReport.text",
"short": "Text summary of the resource, for human interpretation",
"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.",
"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.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "DiagnosticReport.contained",
"path": "DiagnosticReport.contained",
"short": "Contained, inline Resources",
"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.",
"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.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension",
"path": "DiagnosticReport.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. 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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:recommended-action",
"path": "DiagnosticReport.extension",
"sliceName": "recommended-action",
"short": "Recommended Action",
"definition": "TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Task resource indicating recommended action to take in response to the report's result/conclusion.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:genomic-risk-assessment",
"path": "DiagnosticReport.extension",
"sliceName": "genomic-risk-assessment",
"short": "Genomic Risk Assessment",
"definition": "RiskAssessment delivered as part of a genomics report or observation",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-risk-assessment"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:coded-note",
"path": "DiagnosticReport.extension",
"sliceName": "coded-note",
"short": "Comments about the report that also contain a coded type",
"definition": "Adds codified notes to a report to capture additional content",
"comment": "May include general statements about the report, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.\nThe CodedAnnotation data type, while not allowing for or intending to make the content computable, does allow the author to indicate the type of note. This does not replace the use of results or conclusion or conclusionCode.\nOne important note is that Annotation is a FHIR data type, this is **NOT** about annotations in the genomic context.",
"requirements": "Need to be able to provide free text additional information. Notes SHALL NOT contain information which can be captured in a structured way.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:supporting-info",
"path": "DiagnosticReport.extension",
"sliceName": "supporting-info",
"short": "Other information that may be relevant to this event.",
"definition": "TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to the genomic data files analysed as part of the test order, forming the report. Reference to DocumentReference resource which links to the binary data file.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:genomic-study",
"path": "DiagnosticReport.extension",
"sliceName": "genomic-study",
"short": "Reference to full details of an genomic study associated with the diagnostic report",
"definition": "TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Procedure resources indicating the analyses performed as part the genomic test order.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:hla-genotyping-results-allele-database",
"path": "DiagnosticReport.extension",
"sliceName": "hla-genotyping-results-allele-database",
"short": "Allele Database",
"definition": "Allele Database.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:hla-genotyping-results-glstring",
"path": "DiagnosticReport.extension",
"sliceName": "hla-genotyping-results-glstring",
"short": "glstring",
"definition": "glstring.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact",
"path": "DiagnosticReport.extension",
"sliceName": "workflow-relatedArtifact",
"short": "Documentation relevant to the 'parent' resource",
"definition": "TBC. Only relevant for structured genomic reports (included in Genomic Report Profile in the Genomics Report IG). A reference to the guidelines or other knowledge artifacts which were used to guide interpretation or recommended actions included within this DiagnosticReport.\nIf entries constitute published papers, they SHOULD be referenced using a known citation style, e.g. Vancouver/Harvard. Alternatively for online texts, these MAY be referenced via URL only.\n\nA fixed value of 'citation' is expected for the type element, though this recommendation is pending further use cases.",
"comment": "Note that in contrast this extension, the supportingInfo extension references other resources from the patient record that were used in creating the resource.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.id",
"path": "DiagnosticReport.extension.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.extension",
"path": "DiagnosticReport.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "0",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.url",
"path": "DiagnosticReport.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a 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.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x]",
"path": "DiagnosticReport.extension.value[x]",
"short": "Value of extension",
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "RelatedArtifact"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].id",
"path": "DiagnosticReport.extension.value[x].id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].extension",
"path": "DiagnosticReport.extension.value[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].type",
"path": "DiagnosticReport.extension.value[x].type",
"short": "documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of",
"definition": "The type of relationship to the related artifact.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 1,
"max": "1",
"base": {
"path": "RelatedArtifact.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"fixedCode": "citation",
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RelatedArtifactType"
}
],
"strength": "required",
"description": "The type of relationship to the related artifact.",
"valueSet": "http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].label",
"path": "DiagnosticReport.extension.value[x].label",
"short": "Short label",
"definition": "A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "1",
"base": {
"path": "RelatedArtifact.label",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].display",
"path": "DiagnosticReport.extension.value[x].display",
"short": "Brief description of the related artifact",
"definition": "A brief description of the document or knowledge resource being referenced, suitable for display to a consumer.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "1",
"base": {
"path": "RelatedArtifact.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].citation",
"path": "DiagnosticReport.extension.value[x].citation",
"short": "Bibliographic citation for the artifact",
"definition": "A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format.",
"comment": "Additional structured information about citations should be captured as extensions.",
"min": 0,
"max": "1",
"base": {
"path": "RelatedArtifact.citation",
"min": 0,
"max": "1"
},
"type": [
{
"code": "markdown"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].url",
"path": "DiagnosticReport.extension.value[x].url",
"short": "Where the artifact can be accessed",
"definition": "A url for the artifact that can be followed to access the actual content.",
"comment": "If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference).",
"min": 0,
"max": "1",
"base": {
"path": "RelatedArtifact.url",
"min": 0,
"max": "1"
},
"type": [
{
"code": "url"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].document",
"path": "DiagnosticReport.extension.value[x].document",
"short": "What document is being referenced",
"definition": "The document being referenced, represented as an attachment. This is exclusive with the resource element.",
"comment": "When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as \"Signed Procedure Consent\".",
"min": 0,
"max": "1",
"base": {
"path": "RelatedArtifact.document",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Attachment"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "att-1",
"severity": "error",
"human": "If the Attachment has data, it SHALL have a contentType",
"expression": "data.empty() or contentType.exists()",
"xpath": "not(exists(f:data)) or exists(f:contentType)",
