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Query
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    FQL is a query language that allows you to retrieve, filter and project data from any data source containing FHIR Resources. It brings the power of three existing languages together: SQL, JSON and FhirPath. It allows you to create tables and is useful for gaining insight and perform quality control.

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Project strict

Laborbericht für Shigella sp.

Der Shigella sp.-Laborbericht kann mehrere Shigella sp.-Erregernachweise enthalten und fasst die Ergebnisse der Einzeltests zusammen.

  • type Profile on DiagnosticReport
  • FHIR R4
  • status Active
  • version
    1.3.0
  Unregistered conflicting canonical

The canonical from this resource does not match any claim in this context and conflicts with a claim from another scope.

https://demis.rki.de/fhir

Canonical claims are used to verify ownership of your canonical URLs.

 Canonical
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LaboratoryReportSHIP (DiagnosticReport)ILaboratoryReport
There are no (further) constraints on this element
Element id

DiagnosticReport

Short description

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

Alternate names

Report, Test, Result, Results, Labs, Laboratory

Definition

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

Comments

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

Data type

LaboratoryReport

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • v2: ORU -> OBR
  • rim: Observation[classCode=OBS, moodCode=EVN]
idΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

metaS Σ1..1Meta
There are no (further) constraints on this element
Element id

DiagnosticReport.meta

Short description

Metadata about the resource

Definition

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

Data type

Meta

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
versionIdΣ0..1id
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.versionId

Short description

Version specific identifier

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Data type

id

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
lastUpdatedΣ0..1instant
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.lastUpdated

Short description

When the resource version last changed

Definition

When the resource last changed - e.g. when the version changed.

Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Data type

instant

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
sourceΣ0..1uri
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.source

Short description

Identifies where the resource comes from

Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
profileS Σ1..1canonical(StructureDefinition)Fixed ValueElement id

DiagnosticReport.meta.profile

Short description

Profiles this resource claims to conform to

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Data type

canonical(StructureDefinition)

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

https://demis.rki.de/fhir/StructureDefinition/LaboratoryReportSHIP

securityΣ0..*CodingBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.security

Short description

Security Labels applied to this resource

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

Coding

Binding

Security Labels from the Healthcare Privacy and Security Classification System.

All Security Labels (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
tagΣ0..*Coding
There are no (further) constraints on this element
Element id

DiagnosticReport.meta.tag

Short description

Tags applied to this resource

Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

Coding

Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id

DiagnosticReport.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
language0..1codeBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
text0..1Narrative
There are no (further) constraints on this element
Element id

DiagnosticReport.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id

DiagnosticReport.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings
  • rim: N/A
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
reasonForTestingI0..1Extension(CodeableConcept)
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting

Short description

Why was event performed?

Alternate names

extensions, user content

Definition

Describes why the event occurred in coded or textual form.

Comments

For free text (uncoded data) use reasonCode.text.

Data type

Extension(CodeableConcept)

Extension URL

http://hl7.org/fhir/StructureDefinition/workflow-reasonCode

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • workflow: Event.reasonCode
  • v2: EVN.4 or by domain
  • rim: .reasonCode
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..0Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.extension

Short description

Extension

Definition

An Extension

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
url1..1uriFixed Value
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.url

Short description

identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Data type

uri

Fixed value

http://hl7.org/fhir/StructureDefinition/workflow-reasonCode

Mappings
  • rim: N/A
value[x]S1..1Binding
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x]

Short description

Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Binding

ReasonForTesting (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
valueCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingS Σ1..1Coding
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemS Σ1..1uri
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.system

Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

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

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.version

Short description

Version of the system - if relevant

Definition

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

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeS Σ1..1code
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.code

Short description

Symbol in syntax defined by the system

Definition

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

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.display

Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

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

Requirements

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

Comments

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

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
textΣ0..0string
There are no (further) constraints on this element
Element id

DiagnosticReport.extension:reasonForTesting.value[x].text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
modifierExtension?! I0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id

DiagnosticReport.identifier

Short description

Business identifier for report

Alternate names

ReportID, Filler ID, Placer ID

Definition

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

Requirements

Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.

Comments

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

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
basedOnS0..1Reference(ServiceRequest)
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn

Short description

Laborauftragsnummer

Alternate names

Request

Definition

Es ist nicht ein echter ServiceRequest anzugeben, sondern eine logische Variante, die über die Laborauftragsnummer referenziert wird.

Requirements

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

Comments

Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.

Data type

Reference(ServiceRequest)

Allowed aggregation: referenced

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.basedOn
  • v2: ORC? OBR-2/3?
  • rim: outboundRelationship[typeCode=FLFS].target
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
referenceΣ I0..0string
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.reference

Short description

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.

Comments

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.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
typeS Σ1..1uriBindingFixed Value
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.type

Short description

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).

Comments

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.

Data type

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())
Fixed value

ServiceRequest

Mappings
  • rim: N/A
identifierS Σ1..1Identifier
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier

Short description

Laborauftragsnummer

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.

