Interweave Implementation Guide
0.1.0 - ci-build United Kingdom flag

Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: InterweaveDiagnosticReport

Official URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-DiagnosticReport Version: 0.0.1
Draft as of 2024-07-15 Computable Name: InterweaveDiagnosticReport

Interweave DiagnosticReport resource profile - DRAFT.

Status: DRAFT: For Review

Introduction

This profile sets out the expectations for the interweave DiagnosticReport resource. We use the UKCore-DiagnosticReport structure definition as a base to this profile.

As noted in the FHIR specifications, a Diagnostic Report allows for presenting a combination of:

  • Laboratory (Clinical Chemistry, Hematology, Microbiology, etc.)
  • Pathology / Histopathology / related disciplines
  • Imaging Investigations (x-ray, CT, MRI etc.) (images are currently out of scope for the shared care record)
  • Other diagnostics - Cardiology, Gastroenterology etc.

Mandatory fields

The following mandatory fields are defined:

  1. Status - The status of the diagnostic report. This is mandatory in FHIR, with a short list of codes provided. Most commonly the status will be "final". (Other statuses may be used if relevant, but must be kept up-to-date)

  2. Subject - every Diagnostic Report must be linked to a Patient.

  3. Issued date - when the report was issued.

  4. Category - A code that classifies the clinical discipline, department or diagnostic service that created the report. Provides a high-level categorisation of the report. This is based on a short and simple list provided by FHIR which is expected to be straightforward to map to (eg "Radiology"). Useful for sorting and filtering.

  5. Code - A code or name that describes this diagnostic report. This is mandatory in FHIR and defines in more detail the type of diagnostic report. The coding of diagnostic reports is known to be a difficult topic, and at this stage a single set of codes is difficult to prescribe. However the following are preferred, most favoured first:

    • SNOMED - UKCore defines the use of SNOMED coding based on the use of 371525003 - Clinical procedure report

    • NICIP - this code list covers only imaging. However within that domain it has been defined by NHS Digital and mandated for use by the Information Standards Board. See https://digital.nhs.uk/services/terminology-and-classifications/national-interim-clinical-imaging-procedure-nicip-code-set. Note that the NICIP codes include a maintained standard mapping to SNOMED, and so typically the associated SNOMED code can also be provided as a second coding

    • LOINC - the default mapping in FHIR is to LOINC codes for diagnostic reporting

    • Local Codes - outside of the imaging domain there is significant variation in coding and, whilst mapping to one of the above standards is preferred, it may not always be feasible.

    NB: Any intention to use local codes must be explicitly discussed and approved

    NB: In all cases display text must be provided so that, regardless of coding, the type of report can be understood by a user

Must Support fields

In addition the following fields are "Must Support" – i.e., they must be populated if relevant and known.

  1. identifier - A Local Id should be provided, such that could be quoted if manually getting in touch to find out more.

  2. encounter - This provides a link to the Encounter. Whilst there will not always be an Encounter, it is important to populate if it is relevant - to help build the complete picture by linking together all activities surrounding the Encounter.

  3. Effective[x] - Clinically relevant time/time-period for report. 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.

  4. Result - this allows for (semi) structured results to be offered in the form of a list of Observations. Whilst some types of Diagnostic Report are purely textual, for others these structured Observations are extremely important.

    Note: The relevant Observations for different types of report, and tips for populating from common Radiology and Lab systems is potentially a topic for a further paper in its own right

  5. Presented Form - this allows for a textual report to be offered. This must be provided whenever a written report "document" is present.

    • Within "presented form" it is mandatory to populate the Content Type, so that consumers can be aware and process accordingly.

      Data Providers and Data Consumers SHOULD support the following contentTypes:

      • application/pdf
      • text/html
      • image/jpeg
      • image/png (currently not supported in Interweave Portal, however it is on the roadmap)

      (This list may be added to by request and discussion)

      Other contentTypes should only be used with caution, as not all Data Consumers may be able to view them.

    • As of this writing (Jul 2024) the actual content must be Base64 encoded and included in the "data" element
    • Longer term it is anticipated that the messaging infrastructure will be enhanced to also support "url" links to a separately saved document - with this then becoming the preferred mechanism due to the reduced message size. (See DocumentReference for further guidance on providing url links)
    • A particular issue for Diagnostic Reports is that the underlying source for many diagnostic reports is messages extracted from a text-based lab or RIS system.
      • The strongly preferred approach is to reformat textual reports as HTML - as this is an interoperable standard which guarantees consistent presentation across any consumer system
      • It is also important to ensure that any such text is HTML Encoded - for example to make sure that characters such as "<" in the report do not cause problems when displaying.
      • In some cases this presentation as HTML may be relatively easy to do - for example if the report is already structured as separate lines which can be simply "decorated" with HTML tags
      • In other cases it may be much more difficult to format the report text - for example if the original report is structured as a single block of text containing various escape characters. Tackling this is, however, a key part of a Data Provider's work in offering their reports in an interoperable format for wider sharing.

Optional fields

Other fields are optional and may be populated if known – on the understanding that not all data consumers will necessarily make use of them. Points of note include:

  • extension:noteR5 - Comments about the diagnostic report. This is a R5 backport. It may include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.

  • extension:supportingInfoR5 - Additional info supporting the diagnostic report. This is a R5 backport. This backbone element contains supporting information that was used in the creation of the report not included in the results already included in the report.

  • basedOn - What was requested. Details concerning a service requested.

  • Performer - again this may be useful if available. (Noting that for a regional shared care record the practitioner managing the overall encounter may often be of greater relevance).

    • performer.extension:deviceReference - An UKCore extension that reference to a Device which interprets / performs the results of the DiagnosticReport
  • Specimen - if relevant and available then details of the specimen should be provided.