"source": "http://hl7.org/fhir/StructureDefinition/Attachment"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "ED/RP"
},
{
"identity": "rim",
"map": "ED"
}
]
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].resource",
"path": "DiagnosticReport.extension.value[x].resource",
"short": "What resource is being referenced",
"definition": "The related resource, such as a library, value set, profile, or other knowledge resource.",
"comment": "If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource.",
"min": 0,
"max": "1",
"base": {
"path": "RelatedArtifact.resource",
"min": 0,
"max": "1"
},
"type": [
{
"code": "canonical",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.extension:diagnosticReportCompositionR5",
"path": "DiagnosticReport.extension",
"sliceName": "diagnosticReportCompositionR5",
"short": "A Composition reference for a DiagnosticReport.",
"definition": "TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: DiagnosticReport Profile). A reference to the Composition which wraps this report for data sharing.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.modifierExtension",
"path": "DiagnosticReport.modifierExtension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extensions that cannot be ignored",
"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).",
"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.",
"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](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier",
"path": "DiagnosticReport.identifier",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"short": "Business identifier for report",
"definition": "Identifiers assigned to this report by the performer or other systems.",
"comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
"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.",
"alias": [
"ReportID",
"Filler ID",
"Placer ID"
],
"min": 1,
"max": "*",
"base": {
"path": "DiagnosticReport.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"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": "rim",
"map": "id"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport",
"path": "DiagnosticReport.identifier",
"sliceName": "identifierGMSReport",
"short": "Business identifier for report",
"definition": "Identifiers assigned to this report by the performer or other systems.",
"comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
"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.",
"alias": [
"ReportID",
"Filler ID",
"Placer ID"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"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": "rim",
"map": "id"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.id",
"path": "DiagnosticReport.identifier.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.extension",
"path": "DiagnosticReport.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.use",
"path": "DiagnosticReport.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.type",
"path": "DiagnosticReport.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.system",
"path": "DiagnosticReport.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"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,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/Id/GMSReport",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.value",
"path": "DiagnosticReport.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"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](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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.period",
"path": "DiagnosticReport.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.assigner",
"path": "DiagnosticReport.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"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.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier",
"path": "DiagnosticReport.identifier",
"sliceName": "localIdentifier",
"short": "Business identifier for report",
"definition": "Identifiers assigned to this report by the performer or other systems.",
"comment": "Usually assigned by the Information System of the diagnostic service provider (filler id).",
"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.",
"alias": [
"ReportID",
"Filler ID",
"Placer ID"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"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": "rim",
"map": "id"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.id",
"path": "DiagnosticReport.identifier.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.extension",
"path": "DiagnosticReport.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.use",
"path": "DiagnosticReport.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.type",
"path": "DiagnosticReport.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.system",
"path": "DiagnosticReport.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"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,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/local-identifier/diagnosticreport",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.value",
"path": "DiagnosticReport.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"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](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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.period",
"path": "DiagnosticReport.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner",
"path": "DiagnosticReport.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.id",
"path": "DiagnosticReport.identifier.assigner.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.extension",
"path": "DiagnosticReport.identifier.assigner.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.reference",
"path": "DiagnosticReport.identifier.assigner.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "0",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1",
"ref-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.type",
"path": "DiagnosticReport.identifier.assigner.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.identifier",
"path": "DiagnosticReport.identifier.assigner.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"min": 1,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"fixedIdentifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code"
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "DiagnosticReport.identifier.assigner.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.basedOn",
"path": "DiagnosticReport.basedOn",
"short": "What was requested",
"definition": "SHOULD reference the originating ServiceRequest if this is an instance of a genomic diagnostic report resulting from a GMS test order.",
"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.",
"requirements": "This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.",
"alias": [
"Request"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.basedOn",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics",
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"http://hl7.org/fhir/StructureDefinition/NutritionOrder",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest"
],
"aggregation": [
"referenced"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.basedOn"
},
{
"identity": "v2",
"map": "ORC? OBR-2/3?"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=FLFS].target"
}
]
},
{
"id": "DiagnosticReport.status",
"path": "DiagnosticReport.status",
"short": "registered | partial | preliminary | final +",
"definition": "SHALL use base HL7 codes for DiagnosticReport.status. A DiagnosticReport SHOULD only be marked as final if the report is complete and verified by an authorised person.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.",
"min": 1,
"max": "1",
"base": {
"path": "DiagnosticReport.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"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,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticReportStatus"
}
],
"strength": "required",
"description": "The status of the diagnostic report.",
"valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "v2",
"map": "OBR-25 (not 1:1 mapping)"
},
{
"identity": "rim",
"map": "statusCode  Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type \"revise\""
}
]
},
{
"id": "DiagnosticReport.category",
"path": "DiagnosticReport.category",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "coding"
