HL7 FHIR® CareConnect Baseline Profiles for STU3 (Draft Standard for Trial Use)

Important Announcement regarding CareConnect STU3

As of 19/09/2023, CareConnect has been deprecated and all development on the CareConnect FHIR assets has ceased.
Therefore, vendors looking to start new implementations or looking to update existing implementations should use UK Core R4 based solutions. Vendors continuing to implement CareConnect based solutions do so at their own risk and on the understanding that no maintenance or support will be available.

StructureDefinition-CareConnect-DiagnosticReport

A test report for National Pathology that contains data on the pathology tests performed on patients specimens populated by the performing organisation.

Snapshot View

CareConnect-DiagnosticReport-1 (DiagnosticReport)

DiagnosticReport

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

DiagnosticReport

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.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
contained.where(('#'+id in %resource.descendants().reference).not()).empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
v2: ORU -> OBR
rim: Observation[classCode=OBS, moodCode=EVN]
w5: clinical.diagnostics

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() | (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

DiagnosticReport.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Data type

Meta

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() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

DiagnosticReport.implicitRules

Short description

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.

Comments

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Data type

uri

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() | (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

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).

Data type

code

Binding

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

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() | (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

DiagnosticReport.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Comments

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 in formation is added later.

Data type

Narrative

Conditions

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

Constraints

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

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

DiagnosticReport.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained 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.

Comments

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.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Comments

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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. Usually modifier elements provide negation or qualification. In order 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.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier

Short description

Business identifier for report

Alternate names

ReportID, Filler ID, Placer ID

Definition

Identifiers assigned to this report by the performer or other systems.

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.

Comments

Usually assigned by the Information System of the diagnostic service provider (filler id).

Data type

Identifier

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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]
servd: Identifier
workflow: Event.identifier
v2: OBR-51
rim: id
w5: id

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.use

Short description

usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

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.

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

1..1

uri

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.system

Short description

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.

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.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

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() | (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.value

Short description

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.

Comments

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.

Data type

string

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() | (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.

Data type

Period

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() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(CareConnect-Organization-1)

Element id

DiagnosticReport.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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.

Data type

Reference(CareConnect-Organization-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

basedOn

0..*

Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1 | CareConnect-ReferralRequest-1)

Element id

DiagnosticReport.basedOn

Short description

What was requested

Alternate names

Request

Definition

Details concerning a test or procedure requested.

Requirements

This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.

Comments

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.

Data type

Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1 | CareConnect-ReferralRequest-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: ORC? OBR-2/3?
rim: outboundRelationship[typeCode=FLFS].target

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.status

Short description

registered | partial | preliminary | final +

Definition

The status of the diagnostic report as a whole.

Requirements

Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

Comments

This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn.

Data type

code

Binding

The status of the diagnostic report as a whole.

DiagnosticReportStatus (required)

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
v2: OBR-25 (not 1:1 mapping)
rim: statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"
w5: status

category

0..1

CodeableConceptBinding

Element id

DiagnosticReport.category

Short description

Service category

Alternate names

Department, Sub-department, Service, Discipline

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.

Comments

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.

Data type

CodeableConcept

Binding

Codes for diagnostic service sections.

Diagnostic Service Section Codes (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBR-24
rim: inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
w5: class

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.category.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.category.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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.

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

Coding

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.category.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.category.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.category.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.text

Short description

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.

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.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

code

1..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.code

Short description

Name/Code for this diagnostic report

Alternate names

Type

Definition

A code or name that describes this diagnostic report.

Comments

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.

Data type

CodeableConcept

Binding

Codes that describe Diagnostic Reports.

LOINC Diagnostic Report Codes (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
v2: OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)
rim: code
w5: what

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.code.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

CodingBinding

Element id

DiagnosticReport.code.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK

Care Connect Report Code SnCT (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.code.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.code.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.code.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

subject

Σ C

1..1

Reference(Device | Group | CareConnect-Location-1 | CareConnect-Patient-1)

Element id

DiagnosticReport.subject

Short description

The subject of the report - usually, but not always, the patient

Alternate names

Patient

Definition

The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.