Comments

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).

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.type

Short description

Description of identifier

Definition

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

Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Data type

CodeableConcept

Binding

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

Identifier Type Codes (extensible)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
systemS Σ0..1uriFixed Value
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

uri

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

https://demis.rki.de/fhir/NamingSystem/ServiceRequestId

Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
valueS Σ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. 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.

Data type

string

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

123456


Mappings
  • 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
periodΣ0..1Period
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.period

Short description

Time period when id is/was valid for use

Definition

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

Data type

Period

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ0..1Reference(Organization)
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
displayΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.basedOn.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
statusS Σ ?!1..1codeBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.status

Short description

Status der Testergebnisse

Definition

Status der Testergebnisse

Requirements

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

Comments

Der Status ist szenarienspezifisch folgendermaßen zu belegen. final - bei einer Meldung, bei der kein Bestätigungstest notwendig ist, bei einem erfolgten Bestätigungstest; preliminary - bei einer Meldung, bei der ein Bestätigungstest notwendig ist; amended/corrected - bei einer Korrekturmeldung

Data type

code

Binding

Status des Laborberichts

LaboratoryReportStatus (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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"
categoryΣ0..0CodeableConcept
There are no (further) constraints on this element
Element id

DiagnosticReport.category

Short description

Service category

Alternate names

Department, Sub-department, Service, Discipline

Definition

A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.

Comments

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.

Data type

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())
Mappings
  • w5: FiveWs.class
  • v2: OBR-24
  • rim: inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code < LabService].code
codeS Σ1..1CodeableConceptBindingElement id

DiagnosticReport.code

Short description

Meldetatbestand

Alternate names

Type

Definition

Im Laborbericht für Shigella sp. ist der code immer mit dem Wert "ship" aus dem ValueSet https://demis.rki.de/fhir/CodeSystem/notificationCategory zu belegen.

Data type

CodeableConcept

Binding

Codes that describe Diagnostic Reports.

LOINCDiagnosticReportCodes (preferred)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.code.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.code.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingS Σ1..1CodingBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Binding

Meldetatbestand

NotificationCategory (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.code.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.code.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemS Σ1..1uriFixed ValueElement id

DiagnosticReport.code.coding.system

Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

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

Data type

uri

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

https://demis.rki.de/fhir/CodeSystem/notificationCategory

Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.code.coding.version

Short description

Version of the system - if relevant

Definition

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

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeS Σ1..1codeFixed ValueElement id

DiagnosticReport.code.coding.code

Short description

Symbol in syntax defined by the system

Definition

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

Requirements

Need to refer to a particular code in the system.

Data type

code

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

ship

Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ1..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.code.coding.display

Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id

DiagnosticReport.code.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

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

Requirements

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

Comments

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

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
textΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.code.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subjectS Σ1..1Reference(https://demis.rki.de/fhir/StructureDefinition/NotifiedPerson | https://demis.rki.de/fhir/StructureDefinition/NotifiedPersonAnonymous)
There are no (further) constraints on this element
Element id

DiagnosticReport.subject

Short description

Verweis auf die in der Meldung benannte betroffene Person.

Alternate names

Patient

Definition

Verweis auf die in der Meldung benannte betroffene Person. Hierbei handelt es sich grundsätzlich um den Verweis auf die in der Erregernachweismeldung als „subject“ referenzierte Patient Ressource.

Requirements

SHALL know the subject context.

Data type

Reference(https://demis.rki.de/fhir/StructureDefinition/NotifiedPerson | https://demis.rki.de/fhir/StructureDefinition/NotifiedPersonAnonymous)

Allowed aggregation: bundled

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.subject.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.subject.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
referenceS Σ I1..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.subject.reference

Short description

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.

Comments

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.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.subject.type

Short description

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).

Comments

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.

Data type

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())
Mappings
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id

DiagnosticReport.subject.identifier

Short description

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.

Comments

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).

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.subject.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
encounterΣ0..0Reference(Encounter)
There are no (further) constraints on this element
Element id

DiagnosticReport.encounter

Short description

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.

Requirements

Links the request to the Encounter context.

Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

Data type

Reference(Encounter)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.encounter
  • w5: FiveWs.context
  • v2: PV1-19
  • rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
effective[x]Σ0..0
There are no (further) constraints on this element
Element id

DiagnosticReport.effective[x]

Short description

Clinically relevant time/time-period for report

Alternate names

Observation time, Effective Time, Occurrence

Definition

The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

Requirements

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

Comments

If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: effectiveTime
issuedS Σ1..1instant
There are no (further) constraints on this element
Element id

DiagnosticReport.issued

Short description

Zeitpunkt der Erstellung/Bearbeitung (der aktuellen Version) des Laborberichts

Alternate names

Date published, Date Issued, Date Verified

Definition

Zeitpunkt der Erstellung/Bearbeitung (der aktuellen Version) des Laborberichts. Dieser ändert sich entsprechend bei Ergänzungen/Korrekturen.

Requirements

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

Comments

May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.