}
],
"description": "Slice based on the category code pattern",
"rules": "open"
},
"short": "Service category",
"definition": "Potentially multiple categories to specify the specialty the report is relevant for. Different codings are expected by the Genomic Report and EU Lab profiles.",
"comment": "Multiple categories are allowed using various categorization schemes.   The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
"alias": [
"Department",
"Sub-department",
"Service",
"Discipline"
],
"min": 1,
"max": "*",
"base": {
"path": "DiagnosticReport.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticServiceSection"
}
],
"strength": "example",
"description": "Codes for diagnostic service sections.",
"valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-service-sections"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "OBR-24"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code"
}
]
},
{
"id": "DiagnosticReport.category:Genetics",
"path": "DiagnosticReport.category",
"sliceName": "Genetics",
"short": "Service category",
"definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
"comment": "Multiple categories are allowed using various categorization schemes.   The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
"alias": [
"Department",
"Sub-department",
"Service",
"Discipline"
],
"min": 1,
"max": "1",
"base": {
"path": "DiagnosticReport.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticServiceSection"
}
],
"strength": "example",
"description": "Codes for diagnostic service sections.",
"valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-service-sections"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "OBR-24"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code"
}
]
},
{
"id": "DiagnosticReport.category:Genetics.id",
"path": "DiagnosticReport.category.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.category:Genetics.extension",
"path": "DiagnosticReport.category.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.category:Genetics.coding",
"path": "DiagnosticReport.category.coding",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "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 labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 1,
"max": "1",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"patternCoding": {
"system": "http://terminology.hl7.org/CodeSystem/v2-0074",
"code": "GE"
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "DiagnosticReport.category:Genetics.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "DiagnosticReport.category.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT",
"path": "DiagnosticReport.category",
"sliceName": "GeneticsSnomedCT",
"short": "Service category",
"definition": "A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.",
"comment": "Multiple categories are allowed using various categorization schemes.   The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.",
"alias": [
"Department",
"Sub-department",
"Service",
"Discipline"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticServiceSection"
}
],
"strength": "example",
"description": "Codes for diagnostic service sections.",
"valueSet": "http://hl7.org/fhir/ValueSet/diagnostic-service-sections"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "OBR-24"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code"
}
]
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT.id",
"path": "DiagnosticReport.category.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT.extension",
"path": "DiagnosticReport.category.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT.coding",
"path": "DiagnosticReport.category.coding",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "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 labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"patternCoding": {
"system": "http://snomed.info/sct",
"code": "1236877003",
"display": "Genetic pathology"
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "DiagnosticReport.category.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "DiagnosticReport.code",
"path": "DiagnosticReport.code",
"short": "Name/Code for this diagnostic report",
"definition": "SHOULD use a record artifact concept from SNOMED CT where an appropriate code exists, else text is preferred to indicate the document type.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"alias": [
"Type"
],
"min": 1,
"max": "1",
"base": {
"path": "DiagnosticReport.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"patternCodeableConcept": {
"coding": [
{
"system": "http://loinc.org",
"code": "51969-4"
}
]
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DiagnosticReportCodes"
}
],
"strength": "preferred",
"description": "Codes that describe Diagnostic Reports.",
"valueSet": "http://hl7.org/fhir/ValueSet/report-codes"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"
},
{
"identity": "rim",
"map": "code"
}
]
},
{
"id": "DiagnosticReport.code.id",
"path": "DiagnosticReport.code.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.code.extension",
"path": "DiagnosticReport.code.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.code.coding",
"path": "DiagnosticReport.code.coding",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "$this"
}
],
"rules": "open"
},
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "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 labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "DiagnosticReport.code.coding:codingSnomedCT",
"path": "DiagnosticReport.code.coding",
"sliceName": "codingSnomedCT",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "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 labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "DiagnosticReport.code.text",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "DiagnosticReport.code.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "DiagnosticReport.subject",
"path": "DiagnosticReport.subject",
"short": "The subject of the report - usually, but not always, the patient",
"definition": "SHALL be present. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS",
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"requirements": "SHALL know the subject context.",
"alias": [
"Patient"
],
"min": 1,
"max": "1",
"base": {
"path": "DiagnosticReport.subject",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Location"
],
"aggregation": [
"referenced"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3 (no HL7 v2 mapping for Group or Device)"
},
{
"identity": "rim",
"map": "participation[typeCode=SBJ]"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "DiagnosticReport.encounter",
"path": "DiagnosticReport.encounter",
"short": "Health care event when test ordered",
"definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.",
"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).",
"requirements": "Links the request to the Encounter context.",
"alias": [
"Context"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.encounter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.encounter"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "v2",
"map": "PV1-19"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
}
]
},
{
"id": "DiagnosticReport.effective[x]",
"path": "DiagnosticReport.effective[x]",
"short": "Clinically relevant time/time-period for report",
"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.",
"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.",
"requirements": "Need to know where in the patient history to file/present this report.",
"alias": [
"Observation time",
"Effective Time",
"Occurrence"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.effective[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "v2",
"map": "OBR-7"
},
{
"identity": "rim",
"map": "effectiveTime"
}
]
},
{
"id": "DiagnosticReport.issued",
"path": "DiagnosticReport.issued",
"short": "DateTime this version was made",
"definition": "The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.",
"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.",
"requirements": "Clinicians need to be able to check the date that the report was released.",
"alias": [
"Date published",
"Date Issued",
"Date Verified"
],
"min": 1,
"max": "1",
"base": {
"path": "DiagnosticReport.issued",
"min": 0,
"max": "1"
},
"type": [
{
"code": "instant"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.recorded"