Requirements

SHALL know the subject context.

Comments

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.

Data type

Reference(Device | Group | CareConnect-Location-1 | CareConnect-Patient-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
v2: PID-3 (no HL7 v2 mapping for Group or Device)
rim: participation[typeCode=SBJ]
w5: who.focus

context

Σ C

0..1

Reference(CareConnect-Encounter-1)

Element id

DiagnosticReport.context

Short description

Health care event when test ordered

Alternate names

Encounter

Definition

The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.

Requirements

Links the request to the Encounter context.

Comments

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 or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).

Data type

Reference(CareConnect-Encounter-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
v2: PV1-19
rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
w5: context

effective[x]

0..1

There are no (further) constraints on this element

Element id

DiagnosticReport.effective[x]

Short description

Clinically relevant time/time-period for report

Alternate names

Observation time, Effective Time, Occurrence

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.

Requirements

Need to know where in the patient history to file/present this report.

Comments

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.

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.occurrence[x]
v2: OBR-7
rim: effectiveTime
w5: when.done

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

issued

0..1

instant

There are no (further) constraints on this element

Element id

DiagnosticReport.issued

Short description

DateTime this version was released

Alternate names

Date Created, Date published, Date Issued

Definition

The date and time that this version of the report was released from the source diagnostic service.

Requirements

Clinicians need to be able to check the date that the report was released.

Comments

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.

Data type

instant

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBR-22
rim: participation[typeCode=VRF or AUT].time
w5: when.recorded

performer

0..*

BackboneElement

There are no (further) constraints on this element

Element id

DiagnosticReport.performer

Short description

Participants in producing the report

Alternate names

Laboratory, Service, Practitioner, Department, Company

Definition

Indicates who or what participated in producing the report.

Data type

BackboneElement

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.performer
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .participation[typeCode=PRF]
w5: who.witness

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Comments

Data type

Extension

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

role

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.role

Short description

Type of performer

Definition

Describes the type of participation (e.g. a responsible party, author, or verifier).

Comments

Data type

CodeableConcept

Binding

Indicate a role of diagnostic report performer

Procedure Performer Role Codes (example)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.performer.role
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .functionCode

actor

Σ C

1..1

Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)

Element id

DiagnosticReport.performer.actor

Short description

Practitioner or Organization participant

Definition

The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the 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.

Comments

This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.

Data type

Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .role

specimen

0..*

Reference(CareConnect-Specimen-1)

Element id

DiagnosticReport.specimen

Short description

Specimens this report is based on

Definition

Details about the specimens on which this diagnostic report is based.

Requirements

Need to be able to report information about the collected specimens on which the report is based.

Comments

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.

Data type

Reference(CareConnect-Specimen-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: SPM
rim: participation[typeCode=SBJ]

result

0..*

Reference(CareConnect-Observation-1)

Element id

DiagnosticReport.result

Short description

Observations - simple, or complex nested groups

Alternate names

Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer

Definition

Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. "atomic" results), or they can be grouping observations that include references to other members of the group (e.g. "panels").

Requirements

Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations.

Comments

Data type

Reference(CareConnect-Observation-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: OBXs
rim: outboundRelationship[typeCode=COMP].target

imagingStudy

0..*

Reference(ImagingManifest | ImagingStudy)

There are no (further) constraints on this element

Element id

DiagnosticReport.imagingStudy

Short description

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.

Comments

ImagingStudy and ImageManifest 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.

Data type

Reference(ImagingManifest | ImagingStudy)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]

image

0..*

BackboneElement

There are no (further) constraints on this element

Element id

DiagnosticReport.image

Short description

Key images associated with this report

Alternate names

DICOM, Slides, Scans

Definition

A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).

