UK Core Implementation Guide STU3 Sequence

Please note:

This version of the UK Core is a development copy.
This contains BREAKING CHANGES as a result of the C&TA Sprint 7 Review, and STU2 Sequence ballot reconciliation.
This version is not yet reviewed for implementation. Other versions are available on the UK Core Version History Guide
Please follow the guidance on the Contact Us page if you need any assistance.
A summary of changes is available on the STU3 Sequence Change Log

StructureDefinition Extension-UKCore-DiagnosticReportMediaLink

Context of Use

Canonical_URL	Status	Current_Version	Last_Updated	Description	Profile_Purpose
http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link	draft	0.1.0	2025-01-22	An extension to replicate the changes within R5 to support adding a reference to image or data source(DocumentReference). When using this extension DiagnosticReport.media.link SHALL be populated with the extension http://hl7.org/fhir/StructureDefinition/data-absent-reason with value 'unsupported'.	This is a Genomics use case to support the backporting of R5 functionality to support adding a reference to image or data source(DocumentReference).

Tree View

ExtensionUKCoreDiagnosticReportMediaLink (Extension)	I		Extension	Element id Extension Short description Reference to the image or data source Definition Reference to the image or data source. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (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
id		0..1	string	There are no (further) constraints on this element Element id Extension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.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. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
url		1..1	uriFixed Value	Element id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link Mappings rim: N/A
value[x]		1..1		Element id Extension.value[x] Short description Reference to the image or data source Definition Reference to the image or data source. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
valueReference			Reference(DocumentReference)	Data type Reference(DocumentReference)

Detailed Descriptions

Extension
Definition	Reference to the image or data source.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (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
Extension.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Extension.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
Extension.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Cardinality	1...1
Type	uri
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value	http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link
Mappings	rim: N/A
Extension.value[x]
Definition	Reference to the image or data source.
Cardinality	1...1
Type	Reference(DocumentReference)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: N/A

Table View

Extension		..
Extension.url		..
Extension.value[x]	Reference(DocumentReference)	1..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="Extension-UKCore-DiagnosticReportMediaLink" />
    <url value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link" />
    <version value="0.1.0" />
    <name value="ExtensionUKCoreDiagnosticReportMediaLink" />
    <title value="Extension UK Core Diagnostic Report Media Link" />
    <status value="draft" />
    <date value="2025-01-22" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="An extension to replicate the changes within R5 to support adding a reference to image or data source(DocumentReference). When using this extension DiagnosticReport.media.link SHALL be populated with the extension http://hl7.org/fhir/StructureDefinition/data-absent-reason with value &#39;unsupported&#39;." />
    <purpose value="This is a Genomics use case to support the backporting of R5 functionality to support adding a reference to image or data source(DocumentReference)." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="DiagnosticReport.media" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <short value="Reference to the image or data source" />
            <definition value="Reference to the image or data source." />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <short value="Reference to the image or data source" />
            <definition value="Reference to the image or data source." />
            <min value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "Extension-UKCore-DiagnosticReportMediaLink",
    "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link",
    "version": "0.1.0",
    "name": "ExtensionUKCoreDiagnosticReportMediaLink",
    "title": "Extension UK Core Diagnostic Report Media Link",
    "status": "draft",
    "date": "2025-01-22",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "An extension to replicate the changes within R5 to support adding a reference to image or data source(DocumentReference). When using this extension DiagnosticReport.media.link SHALL be populated with the extension http://hl7.org/fhir/StructureDefinition/data-absent-reason with value 'unsupported'.",
    "purpose": "This is a Genomics use case to support the backporting of R5 functionality to support adding a reference to image or data source(DocumentReference).",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "DiagnosticReport.media"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "short": "Reference to the image or data source",
                "definition": "Reference to the image or data source."
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.media.link"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "short": "Reference to the image or data source",
                "definition": "Reference to the image or data source.",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/DocumentReference"
                        ]
                    }
                ]
            }
        ]
    }
}

Feedback

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Examples

media.link R5 Backport extension - An example to illustrate the pre-adopted R5 element via an extension, which is used to link a DocumentReference resource rather than a Media Resource
Example UKCore-Extension-DiagnosticReportMediaLinkR5

Extension Specific Guidance

With DiagnosticReport.media.link being a mandatory element, the value SHALL be the extension http://hl7.org/fhir/StructureDefinition/data-absent-reason with the valueCode of unsupported. See the example for more details.