},
{
"identity": "v2",
"map": "OBR-22"
},
{
"identity": "rim",
"map": "participation[typeCode=VRF or AUT].time"
}
]
},
{
"id": "DiagnosticReport.performer",
"path": "DiagnosticReport.performer",
"short": "Responsible Diagnostic Service",
"definition": "SHOULD reference the organization responsible for the testing, preferably by ODS code.",
"comment": "This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report.",
"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.",
"alias": [
"Laboratory",
"Service",
"Practitioner",
"Department",
"Company",
"Authorized by",
"Director"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.performer",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam"
],
"aggregation": [
"referenced",
"bundled"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.performer.actor"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "PRT-8 (where this PRT-4-Participation = \"PO\")"
},
{
"identity": "rim",
"map": ".participation[typeCode=PRF]"
}
]
},
{
"id": "DiagnosticReport.performer.id",
"path": "DiagnosticReport.performer.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.performer.extension",
"path": "DiagnosticReport.performer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.performer.reference",
"path": "DiagnosticReport.performer.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "0",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1",
"ref-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.performer.type",
"path": "DiagnosticReport.performer.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.performer.identifier",
"path": "DiagnosticReport.performer.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"min": 1,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.id",
"path": "DiagnosticReport.performer.identifier.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.extension",
"path": "DiagnosticReport.performer.identifier.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.use",
"path": "DiagnosticReport.performer.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.type",
"path": "DiagnosticReport.performer.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.system",
"path": "DiagnosticReport.performer.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"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": 0,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/Id/ods-organisation-code",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.value",
"path": "DiagnosticReport.performer.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"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](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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.period",
"path": "DiagnosticReport.performer.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "DiagnosticReport.performer.identifier.assigner",
"path": "DiagnosticReport.performer.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "DiagnosticReport.performer.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "DiagnosticReport.performer.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.resultsInterpreter",
"path": "DiagnosticReport.resultsInterpreter",
"short": "Primary result interpreter",
"definition": "SHOULD reference the person responsible for interpreting the raw results, preferably by a recognised NHS identifier, such as SDS code.",
"comment": "Might not be the same entity that takes responsibility for the clinical report.",
"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.",
"alias": [
"Analyzed by",
"Reported by"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.resultsInterpreter",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam"
],
"aggregation": [
"referenced",
"bundled"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.performer.actor"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "OBR-32, PRT-8 (where this PRT-4-Participation = \"PI\")"
},
{
"identity": "rim",
"map": ".participation[typeCode=PRF]"
}
]
},
{
"id": "DiagnosticReport.specimen",
"path": "DiagnosticReport.specimen",
"short": "Specimens this report is based on",
"definition": "SHOULD reference the specimen used during testing to generate the report, if the document is a Genomic report.",
"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.",
"requirements": "Need to be able to report information about the collected specimens on which the report is based.",
"min": 1,
"max": "*",
"base": {
"path": "DiagnosticReport.specimen",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics",
"http://hl7.org/fhir/StructureDefinition/Specimen"
],
"aggregation": [
"referenced"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "SPM"
},
{
"identity": "rim",
"map": "participation[typeCode=SBJ]"
}
]
},
{
"id": "DiagnosticReport.result",
"path": "DiagnosticReport.result",
"slicing": {
"discriminator": [
{
"type": "profile",
"path": "resolve()"
}
],
"description": "Slice based on the reference profile and code pattern",
"rules": "open"
},
"short": "Observations",
"definition": "Raw results included within the report, to aid interpretation. These SHOULD take the form of Observation references, if providing a structured report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Observation"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:diagnostic-implication",
"path": "DiagnosticReport.result",
"sliceName": "diagnostic-implication",
"short": "Diagnostic Implication",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:therapeutic-implication",
"path": "DiagnosticReport.result",
"sliceName": "therapeutic-implication",
"short": "Therapeutic Implication",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:molecular-consequence",
"path": "DiagnosticReport.result",
"sliceName": "molecular-consequence",
"short": "Molecular Consequence",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-consequence"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:variant",
"path": "DiagnosticReport.result",
"sliceName": "variant",
"short": "Variant",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:sequence-phase-relation",
"path": "DiagnosticReport.result",
"sliceName": "sequence-phase-relation",
"short": "Sequence Phase Relationship",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/sequence-phase-relationship"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:genotype",
"path": "DiagnosticReport.result",
"sliceName": "genotype",
"short": "Genotype",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genotype"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:haplotype",
"path": "DiagnosticReport.result",
"sliceName": "haplotype",
"short": "Haplotype",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/haplotype"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.result:biomarker",
"path": "DiagnosticReport.result",
"sliceName": "biomarker",
"short": "MolecularBiomarker",
"definition": "[Observations](observation.html)  that are part of this diagnostic report.",
"comment": "Observations can contain observations.",
"requirements": "Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful.",
"alias": [
"Data",
"Atomic Value",
"Result",
"Atomic result",
"Data",
"Test",
"Analyte",
"Battery",
"Organizer"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.result",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-biomarker"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "OBXs"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.imagingStudy",
"path": "DiagnosticReport.imagingStudy",
"short": "Reference to full details of imaging associated with the diagnostic report",
"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.",
"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.",
"min": 0,
"max": "0",
"base": {
"path": "DiagnosticReport.imagingStudy",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/ImagingStudy"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]"
}
]
},
{
"id": "DiagnosticReport.media",
"path": "DiagnosticReport.media",
"short": "Key images associated with this report",
"definition": "TBC. Only relevant for structured genomic reports. Uses the extension:alternate-reference extension to reference DocumentReference resources pointing to the Genomic Data Files used as the basis for the report. Usage of this field over extension:supporting-info is pending further investigation.",