Requirements

Many diagnostic services include images in the report as part of their service.

Data type

BackboneElement

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX?
rim: outboundRelationship[typeCode=COMP].target

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.image.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.image.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.image.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

comment

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.image.comment

Short description

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.

Requirements

The provider of the report should make a comment about each image included in the report.

Comments

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.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value

link

Σ C

1..1

Reference(Media)

There are no (further) constraints on this element

Element id

DiagnosticReport.image.link

Short description

Reference to the image source

Definition

Reference to the image source.

Comments

Data type

Reference(Media)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .value.reference

conclusion

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.conclusion

Short description

Clinical Interpretation of test results

Alternate names

Report

Definition

Concise and clinically contextualized impression / summary of the diagnostic report.

Requirements

Need to be able to provide a conclusion that is not lost among the basic result data.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX
rim: inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)

codedDiagnosis

0..*

CodeableConceptBinding

Element id

DiagnosticReport.codedDiagnosis

Short description

Codes for the conclusion

Definition

Codes for the conclusion.

Comments

Data type

CodeableConcept

Binding

A SNOMED Coded finding for the test report.

Care Connect Finding Code (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBX
rim: inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.codedDiagnosis.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

CodingBinding

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK

Care Connect Finding Code (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

presentedForm

0..*

Attachment

There are no (further) constraints on this element

Element id

DiagnosticReport.presentedForm

Short description

Entire report as issued

Definition

Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

Requirements

Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

Comments

"application/pdf" is recommended as the most reliable and interoperable in this context.

Data type

Attachment

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() | (children().count() > id.count())
att-1: It the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()

Mappings

rim: n/a
v2: ED/RP
rim: ED
v2: OBX
rim: text (type=ED)

Differential View

CareConnect-DiagnosticReport-1 (DiagnosticReport)

DiagnosticReport

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

Comments

Data type

DiagnosticReport

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.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
contained.where(('#'+id in %resource.descendants().reference).not()).empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
v2: ORU -> OBR
rim: Observation[classCode=OBS, moodCode=EVN]
w5: clinical.diagnostics

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() | (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

DiagnosticReport.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Data type

Meta

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() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

DiagnosticReport.implicitRules

Short description

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.

Comments

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Data type

uri

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() | (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

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() | (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

DiagnosticReport.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

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

Constraints

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

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

DiagnosticReport.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

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.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier

Short description

Business identifier for report

Alternate names

ReportID, Filler ID, Placer ID

Definition

Identifiers assigned to this report by the performer or other systems.

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.

Comments

Usually assigned by the Information System of the diagnostic service provider (filler id).

Data type

Identifier

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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]
servd: Identifier
workflow: Event.identifier
v2: OBR-51
rim: id
w5: id

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.use

Short description

usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

1..1

uri

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.system

Short description

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.

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.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

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() | (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.value

Short description

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.

Comments

Data type

string

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() | (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

Data type

Period

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() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(CareConnect-Organization-1)

Element id

DiagnosticReport.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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.

Data type

Reference(CareConnect-Organization-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

basedOn

0..*

Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1 | CareConnect-ReferralRequest-1)

Element id

DiagnosticReport.basedOn

Short description

What was requested

Alternate names

Request

Definition

Details concerning a test or procedure requested.

Requirements

This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.

Comments

Data type

Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1 | CareConnect-ReferralRequest-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: ORC? OBR-2/3?
rim: outboundRelationship[typeCode=FLFS].target

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.status

Short description

registered | partial | preliminary | final +

Definition

The status of the diagnostic report as a whole.

Requirements

Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

Comments

This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn.

Data type

code

Binding

The status of the diagnostic report as a whole.

DiagnosticReportStatus (required)

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
v2: OBR-25 (not 1:1 mapping)
rim: statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"
w5: status

category

0..1

CodeableConceptBinding

Element id

DiagnosticReport.category

Short description

Service category

Alternate names

Department, Sub-department, Service, Discipline

Definition

Comments

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.

