| DiagnosticReport | I | | DiagnosticReport | There are no (further) constraints on this element Element IdShort 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.
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.
DiagnosticReport Constraints- dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-6:A resource should have narrative for robust management
text.`div`.exists() - dom-5:If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()
- rim:Entity. Role, or Act
- workflow:Event
- v2:ORU -> OBR
- rim:Observation[classCode=OBS, moodCode=EVN]
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| extension | I | 0..* | Extension | Element IdDiagnosticReport.extension 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. 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.
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.
Extension Sliced: Unordered, Open, by url(Value) 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()
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| compositionReferenceR5 | I | 0..1 | Extension(Reference(UK Core Composition)) | Element IdDiagnosticReport.extension:compositionReferenceR5 A Composition reference for a DiagnosticReport. This is a R5 backport. Alternate names extensions, user content Definition A Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
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.
Extension(Reference(UK Core Composition)) Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition 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()
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| url | | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdDiagnosticReport.extension:compositionReferenceR5.url identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL.
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.
System.String Fixed Value
http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition Mappings |
| value[x] | | 1..1 | | Element IdDiagnosticReport.extension:compositionReferenceR5.value[x] Reference to a Composition resource. Definition Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| valueReference | | | Reference(UK Core Composition) | There are no (further) constraints on this element Data Type Reference(UK Core Composition) |
| noteR5 | I | 0..1 | Extension(Annotation) | Element IdDiagnosticReport.extension:noteR5 Comments about the diagnostic report. This is a R5 backport. Alternate names extensions, user content Definition May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.
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.
Extension(Annotation) Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note 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()
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| url | | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdDiagnosticReport.extension:noteR5.url identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL.
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.
System.String Fixed Value
http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note Mappings |
| value[x] | | 1..1 | | Element IdDiagnosticReport.extension:noteR5.value[x] Comments about the diagnostic report. Definition May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.
- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| valueAnnotation | | | Annotation | There are no (further) constraints on this element Data Type Annotation |
| identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.identifier Business identifier for report Alternate names ReportID, Filler ID, Placer ID Definition Identifiers assigned to this report by the performer or other systems.
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.
Usually assigned by the Information System of the diagnostic service provider (filler id).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- workflow:Event.identifier
- w5:FiveWs.identifier
- v2:OBR-51/ for globally unique filler ID - OBR-3 , For non-globally unique filler-id the flller/placer number must be combined with the universal service Id - OBR-2(if present)+OBR-3+OBR-4
- rim:id
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
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| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://www.acme.com/identifiers/patient
Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
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| value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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
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| period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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
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| assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
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| basedOn | I | 0..* | Reference(ImmunizationRecommendation | NutritionOrder | UK Core ServiceRequest | UK Core CarePlan | UK Core MedicationRequest) | Element IdShort description What was requested Alternate names Request Definition Details concerning a service requested.
This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.
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.
Reference(ImmunizationRecommendation | NutritionOrder | UK Core ServiceRequest | UK Core CarePlan | UK Core MedicationRequest) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
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| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
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| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://www.acme.com/identifiers/patient
Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
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| value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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
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| period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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
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| assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.basedOn.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.basedOn.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdShort description registered | partial | preliminary | final + Definition The status of the diagnostic report.
Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.
Note that FHIR strings SHALL NOT exceed 1MB in size
code Binding The status of the diagnostic report. DiagnosticReportStatus (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- workflow:Event.status
- w5:FiveWs.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"
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| category | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdDiagnosticReport.category 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.
Multiple categories are allowed using various categorization schemes. The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.
CodeableConcept Binding Codes for diagnostic service sections. DiagnosticServiceSectionCodes (example)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5:FiveWs.class
- v2:OBR-24
- rim:inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
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| code | Σ | 1..1 | CodeableConceptBinding | Element IdShort description Name/Code for this diagnostic report Alternate names Type Definition A code or name that describes this diagnostic report.
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.
CodeableConcept Binding Codes that describe Diagnostic Reports. UKCoreReportCode (preferred)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- workflow:Event.code
- w5:FiveWs.what[x]
- v2:OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)
- rim:code
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| subject | Σ I | 0..1 | Reference(Group | UK Core Device | UK Core Patient | UK Core Location) | Element IdShort 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.
SHALL know the subject context.
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.
Reference(Group | UK Core Device | UK Core Patient | UK Core Location) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.subject
- w5:FiveWs.subject[x]
- v2:PID-3 (no HL7 v2 mapping for Group or Device)
- rim:participation[typeCode=SBJ]
- w5:FiveWs.subject
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.subject.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.subject.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.subject.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.subject.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.subject.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.subject.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.subject.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.subject.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.subject.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.subject.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| encounter | Σ I | 0..1 | Reference(UK Core Encounter) | Element IdDiagnosticReport.encounter Health care event when test ordered Alternate names Context Definition The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Links the request to the Encounter context.
This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Reference(UK Core Encounter) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.encounter
- w5:FiveWs.context
- v2:PV1-19
- rim:inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.encounter.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.encounter.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| effective[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdDiagnosticReport.effective[x] 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.
Need to know where in the patient history to file/present this report.
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.
- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- workflow:Event.occurrence[x]
- w5:FiveWs.done[x]
- v2:OBR-7
- rim:effectiveTime
|
| 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 | Σ | 0..1 | instant | There are no (further) constraints on this element Element IdShort description DateTime this version was made Alternate names Date published, Date Issued, Date Verified Definition The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.
Clinicians need to be able to check the date that the report was released.