"requirements": "Many diagnostic services include images in the report as part of their service.",
"alias": [
"DICOM",
"Slides",
"Scans"
],
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.media",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "OBX?"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
}
]
},
{
"id": "DiagnosticReport.media.id",
"path": "DiagnosticReport.media.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.media.extension",
"path": "DiagnosticReport.media.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.modifierExtension",
"path": "DiagnosticReport.media.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"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).",
"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.",
"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](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.comment",
"path": "DiagnosticReport.media.comment",
"short": "Comment about the image (e.g. explanation)",
"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.",
"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.",
"requirements": "The provider of the report should make a comment about each image included in the report.",
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.media.comment",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
},
{
"id": "DiagnosticReport.media.link",
"path": "DiagnosticReport.media.link",
"short": "Reference to the image source",
"definition": "Reference to the image source.",
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"min": 1,
"max": "1",
"base": {
"path": "DiagnosticReport.media.link",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Media"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".value.reference"
}
]
},
{
"id": "DiagnosticReport.media.link.id",
"path": "DiagnosticReport.media.link.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.media.link.extension",
"path": "DiagnosticReport.media.link.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference",
"path": "DiagnosticReport.media.link.extension",
"sliceName": "alternateReference",
"short": "Alternative reference (target type is wrong)",
"definition": "Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.",
"comment": "Given that a reference SHALL have a display or reference, using this extension implies that there's a display present.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/alternate-reference"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference.id",
"path": "DiagnosticReport.media.link.extension.id",
"representation": [
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference.extension",
"path": "DiagnosticReport.media.link.extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "0",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference.url",
"path": "DiagnosticReport.media.link.extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a 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.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "http://hl7.org/fhir/StructureDefinition/alternate-reference",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference.value[x]",
"path": "DiagnosticReport.media.link.extension.value[x]",
"short": "Value of extension",
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-DocumentReference-Genomics",
"http://hl7.org/fhir/StructureDefinition/Resource"
],
"aggregation": [
"referenced",
"bundled"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.reference",
"path": "DiagnosticReport.media.link.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1",
"ref-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.type",
"path": "DiagnosticReport.media.link.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"comment": "This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.media.link.identifier",
"path": "DiagnosticReport.media.link.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "DiagnosticReport.media.link.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "DiagnosticReport.media.link.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "DiagnosticReport.conclusion",
"path": "DiagnosticReport.conclusion",
"short": "Assessment of overall results",
"definition": "Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to provide a conclusion that is not lost among the basic result data.",
"alias": [
"Report"
],
"min": 0,
"max": "1",
"base": {
"path": "DiagnosticReport.conclusion",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=\"SPRT\"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)"
}
]
},
{
"id": "DiagnosticReport.conclusionCode",
"path": "DiagnosticReport.conclusionCode",
"short": "Coarse overall interpretation of the genomic results",
"definition": "If possible, unstructured reports wrapped within DiagnosticReports, SHOULD contain a conclusionCode element indicating the coded finding from the report, to aid analytics.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"min": 0,
"max": "*",
"base": {
"path": "DiagnosticReport.conclusionCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdjunctDiagnosis"
}
],
"strength": "example",
"description": "Diagnosis codes provided as adjuncts to the report.",
"valueSet": "http://hl7.org/fhir/ValueSet/clinical-findings"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": "inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)"
}
]
},
{
"id": "DiagnosticReport.presentedForm",
"path": "DiagnosticReport.presentedForm",
"short": "Entire report as issued",
"definition": "Genomic reports SHALL include a presentedForm element either referencing the location of the PDF report (located and accessible on either the source/client system or via NRL using appropriate authentication) or include the PDF report as a base64 encoded attachment within the message payload.\nNote: this guidance may change in the future as work on Structured Reporting matures",
"comment": "\"application/pdf\" is recommended as the most reliable and interoperable in this context.",
"requirements": "Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.",
"min": 1,
"max": "*",
"base": {
"path": "DiagnosticReport.presentedForm",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Attachment"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "att-1",
"severity": "error",
"human": "If the Attachment has data, it SHALL have a contentType",
"expression": "data.empty() or contentType.exists()",
"xpath": "not(exists(f:data)) or exists(f:contentType)",
"source": "http://hl7.org/fhir/StructureDefinition/Attachment"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "ED/RP"
},
{
"identity": "rim",
"map": "ED"
},
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": "text (type=ED)"
}
]
}
]
},
"differential": {
"element": [
{
"id": "DiagnosticReport.extension:recommended-action",
"path": "DiagnosticReport.extension",
"sliceName": "recommended-action",
"definition": "TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Task resource indicating recommended action to take in response to the report's result/conclusion."
},
{
"id": "DiagnosticReport.extension:supporting-info",
"path": "DiagnosticReport.extension",
"sliceName": "supporting-info",
"definition": "TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to the genomic data files analysed as part of the test order, forming the report. Reference to DocumentReference resource which links to the binary data file."
},
{
"id": "DiagnosticReport.extension:genomic-study",
"path": "DiagnosticReport.extension",
"sliceName": "genomic-study",
"definition": "TBC. Only relevant for structured genomic reports (included in the Genomic Report Profile in the Genomics Report IG). Reference to Procedure resources indicating the analyses performed as part the genomic test order."
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact",
"path": "DiagnosticReport.extension",
"sliceName": "workflow-relatedArtifact",
"definition": "TBC. Only relevant for structured genomic reports (included in Genomic Report Profile in the Genomics Report IG). A reference to the guidelines or other knowledge artifacts which were used to guide interpretation or recommended actions included within this DiagnosticReport.\nIf entries constitute published papers, they SHOULD be referenced using a known citation style, e.g. Vancouver/Harvard. Alternatively for online texts, these MAY be referenced via URL only.\n\nA fixed value of 'citation' is expected for the type element, though this recommendation is pending further use cases."