Data type

CodeableConcept

Binding

Codes for diagnostic service sections.

Diagnostic Service Section Codes (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBR-24
rim: inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
w5: class

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.category.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.category.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

Coding

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.category.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.category.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.category.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

code

1..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.code

Short description

Name/Code for this diagnostic report

Alternate names

Type

Definition

A code or name that describes this diagnostic report.

Comments

Data type

CodeableConcept

Binding

Codes that describe Diagnostic Reports.

LOINC Diagnostic Report Codes (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
v2: OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)
rim: code
w5: what

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.code.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

CodingBinding

Element id

DiagnosticReport.code.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK

Care Connect Report Code SnCT (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.code.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.code.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.code.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

subject

Σ C

1..1

Reference(Device | Group | CareConnect-Location-1 | CareConnect-Patient-1)

Element id

DiagnosticReport.subject

Short description

The subject of the report - usually, but not always, the patient

Alternate names

Patient

Definition

The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.

Requirements

SHALL know the subject context.

Comments

Data type

Reference(Device | Group | CareConnect-Location-1 | CareConnect-Patient-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
v2: PID-3 (no HL7 v2 mapping for Group or Device)
rim: participation[typeCode=SBJ]
w5: who.focus

context

Σ C

0..1

Reference(CareConnect-Encounter-1)

Element id

DiagnosticReport.context

Short description

Health care event when test ordered

Alternate names

Encounter

Definition

The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.

Requirements

Links the request to the Encounter context.

Comments

Data type

Reference(CareConnect-Encounter-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
v2: PV1-19
rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
w5: context

effective[x]

0..1

There are no (further) constraints on this element

Element id

DiagnosticReport.effective[x]

Short description

Clinically relevant time/time-period for report

Alternate names

Observation time, Effective Time, Occurrence

Definition

Requirements

Need to know where in the patient history to file/present this report.

Comments

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.occurrence[x]
v2: OBR-7
rim: effectiveTime
w5: when.done

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

issued

0..1

instant

There are no (further) constraints on this element

Element id

DiagnosticReport.issued

Short description

DateTime this version was released

Alternate names

Date Created, Date published, Date Issued

Definition

The date and time that this version of the report was released from the source diagnostic service.

Requirements

Clinicians need to be able to check the date that the report was released.

Comments

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.

Data type

instant

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBR-22
rim: participation[typeCode=VRF or AUT].time
w5: when.recorded

performer

0..*

BackboneElement

There are no (further) constraints on this element

Element id

DiagnosticReport.performer

Short description

Participants in producing the report

Alternate names

Laboratory, Service, Practitioner, Department, Company

Definition

Indicates who or what participated in producing the report.

Data type

BackboneElement

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.performer
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .participation[typeCode=PRF]
w5: who.witness

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

role

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.role

Short description

Type of performer

Definition

Describes the type of participation (e.g. a responsible party, author, or verifier).

Comments

Data type

CodeableConcept

Binding

Indicate a role of diagnostic report performer

Procedure Performer Role Codes (example)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.performer.role
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .functionCode

actor

Σ C

1..1

Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)

Element id

DiagnosticReport.performer.actor

Short description

Practitioner or Organization participant

Definition

The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the 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.

Comments

This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.

Data type

Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .role

specimen

0..*

Reference(CareConnect-Specimen-1)

Element id

DiagnosticReport.specimen

Short description

Specimens this report is based on

Definition

Details about the specimens on which this diagnostic report is based.

Requirements

Need to be able to report information about the collected specimens on which the report is based.

Comments

Data type

Reference(CareConnect-Specimen-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: SPM
rim: participation[typeCode=SBJ]

result

0..*

Reference(CareConnect-Observation-1)

Element id

DiagnosticReport.result

Short description

Observations - simple, or complex nested groups

Alternate names

Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer

Definition

Requirements

Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations.