Data type

instant

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.recorded
  • v2: OBR-22
  • rim: participation[typeCode=VRF or AUT].time
performerΣ0..0Reference(Practitioner | PractitionerRole | Organization | CareTeam)
There are no (further) constraints on this element
Element id

DiagnosticReport.performer

Short description

Responsible Diagnostic Service

Alternate names

Laboratory, Service, Practitioner, Department, Company, Authorized by, Director

Definition

The diagnostic service that is responsible for issuing the report.

Requirements

Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.

Comments

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

Data type

Reference(Practitioner | PractitionerRole | Organization | CareTeam)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • v2: PRT-8 (where this PRT-4-Participation = "PO")
  • rim: .participation[typeCode=PRF]
resultsInterpreterΣ0..0Reference(Practitioner | PractitionerRole | Organization | CareTeam)
There are no (further) constraints on this element
Element id

DiagnosticReport.resultsInterpreter

Short description

Primary result interpreter

Alternate names

Analyzed by, Reported by

Definition

The practitioner or organization that is responsible for the report's conclusions and interpretations.

Requirements

Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.

Comments

Might not be the same entity that takes responsibility for the clinical report.

Data type

Reference(Practitioner | PractitionerRole | Organization | CareTeam)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • v2: OBR-32, PRT-8 (where this PRT-4-Participation = "PI")
  • rim: .participation[typeCode=PRF]
specimen0..0Reference(Specimen)
There are no (further) constraints on this element
Element id

DiagnosticReport.specimen

Short description

Specimens this report is based on

Definition

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

Requirements

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

Comments

If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.

Data type

Reference(Specimen)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SPM
  • rim: participation[typeCode=SBJ]
resultS1..*Reference(PathogenDetectionSHIP)Element id

DiagnosticReport.result

Short description

Shigella sp.-Erregernachweis

Alternate names

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

Definition

Referenziert einen Shigella sp.-Erregernachweis

Requirements

Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

Comments

Observations can contain observations.

Data type

Reference(PathogenDetectionSHIP)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBXs
  • rim: outboundRelationship[typeCode=COMP].target
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.result.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.result.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
referenceS Σ I1..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.result.reference

Short description

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.

Comments

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.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.result.type

Short description

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).

Comments

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.

Data type

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())
Mappings
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id

DiagnosticReport.result.identifier

Short description

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.

Comments

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).

Data type

Identifier

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .identifier
displayΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.result.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

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.

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
imagingStudy0..0Reference(ImagingStudy)
There are no (further) constraints on this element
Element id

DiagnosticReport.imagingStudy

Short description

Reference to full details of imaging associated with the diagnostic report

Definition

One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.

Comments

ImagingStudy and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However, each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.

Data type

Reference(ImagingStudy)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]
mediaΣ0..0BackboneElement
There are no (further) constraints on this element
Element id

DiagnosticReport.media

Short description

Key images associated with this report

Alternate names

DICOM, Slides, Scans

Definition

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

Requirements

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

Data type

BackboneElement

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX?
  • rim: outboundRelationship[typeCode=COMP].target
conclusionS0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusion

Short description

Textuelle Zusammenfassung der Testergebnisse

Alternate names

Report

Definition

Fasst die Ergebnisse der Einzeltests in textueller Form zusammen.

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX
  • rim: inboundRelationship[typeCode="SPRT"].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)
conclusionCodeS1..1CodeableConcept
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode

Short description

Kodierte Zusammenfassung der Testergebnisse

Definition

Fasst die Ergebnisse der Einzeltests in kodierter Form zusammen und gibt damit an, ob der Meldetatbestand erfüllt ist.

Data type

CodeableConcept

Binding

Diagnosis codes provided as adjuncts to the report.

SNOMEDCTClinicalFindings (example)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX
  • rim: inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
codingS Σ1..1CodingBinding
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Binding

Gesamttestergebnis

ConclusionCode (required)

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionI0..*Extension
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Extension

Sliced:

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
systemS Σ1..1uri
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.system

Short description

Identity of the terminology system

Definition

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

Requirements

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

Comments

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

Data type

uri

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
versionΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.version

Short description

Version of the system - if relevant

Definition

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

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
codeS Σ1..1code
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.code

Short description

Symbol in syntax defined by the system

Definition

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

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
displayΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.display

Short description

Representation defined by the system

Definition

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

Requirements

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelectedΣ0..1boolean
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

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

Requirements

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

Comments

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

Data type

boolean

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
textΣ0..1string
There are no (further) constraints on this element
Element id

DiagnosticReport.conclusionCode.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

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

Data type

string

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
presentedForm0..0Attachment
There are no (further) constraints on this element
Element id

DiagnosticReport.presentedForm

Short description

Entire report as issued

Definition

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

Requirements

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

Comments

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

Data type

Attachment

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: OBX
  • rim: text (type=ED)

Documentation:
https://simplifier.net/strict/laboratoryreportship
Last updated on 4/15/2025, 1:37:18 PM

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