},
{
"id": "DiagnosticReport.extension:workflow-relatedArtifact.value[x].type",
"path": "DiagnosticReport.extension.value[x].type",
"fixedCode": "citation"
},
{
"id": "DiagnosticReport.extension:diagnosticReportCompositionR5",
"path": "DiagnosticReport.extension",
"sliceName": "diagnosticReportCompositionR5",
"definition": "TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: DiagnosticReport Profile). A reference to the Composition which wraps this report for data sharing.",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"
]
}
],
"isModifier": false
},
{
"id": "DiagnosticReport.identifier",
"path": "DiagnosticReport.identifier",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"min": 1
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport",
"path": "DiagnosticReport.identifier",
"sliceName": "identifierGMSReport",
"max": "1"
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.use",
"path": "DiagnosticReport.identifier.use",
"max": "0"
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.type",
"path": "DiagnosticReport.identifier.type",
"max": "0"
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.system",
"path": "DiagnosticReport.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/Id/GMSReport"
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.value",
"path": "DiagnosticReport.identifier.value",
"min": 1
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.period",
"path": "DiagnosticReport.identifier.period",
"max": "0"
},
{
"id": "DiagnosticReport.identifier:identifierGMSReport.assigner",
"path": "DiagnosticReport.identifier.assigner",
"max": "0"
},
{
"id": "DiagnosticReport.identifier:localIdentifier",
"path": "DiagnosticReport.identifier",
"sliceName": "localIdentifier"
},
{
"id": "DiagnosticReport.identifier:localIdentifier.system",
"path": "DiagnosticReport.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/local-identifier/diagnosticreport"
},
{
"id": "DiagnosticReport.identifier:localIdentifier.value",
"path": "DiagnosticReport.identifier.value",
"min": 1
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner",
"path": "DiagnosticReport.identifier.assigner",
"min": 1
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.reference",
"path": "DiagnosticReport.identifier.assigner.reference",
"max": "0"
},
{
"id": "DiagnosticReport.identifier:localIdentifier.assigner.identifier",
"path": "DiagnosticReport.identifier.assigner.identifier",
"min": 1,
"fixedIdentifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code"
}
},
{
"id": "DiagnosticReport.basedOn",
"path": "DiagnosticReport.basedOn",
"definition": "SHOULD reference the originating ServiceRequest if this is an instance of a genomic diagnostic report resulting from a GMS test order.",
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics",
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://hl7.org/fhir/StructureDefinition/MedicationRequest",
"http://hl7.org/fhir/StructureDefinition/NutritionOrder",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest"
],
"aggregation": [
"referenced"
]
}
]
},
{
"id": "DiagnosticReport.status",
"path": "DiagnosticReport.status",
"definition": "SHALL use base HL7 codes for DiagnosticReport.status. A DiagnosticReport SHOULD only be marked as final if the report is complete and verified by an authorised person."
},
{
"id": "DiagnosticReport.category",
"path": "DiagnosticReport.category",
"definition": "Potentially multiple categories to specify the specialty the report is relevant for. Different codings are expected by the Genomic Report and EU Lab profiles."
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT",
"path": "DiagnosticReport.category",
"sliceName": "GeneticsSnomedCT"
},
{
"id": "DiagnosticReport.category:GeneticsSnomedCT.coding",
"path": "DiagnosticReport.category.coding",
"patternCoding": {
"system": "http://snomed.info/sct",
"code": "1236877003",
"display": "Genetic pathology"
}
},
{
"id": "DiagnosticReport.code",
"path": "DiagnosticReport.code",
"definition": "SHOULD use a record artifact concept from SNOMED CT where an appropriate code exists, else text is preferred to indicate the document type."
},
{
"id": "DiagnosticReport.code.coding",
"path": "DiagnosticReport.code.coding",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "$this"
}
],
"rules": "open"
}
},
{
"id": "DiagnosticReport.code.coding:codingSnomedCT",
"path": "DiagnosticReport.code.coding",
"sliceName": "codingSnomedCT",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ReportCode"
}
},
{
"id": "DiagnosticReport.subject",
"path": "DiagnosticReport.subject",
"definition": "SHALL be present. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Location"
],
"aggregation": [
"referenced"
]
}
]
},
{
"id": "DiagnosticReport.issued",
"path": "DiagnosticReport.issued",
"min": 1
},
{
"id": "DiagnosticReport.performer",
"path": "DiagnosticReport.performer",
"definition": "SHOULD reference the organization responsible for the testing, preferably by ODS code.",
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam"
],
"aggregation": [
"referenced",
"bundled"
]
}
]
},
{
"id": "DiagnosticReport.performer.reference",
"path": "DiagnosticReport.performer.reference",
"max": "0"
},
{
"id": "DiagnosticReport.performer.identifier",
"path": "DiagnosticReport.performer.identifier",
"min": 1
},
{
"id": "DiagnosticReport.performer.identifier.system",
"path": "DiagnosticReport.performer.identifier.system",
"fixedUri": "https://fhir.nhs.uk/Id/ods-organisation-code"
},
{
"id": "DiagnosticReport.resultsInterpreter",
"path": "DiagnosticReport.resultsInterpreter",
"definition": "SHOULD reference the person responsible for interpreting the raw results, preferably by a recognised NHS identifier, such as SDS code.",
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/CareTeam"
],
"aggregation": [
"referenced",
"bundled"
]
}
]
},
{
"id": "DiagnosticReport.specimen",
"path": "DiagnosticReport.specimen",
"definition": "SHOULD reference the specimen used during testing to generate the report, if the document is a Genomic report.",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics",
"http://hl7.org/fhir/StructureDefinition/Specimen"
],
"aggregation": [
"referenced"
]
}
]
},
{
"id": "DiagnosticReport.result",
"path": "DiagnosticReport.result",
"definition": "Raw results included within the report, to aid interpretation. These SHOULD take the form of Observation references, if providing a structured report."
},
{
"id": "DiagnosticReport.imagingStudy",
"path": "DiagnosticReport.imagingStudy",
"max": "0"
},
{
"id": "DiagnosticReport.media",
"path": "DiagnosticReport.media",
"definition": "TBC. Only relevant for structured genomic reports. Uses the extension:alternate-reference extension to reference DocumentReference resources pointing to the Genomic Data Files used as the basis for the report. Usage of this field over extension:supporting-info is pending further investigation."
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference",
"path": "DiagnosticReport.media.link.extension",
"sliceName": "alternateReference",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/alternate-reference"
]
}
],
"isModifier": false
},
{
"id": "DiagnosticReport.media.link.extension:alternateReference.value[x]",
"path": "DiagnosticReport.media.link.extension.value[x]",
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-DocumentReference-Genomics",
"http://hl7.org/fhir/StructureDefinition/Resource"
],
"aggregation": [
"referenced",
"bundled"
]
}
]
},
{
"id": "DiagnosticReport.conclusionCode",
"path": "DiagnosticReport.conclusionCode",
"definition": "If possible, unstructured reports wrapped within DiagnosticReports, SHOULD contain a conclusionCode element indicating the coded finding from the report, to aid analytics."
},
{
"id": "DiagnosticReport.presentedForm",
"path": "DiagnosticReport.presentedForm",
"definition": "Genomic reports SHALL include a presentedForm element either referencing the location of the PDF report (located and accessible on either the source/client system or via NRL using appropriate authentication) or include the PDF report as a base64 encoded attachment within the message payload.\nNote: this guidance may change in the future as work on Structured Reporting matures",
"min": 1
}
]
}