Comments

Data type

Reference(CareConnect-Observation-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: OBXs
rim: outboundRelationship[typeCode=COMP].target

imagingStudy

0..*

Reference(ImagingManifest | ImagingStudy)

There are no (further) constraints on this element

Element id

DiagnosticReport.imagingStudy

Short description

Reference to full details of imaging associated with the diagnostic report

Definition

Comments

Data type

Reference(ImagingManifest | ImagingStudy)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]

image

0..*

BackboneElement

There are no (further) constraints on this element

Element id

DiagnosticReport.image

Short description

Key images associated with this report

Alternate names

DICOM, Slides, Scans

Definition

Requirements

Many diagnostic services include images in the report as part of their service.

Data type

BackboneElement

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX?
rim: outboundRelationship[typeCode=COMP].target

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.image.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.image.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.image.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

comment

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.image.comment

Short description

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.

Requirements

The provider of the report should make a comment about each image included in the report.

Comments

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.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value

link

Σ C

1..1

Reference(Media)

There are no (further) constraints on this element

Element id

DiagnosticReport.image.link

Short description

Reference to the image source

Definition

Reference to the image source.

Comments

Data type

Reference(Media)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .value.reference

conclusion

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.conclusion

Short description

Clinical Interpretation of test results

Alternate names

Report

Definition

Concise and clinically contextualized impression / summary of the diagnostic report.

Requirements

Need to be able to provide a conclusion that is not lost among the basic result data.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX
rim: inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)

codedDiagnosis

0..*

CodeableConceptBinding

Element id

DiagnosticReport.codedDiagnosis

Short description

Codes for the conclusion

Definition

Codes for the conclusion.

Comments

Data type

CodeableConcept

Binding

A SNOMED Coded finding for the test report.

Care Connect Finding Code (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBX
rim: inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.codedDiagnosis.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

CodingBinding

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK

Care Connect Finding Code (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

presentedForm

0..*

Attachment

There are no (further) constraints on this element

Element id

DiagnosticReport.presentedForm

Short description

Entire report as issued

Definition

Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

Requirements

Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

Comments

"application/pdf" is recommended as the most reliable and interoperable in this context.

Data type

Attachment

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() | (children().count() > id.count())
att-1: It the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()

Mappings

rim: n/a
v2: ED/RP
rim: ED
v2: OBX
rim: text (type=ED)

Hybrid View

CareConnect-DiagnosticReport-1 (DiagnosticReport)

DiagnosticReport

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

Comments

Data type

DiagnosticReport

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.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
contained.where(('#'+id in %resource.descendants().reference).not()).empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
v2: ORU -> OBR
rim: Observation[classCode=OBS, moodCode=EVN]
w5: clinical.diagnostics

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() | (children().count() > id.count())

Mappings

rim: n/a

Meta

There are no (further) constraints on this element

Element id

DiagnosticReport.meta

Short description

Metadata about the resource

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Data type

Meta

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() | (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

DiagnosticReport.implicitRules

Short description

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.

Comments

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Data type

uri

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() | (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

Common Languages (extensible)

Binding extensions

maxValueSet	All Languages

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() | (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

DiagnosticReport.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

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

Constraints

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

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

DiagnosticReport.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

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.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier

Short description

Business identifier for report

Alternate names

ReportID, Filler ID, Placer ID

Definition

Identifiers assigned to this report by the performer or other systems.

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.

Comments

Usually assigned by the Information System of the diagnostic service provider (filler id).

Data type

Identifier

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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]
servd: Identifier
workflow: Event.identifier
v2: OBR-51
rim: id
w5: id

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.use

Short description

usual | official | temp | secondary (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

CodeableConcept

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: CX.5
rim: Role.code or implied by context

system

1..1

uri

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.system

Short description

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.

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.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

Data type

uri

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() | (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.value

Short description

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.