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.
instant Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- w5:FiveWs.recorded
- v2:OBR-22
- rim:participation[typeCode=VRF or AUT].time
|
| performer | Σ I | 0..* | Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization | UK Core CareTeam) | Element IdDiagnosticReport.performer Responsible Diagnostic Service Alternate names Laboratory, Service, Practitioner, Department, Company, Authorized by, Director Definition The diagnostic service that is responsible for issuing the report.
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.
This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report.
Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization | UK Core CareTeam) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.performer.actor
- w5:FiveWs.actor
- v2:PRT-8 (where this PRT-4-Participation = "PO")
- rim:.participation[typeCode=PRF]
|
| extension | I | 0..* | Extension | Element IdDiagnosticReport.performer.extension 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.
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.
Extension Sliced: Unordered, Open, by url(Value) 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()
|
| deviceReference | I | 0..1 | Extension(Reference(UK Core Device)) | Element IdDiagnosticReport.performer.extension:deviceReference An additional Device reference for a DiagnosticReport. Alternate names extensions, user content Definition An additional Device reference for a DiagnosticReport, to allow Software as a Medical Device to perform / interpret a DiagnosticReport
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.
Extension(Reference(UK Core Device)) Extension URL https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference 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()
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.performer.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.performer.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.performer.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.performer.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.performer.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.performer.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.performer.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.performer.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.performer.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.performer.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| resultsInterpreter | Σ I | 0..* | Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization | UK Core CareTeam) | Element IdDiagnosticReport.resultsInterpreter Primary result interpreter Alternate names Analyzed by, Reported by Definition The practitioner or organization that is responsible for the report's conclusions and interpretations.
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.
Might not be the same entity that takes responsibility for the clinical report.
Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Organization | UK Core CareTeam) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- workflow:Event.performer.actor
- w5:FiveWs.actor
- v2:OBR-32, PRT-8 (where this PRT-4-Participation = "PI")
- rim:.participation[typeCode=PRF]
|
| extension | I | 0..* | Extension | Element IdDiagnosticReport.resultsInterpreter.extension 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.
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.
Extension Sliced: Unordered, Open, by url(Value) 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()
|
| deviceReference | I | 0..* | Extension(Reference(UK Core Device)) | Element IdDiagnosticReport.resultsInterpreter.extension:deviceReference An additional Device reference for a DiagnosticReport. Alternate names extensions, user content Definition An additional Device reference for a DiagnosticReport, to allow Software as a Medical Device to perform / interpret a DiagnosticReport
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.
Extension(Reference(UK Core Device)) Extension URL https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference 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()
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.resultsInterpreter.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.resultsInterpreter.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| specimen | I | 0..* | Reference(UK Core Specimen) | Element IdDiagnosticReport.specimen Specimens this report is based on Definition Details about the specimens on which this diagnostic report is based.
Need to be able to report information about the collected specimens on which the report is based.
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.
Reference(UK Core Specimen) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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]
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.specimen.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.specimen.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| result | I | 0..* | Reference(UK Core Observation) | Element IdShort description Observations Alternate names Data, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer Definition Requirements Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.
Observations can contain observations.
Reference(UK Core Observation) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.result.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.result.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.result.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.result.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.result.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.result.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.result.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.result.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.result.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.result.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| imagingStudy | I | 0..* | Reference(UK Core Imaging Study) | Element IdDiagnosticReport.imagingStudy 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.
ImagingStudy and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However, each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.
Reference(UK Core Imaging Study) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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]
|
| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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 | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://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 | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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 I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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 I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.imagingStudy.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.imagingStudy.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
|
| media | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element IdShort 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).
Many diagnostic services include images in the report as part of their service.
BackboneElement Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:OBX?
- rim:outboundRelationship[typeCode=COMP].target
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| link | Σ I | 1..1 | Reference(Media) | There are no (further) constraints on this element Element IdDiagnosticReport.media.link Reference to the image source Definition Reference to the image source.
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.
Reference(Media) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- rim:.value.reference
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| reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.reference Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.type Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.identifier Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
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| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.identifier.use usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
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| type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.identifier.type Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Allows users to make use of identifiers when the identifier system is not known.
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.
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)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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
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| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.identifier.system 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.
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.
Identifier.system is always case sensitive.
uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Generalhttp://www.acme.com/identifiers/patient
Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
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| value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.identifier.value 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.
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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
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| period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.identifier.period Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
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").
Period is not used for a duration (a measure of elapsed time). See Duration.
Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
- 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
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| assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdDiagnosticReport.media.link.identifier.assigner Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
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.
Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
- 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
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.media.link.display Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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| conclusion | | 0..1 | string | There are no (further) constraints on this element Element IdDiagnosticReport.conclusion Clinical conclusion (interpretation) of test results Alternate names Report Definition Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.
Need to be able to provide a conclusion that is not lost among the basic result data.
Note that FHIR strings SHALL NOT exceed 1MB in size
string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- rim:n/a
- v2:OBX
- rim:inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)
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| conclusionCode | | 0..* | CodeableConceptBinding | Element IdDiagnosticReport.conclusionCode Codes for the clinical conclusion of test results Definition One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.
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.
CodeableConcept Binding Diagnosis codes provided as adjuncts to the report. SNOMEDCTClinicalFindings (preferred)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
- 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)
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| presentedForm | I | 0..* | Attachment | There are no (further) constraints on this element Element IdDiagnosticReport.presentedForm 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.
Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.
"application/pdf" is recommended as the most reliable and interoperable in this context.
Attachment Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - att-1:If the Attachment has data, it SHALL have a contentType
data.empty() or contentType.exists()
- rim:n/a
- v2:ED/RP
- rim:ED
- v2:OBX
- rim:text (type=ED)
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