}

Propose a change to NHSEngland-DiagnosticReport-GenomicReport

FHIR	MDS	HL7v2
DiagnosticReport	Previous Genomic Report, Previous Diagnostic Report	OBX
DiagnosticReport.effectiveDateTime	PLCM activity - Date and time dataset created, PLCM activity - Turnaround time (calendar days), Previous genomic report - Test performed date, Previous non genomic report - Test performed date	Derived from OBR-7 in the ORU response message for the activity based on the OML request, OBX-19
DiagnosticReport.identifier	PLCM activity - Local report identifier, Previous genomic report - Report identifier, Previous non genomic report - Report identifier	OBR-3 for report
DiagnosticReport.result	PLCM activity - Test outcome code (Many), Previous non genomic report - Test result value comparator, Previous non genomic report - Test result value unit of measure, Previous non genomic report - Test result reference range low, Previous non genomic report - Test result reference range high, Previous non genomic report - Test result test method, Previous non genomic report - Test result reference range text, Previous non genomic report - Test result clinical summary	OBX-3 elements for resulting report, OBX-5, OBX-6, OBX-7 (before operator), OBX-7 (after operator), OBX-17, OBX-7, OBX-8
DiagnosticReport.conclusion	Previous genomic report - Report referral summary, Previous non genomic report - Report referral summary	OBX-5
DiagnosticReport.presentedForm	Previous genomic report - Report file/link, Previous non genomic report - Report file/link	OBX-5 where OBX-2=ED or RP
DiagnosticReport.subject	Previous genomic report - Patient's first name, Previous genomic report - Patient's surname, Previous genomic report - Patient's address, Previous genomic report - Patient's post code, Previous genomic report - Patient's country, Previous genomic report - Patient's date of birth, Previous genomic report - Patient's NHS number, Previous genomic report - Patient's alternative identifier, Previous genomic report - Patient's relationship to requesting patient, Previous genomic report - Patient's clinical genetics number, Previous genomic report - Patient's pedigree number	PID attached to Patient Prior
DiagnosticReport.basedOn	Previous genomic report - Report lab test number, Previous genomic report - Original requester full name, Previous genomic report - Original requester organisation ODS code, Previous genomic report - Original requester reason for request, Previous non genomic report - Original requester full name, Previous non genomic report - Original requester organisation ODS code, Previous non genomic report - Original requester reason for request	ORC-2, ORC-12, ORC-21.10, ORC-16
DiagnosticReport.conclusionCode	Previous genomic report - Report of genetic analysis, Previous non genomic report - Report result	OBR-5
DiagnosticReport.performer	Previous genomic report - Report performer full name, Previous genomic report - Report performer organisation ODS code, Previous non genomic report - Report performer full name, Previous non genomic report - Report performer organisation ODS code	OBX-16, OBX-23.10
DiagnosticReport.code	Previous non genomic report - Test type	OBR-4

Propose a change to NHSEngland-DiagnosticReport-GenomicReport

Additional Guidance

extension:recommended-action
extension:genomic-study
extension:supporting-info
extension:workflow-relatedArtifact
extension:DiagnosticReportCompositionR5
basedOn
status
category
code
subject
performer
resultsInterpreter
specimen
media
result
conclusionCode
presentedForm

extension:recommended-action

"extension" : [
        {
            "url" : "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action",
            "valueReference" : {
                "reference" : "Task/MedicationRecommendationExample1"
            }
        }
    ],

extension:genomic-study

"extension" : [
    {
      "url" : "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference",
      "valueReference" : {
        🔗 "reference" : "Procedure/PGXGenomicStudy"
      }
    }
  ]

extension:supporting-info

"extension" : [
        {
            "url" : "http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo",
            "valueReference" : {
                "reference" : "DocumentReference/DocumentReference-PharmCAT-Example"
            }
        }
    ],

extension:workflow-relatedArtifact

If entries constitute published papers, they SHOULD be referenced using a known citation style, e.g. Vancouver/Harvard. Alternatively for online texts, these MAY be referenced via URL only.

A fixed value of 'citation' is expected for the type element, though this recommendation is pending further use cases.