Comments

Data type

string

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() | (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

Period

There are no (further) constraints on this element

Element id

DiagnosticReport.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Comments

Data type

Period

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() | (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.empty() or end.empty() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(CareConnect-Organization-1)

Element id

DiagnosticReport.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

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.

Data type

Reference(CareConnect-Organization-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

basedOn

0..*

Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1 | CareConnect-ReferralRequest-1)

Element id

DiagnosticReport.basedOn

Short description

What was requested

Alternate names

Request

Definition

Details concerning a test or procedure requested.

Requirements

This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.

Comments

Data type

Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ProcedureRequest-1 | CareConnect-ReferralRequest-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: ORC? OBR-2/3?
rim: outboundRelationship[typeCode=FLFS].target

status

Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.status

Short description

registered | partial | preliminary | final +

Definition

The status of the diagnostic report as a whole.

Requirements

Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

Comments

This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn.

Data type

code

Binding

The status of the diagnostic report as a whole.

DiagnosticReportStatus (required)

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
v2: OBR-25 (not 1:1 mapping)
rim: statusCode Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type "revise"
w5: status

category

0..1

CodeableConceptBinding

Element id

DiagnosticReport.category

Short description

Service category

Alternate names

Department, Sub-department, Service, Discipline

Definition

Comments

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.

Data type

CodeableConcept

Binding

Codes for diagnostic service sections.

Diagnostic Service Section Codes (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBR-24
rim: inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
w5: class

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.category.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.category.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

Coding

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.category.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.category.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.category.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.category.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.category.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

code

1..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

DiagnosticReport.code

Short description

Name/Code for this diagnostic report

Alternate names

Type

Definition

A code or name that describes this diagnostic report.

Comments

Data type

CodeableConcept

Binding

Codes that describe Diagnostic Reports.

LOINC Diagnostic Report Codes (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
v2: OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)
rim: code
w5: what

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.code.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

CodingBinding

Element id

DiagnosticReport.code.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK

Care Connect Report Code SnCT (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.code.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.code.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.code.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.code.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.code.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

subject

Σ C

1..1

Reference(Device | Group | CareConnect-Location-1 | CareConnect-Patient-1)

Element id

DiagnosticReport.subject

Short description

The subject of the report - usually, but not always, the patient

Alternate names

Patient

Definition

The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.

Requirements

SHALL know the subject context.

Comments

Data type

Reference(Device | Group | CareConnect-Location-1 | CareConnect-Patient-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
v2: PID-3 (no HL7 v2 mapping for Group or Device)
rim: participation[typeCode=SBJ]
w5: who.focus

context

Σ C

0..1

Reference(CareConnect-Encounter-1)

Element id

DiagnosticReport.context

Short description

Health care event when test ordered

Alternate names

Encounter

Definition

The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.

Requirements

Links the request to the Encounter context.

Comments

Data type

Reference(CareConnect-Encounter-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
v2: PV1-19
rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
w5: context

effective[x]

0..1

There are no (further) constraints on this element

Element id

DiagnosticReport.effective[x]

Short description

Clinically relevant time/time-period for report

Alternate names

Observation time, Effective Time, Occurrence

Definition

Requirements

Need to know where in the patient history to file/present this report.

Comments

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.occurrence[x]
v2: OBR-7
rim: effectiveTime
w5: when.done

effectiveDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

effectivePeriod

Period

There are no (further) constraints on this element

Data type

Period

issued

0..1

instant

There are no (further) constraints on this element

Element id

DiagnosticReport.issued

Short description

DateTime this version was released

Alternate names

Date Created, Date published, Date Issued

Definition

The date and time that this version of the report was released from the source diagnostic service.

Requirements

Clinicians need to be able to check the date that the report was released.

Comments

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.