"extension" : [
        {
            "url" : "http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact",
            "valueRelatedArtifact" : {
                "type" : "citation",
                "url" : "https://cpicpgx.org/guidelines/guideline-for-clopidogrel-and-cyp2c19)"
            }
        }
    ],

extension:DiagnosticReportCompositionR5

TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: DiagnosticReport Profile). A reference to the Composition which wraps this report for data sharing.

"extension": [
    {
      "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition",
      "valueReference": {
        "reference": "Composition/Composition-EULabGenomicReport-Example"
      }
    }
],

basedOn

SHOULD reference the originating ServiceRequest if this is an instance of a genomic diagnostic report resulting from a GMS test order.

"basedOn":  [
        {
            "reference": "ServiceRequest-SavedTestOrder-Example"
        }
    ],

status

SHALL use base HL7 codes for DiagnosticReport.status. A DiagnosticReport SHOULD only be marked as final if the report is complete and verified by an authorised person.

Codes for DiagnosticReport status and usage within Genomics are provided below:

Lvl	Code	Definition	Usage within Genomics
1	registered	The existence of the report is registered, but there is nothing yet available.	Not expected to be used within Genomics
1	partial	This is a partial (e.g. initial, interim or preliminary) report: data in the report may be incomplete or unverified.	MAY be used for interim reports, SHALL NOT be used for reports intended to be acted upon by clinicians
2	preliminary	Verified early results are available, but not all results are final.	MAY be used within Genomics
1	final	The report is complete and verified by an authorized person.	SHALL be used for final reports
1	amended	Subsequent to being final, the report has been modified. This includes any change in the results, diagnosis, narrative text, or other content of a report that has been issued.	SHOULD be used for resports ammended after submission of a final report
2	corrected	Subsequent to being final, the report has been modified to correct an error in the report or referenced results.	MAY be used in place of ammended for a correction to a finalised report
2	appended	Subsequent to being final, the report has been modified by adding new content. The existing content is unchanged.	Not expected to be used within Genomics but MAY be used where applicable, pending use case identification
1	cancelled	The report is unavailable because the measurement was not started or not completed (also sometimes called "aborted").	MAY be used where a lab submits a cancellation/failure report, pending use case identification and testing
1	entered-in-error	The report has been withdrawn following a previous final release. This electronic record should never have existed, though it is possible that real-world decisions were based on it. (If real-world activity has occurred, the status should be "cancelled" rather than "entered-in-error".).	Not expected to be used within Genomics
1	unknown	The authoring/source system does not know which of the status values currently applies for this observation. Note: This concept is not to be used for "other" - one of the listed statuses is presumed to apply, but the authoring/source system does not know which.	SHALL NOT be used within Genomics

 "status": "final",

code

SHOULD use a record artifact concept from SNOMED CT where an appropriate code exists, else text is preferred to indicate the document type.

"code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "4321000179101",
                "display": "Hematology report (record artifact)"
            }
        ]
    },

subject

"subject": {
        "reference": "Patient/Patient-MeirLieberman-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },

performer

SHOULD reference the organization responsible for the testing, preferably by ODS code.

"performer":  [
        {
            "identifier": {
                "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                "value": "REP"
            }
        }
    ],

resultInterpreter

SHOULD reference the person responsible for interpreting the raw results, preferably by a recognised NHS identifier, such as SDS code.

"resultsInterpreter":  [
        {
            "identifier": {
                "system": "https://fhir.nhs.uk/Id/sds-user-id",
                "value": "999999999999"
            }
        }
    ],

specimen

SHOULD reference the specimen used during testing to generate the report, if the document is a Genomic report.

"specimen":  [
        {
            "reference": "Specimen/Specimen-BloodEDTA-Example"
        }
    ],

result

Raw results included within the report, to aid interpretation. These SHOULD take the form of Observation references, if providing a structured report.

"result" : [
        {
            "reference" : "Observation/TherapeuticImplicationExample1",
            "display" : "impact for high risk allele"
        },
        {
            "reference" : "Observation/GenotypeExample1"
        },
        {
            "reference" : "Observation/OverallInterpExample1"
        }
    ]

media

 "media": [
   {
    "link": {
     "extension": [
      {
       "url": "http://hl7.org/fhir/StructureDefinition/alternate-reference",
       "valueReference": {
        "reference": "DocumentReference/UKCore-DocumentReference-ECG-Example"
       }
      }
     ],
     "display": "ECG PDF (DocumentReference via backported extension)"
    }
   }
  ],

conclusionCode

If possible, unstructured reports wrapped within DiagnosticReports, SHOULD contain a conclusionCode element indicating the coded finding from the report, to aid analytics.

"conclusionCode":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "738542003",
                    "display": "Dihydropyrimidine dehydrogenase poor metabolizer (finding)"
                }
            ]
        }
    ],

presentedForm

Genomic reports SHALL include a presentedForm element, preferrably pointing to a DocumentReference that contains metadata and the location of the unstructured report. The DocumentReference SHOULD ideally be registered on [NRL](https://digital.nhs.uk/developer/api-catalogue/national-record-locator-fhir/v3/producer#overview--overview), either pointing to a local repository which contains the document, or stored on the National Document Repository, if a local service that can expose documents, is not available.

Alternative options for sharing unstructured documents include referencing the location of the PDF report directly (using appropriate authentication) or including the PDF report as a base64 encoded attachment within the message payload.

Note: this guidance may change in the future as work on Structured Reporting matures

"presentedForm": [
        {
            "url": "https://sandbox.api.service.nhs.uk/record-locator/producer/FHIR/R4/DocumentReference/Y05868-1234567892"
        }
    ]