Data type

instant

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBR-22
rim: participation[typeCode=VRF or AUT].time
w5: when.recorded

performer

0..*

BackboneElement

There are no (further) constraints on this element

Element id

DiagnosticReport.performer

Short description

Participants in producing the report

Alternate names

Laboratory, Service, Practitioner, Department, Company

Definition

Indicates who or what participated in producing the report.

Data type

BackboneElement

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() | (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.performer
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .participation[typeCode=PRF]
w5: who.witness

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

role

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

DiagnosticReport.performer.role

Short description

Type of performer

Definition

Describes the type of participation (e.g. a responsible party, author, or verifier).

Comments

Data type

CodeableConcept

Binding

Indicate a role of diagnostic report performer

Procedure Performer Role Codes (example)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.performer.role
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .functionCode

actor

Σ C

1..1

Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)

Element id

DiagnosticReport.performer.actor

Short description

Practitioner or Organization participant

Definition

The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the 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.

Comments

This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.

Data type

Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
v2: PRT-8 (where this PRT-4-Participation = "PO")
rim: .role

specimen

0..*

Reference(CareConnect-Specimen-1)

Element id

DiagnosticReport.specimen

Short description

Specimens this report is based on

Definition

Details about the specimens on which this diagnostic report is based.

Requirements

Need to be able to report information about the collected specimens on which the report is based.

Comments

Data type

Reference(CareConnect-Specimen-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: SPM
rim: participation[typeCode=SBJ]

result

0..*

Reference(CareConnect-Observation-1)

Element id

DiagnosticReport.result

Short description

Observations - simple, or complex nested groups

Alternate names

Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer

Definition

Requirements

Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations.

Comments

Data type

Reference(CareConnect-Observation-1)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: OBXs
rim: outboundRelationship[typeCode=COMP].target

imagingStudy

0..*

Reference(ImagingManifest | ImagingStudy)

There are no (further) constraints on this element

Element id

DiagnosticReport.imagingStudy

Short description

Reference to full details of imaging associated with the diagnostic report

Definition

Comments

Data type

Reference(ImagingManifest | ImagingStudy)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]

image

0..*

BackboneElement

There are no (further) constraints on this element

Element id

DiagnosticReport.image

Short description

Key images associated with this report

Alternate names

DICOM, Slides, Scans

Definition

Requirements

Many diagnostic services include images in the report as part of their service.

Data type

BackboneElement

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX?
rim: outboundRelationship[typeCode=COMP].target

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.image.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.image.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.image.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content, modifiers

Definition

Comments

Data type

Extension

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

comment

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.image.comment

Short description

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.

Requirements

The provider of the report should make a comment about each image included in the report.

Comments

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.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="annotation"].value

link

Σ C

1..1

Reference(Media)

There are no (further) constraints on this element

Element id

DiagnosticReport.image.link

Short description

Reference to the image source

Definition

Reference to the image source.

Comments

Data type

Reference(Media)

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() | (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .value.reference

conclusion

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.conclusion

Short description

Clinical Interpretation of test results

Alternate names

Report

Definition

Concise and clinically contextualized impression / summary of the diagnostic report.

Requirements

Need to be able to provide a conclusion that is not lost among the basic result data.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: OBX
rim: inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)

codedDiagnosis

0..*

CodeableConceptBinding

Element id

DiagnosticReport.codedDiagnosis

Short description

Codes for the conclusion

Definition

Codes for the conclusion.

Comments

Data type

CodeableConcept

Binding

A SNOMED Coded finding for the test report.

Care Connect Finding Code (preferred)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: OBX
rim: inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

coding

0..*

Coding

Element id

DiagnosticReport.codedDiagnosis.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Slicing

Unordered, Open, by system(Value)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

snomedCT

0..*

CodingBinding

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Data type

Coding

Binding

A code from the SNOMED Clinical Terminology UK

Care Connect Finding Code (extensible)

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.id

Short description

xml:id (or equivalent in JSON)

Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a

extension

0..*

Extension

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.extension

Short description

Additional Content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

snomedCTDescriptionID

0..1

Extension(Complex)

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.extension:snomedCTDescriptionID

Short description

The SNOMED CT Description ID for the display

Alternate names

extensions, user content

Definition

The SNOMED CT Description ID for the display.

Comments

Data type

Extension(Complex)

Extension URL

Extension-coding-sctdescid

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() | (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

system

1..1

uriFixed Value

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

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() | (children().count() > id.count())

Fixed value

http://snomed.info/sct

Mappings

rim: n/a
v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

code

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

code

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

1..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.coding:snomedCT.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

string

There are no (further) constraints on this element

Element id

DiagnosticReport.codedDiagnosis.text

Short description

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.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

string

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() | (children().count() > id.count())

Mappings

rim: n/a
v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

presentedForm

0..*

Attachment

There are no (further) constraints on this element

Element id

DiagnosticReport.presentedForm

Short description

Entire report as issued

Definition

Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

Requirements

Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.

Comments

"application/pdf" is recommended as the most reliable and interoperable in this context.

Data type

Attachment

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() | (children().count() > id.count())
att-1: It the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()

Mappings

rim: n/a
v2: ED/RP
rim: ED
v2: OBX
rim: text (type=ED)

Table View

DiagnosticReport		..
DiagnosticReport.identifier		..
DiagnosticReport.identifier.system		1..
DiagnosticReport.identifier.value		1..
DiagnosticReport.identifier.assigner	Reference(CareConnect-Organization-1)	..
DiagnosticReport.basedOn	Reference(CareConnect-CarePlan-1 \| CareConnect-MedicationRequest-1 \| CareConnect-ProcedureRequest-1 \| CareConnect-ReferralRequest-1)	..
DiagnosticReport.category		..
DiagnosticReport.category.coding		..
DiagnosticReport.category.coding:snomedCT		..
DiagnosticReport.category.coding:snomedCT.extension		0..
DiagnosticReport.category.coding:snomedCT.extension:snomedCTDescriptionID	Extension	0..
DiagnosticReport.category.coding:snomedCT.system		1..
DiagnosticReport.category.coding:snomedCT.code		1..
DiagnosticReport.category.coding:snomedCT.display		1..
DiagnosticReport.code		..
DiagnosticReport.code.coding		..
DiagnosticReport.code.coding:snomedCT		..
DiagnosticReport.code.coding:snomedCT.extension		0..
DiagnosticReport.code.coding:snomedCT.extension:snomedCTDescriptionID	Extension	0..
DiagnosticReport.code.coding:snomedCT.system		1..
DiagnosticReport.code.coding:snomedCT.code		1..
DiagnosticReport.code.coding:snomedCT.display		1..
DiagnosticReport.subject	Reference(Device \| Group \| CareConnect-Location-1 \| CareConnect-Patient-1)	1..
DiagnosticReport.context	Reference(CareConnect-Encounter-1)	..
DiagnosticReport.performer		..
DiagnosticReport.performer.actor	Reference(CareConnect-Organization-1 \| CareConnect-Practitioner-1)	..
DiagnosticReport.specimen	Reference(CareConnect-Specimen-1)	..
DiagnosticReport.result	Reference(CareConnect-Observation-1)	..
DiagnosticReport.codedDiagnosis		..
DiagnosticReport.codedDiagnosis.coding		..
DiagnosticReport.codedDiagnosis.coding:snomedCT		..
DiagnosticReport.codedDiagnosis.coding:snomedCT.extension		0..
DiagnosticReport.codedDiagnosis.coding:snomedCT.extension:snomedCTDescriptionID	Extension	0..
DiagnosticReport.codedDiagnosis.coding:snomedCT.system		1..
DiagnosticReport.codedDiagnosis.coding:snomedCT.code		1..
DiagnosticReport.codedDiagnosis.coding:snomedCT.display		1..

Examples

Profile specific implementation guidance:

There is no specific guidance for this profile.