  • Conclusion - this is an important field, and only considered "optional" due to the potential difficulty of populating it in practice. It provides a brief summary of the findings, typically easier to understand than the technical detail of the full report. This information can often be found in the "comments" field(s) of a lab or RIS system. However the wide variation in usage of these "comments" fields can make it challenging to identify and extract reliably.

  • conclusionCode - this is in effect the "conclusion" in coded form. Whilst this could obviously be useful to populate, it often may not be feasible given the challenges described above in extracting even a text-based conclusion.

Discouraged or Removed fields

  • resultsInterpreter - Removed.

  • media and Imaging Study - The priority for the shared care record is to share results and reports, rather than raw image data. Please note that there is no support for retrieving these imaging links. (Note that this position could change in future - please get in touch if you have a specific use-case).

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from UKCoreDiagnosticReport

NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..* UKCoreDiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... versionId S 0..1 id Version specific identifier
.... lastUpdated S 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... code S 1..1 code The Data Provider Id of the system supplying the data
...... display S 1..1 string Name of the system supplying the data
..... tag:Provenance S 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... code S 1..1 code The ODS Code of the organisation responsible for the data
...... display S 1..1 string Name of the organisation supplying the data
... implicitRules 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... extension:compositionReferenceR5 0..0
... Slices for identifier 0..* Identifier Business identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... assigner 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
.... identifier:localIdentifier S 0..1 Identifier Business identifier for report
..... system S 1..1 uri The namespace for the identifier value
Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-diagnosticReport-identifier
..... value S 1..1 string The Local diagnosticReport Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
..... period 0..0
... basedOn 0..* Reference(InterweaveCarePlan | InterweaveMedicationRequest | InterweaveServiceRequest) What was requested
... category 1..1 CodeableConcept A code that classifies the clinical discipline, department or diagnostic service that created the report.
Binding: DiagnosticServiceSectionCodes (required)
.... coding
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... code
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:coding.system
..... coding:snomedCT 0..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code S 1..1 code SNOMED CT Clinical Procedure Report code
Binding: UK Core Report Code (required)
...... display S 1..1 string Representation defined by the system
..... coding:nicip 0..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-NICIP
...... code S 1..1 code National Interim Clinical Imaging Procedure code
Binding: InterweaveNICIPcodes (required)
...... display S 1..1 string Representation defined by the system
..... coding:loinc 0..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code S 1..1 code LOINC code
Binding: LOINCDiagnosticReportCodes (required)
...... display S 1..1 string Representation defined by the system
... subject 1..1 Reference(InterweavePatient) The subject of the report - usually, but not always, the patient.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... encounter 0..1 Reference(InterweaveEncounter) Health care event when test ordered.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 0..1 string If relevant, description of the referenced resource
... effective[x] S 0..1 dateTime, Period Clinically relevant time/time-period for report
... issued 1..1 instant Clinically relevant time / time-period for report.
... resultsInterpreter 0..0
... result
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 0..1 string If relevant, description of the referenced resource
... imagingStudy 0..* Reference(ImagingStudy) DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... media 0..* BackboneElement DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... conclusionCode
.... coding
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... presentedForm S 0..* Attachment Entire report as issued
.... contentType S 1..1 code Mime type of the content, with charset etc.

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
DiagnosticReport.categoryrequiredDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
from the FHIR Standard
DiagnosticReport.code.coding:snomedCT.coderequiredUKCoreReportCode
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/UKCore-ReportCode
from this IG
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIPcodes
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-NICIP
from this IG
DiagnosticReport.code.coding:loinc.coderequiredLOINCDiagnosticReportCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/report-codes
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..* UKCoreDiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... noteR5 0..* (Complex) Comments about the diagnostic report. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
..... value[x] 1..1 Annotation Comments about the diagnostic report.
.... supportingInfoR5 0..* (Complex) Additional info supporting the diagnostic report. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.supportingInfo
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
.... identifier:localIdentifier SΣ 0..1 Identifier Business identifier for report
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system SΣ 1..1 uri The namespace for the identifier value
Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-diagnosticReport-identifier
..... value SΣ 1..1 string The Local diagnosticReport Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
Example General: 123456
... basedOn 0..* Reference(InterweaveCarePlan | InterweaveMedicationRequest | InterweaveServiceRequest) What was requested
... status ?!SΣ 1..1 code The status of the diagnostic report.
Binding: DiagnosticReportStatus (required): The status of the diagnostic report.

... category SΣ 1..1 CodeableConcept A code that classifies the clinical discipline, department or diagnostic service that created the report.
Binding: DiagnosticServiceSectionCodes (required)
... code SΣ 1..1 CodeableConcept A code or name that describes this diagnostic report.
Binding: UK Core Report Code (preferred)
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:coding.system
..... coding:snomedCT Σ 0..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code SΣ 1..1 code SNOMED CT Clinical Procedure Report code
Binding: UK Core Report Code (required)
...... display SΣ 1..1 string Representation defined by the system
..... coding:nicip Σ 0..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-NICIP
...... code SΣ 1..1 code National Interim Clinical Imaging Procedure code
Binding: InterweaveNICIPcodes (required)
...... display SΣ 1..1 string Representation defined by the system
..... coding:loinc Σ 0..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code SΣ 1..1 code LOINC code
Binding: LOINCDiagnosticReportCodes (required)
...... display SΣ 1..1 string Representation defined by the system
... subject SΣ 1..1 Reference(InterweavePatient) The subject of the report - usually, but not always, the patient.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Health care event when test ordered.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 0..1 string If relevant, description of the referenced resource
... effective[x] SΣ 0..1 Clinically relevant time/time-period for report
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued SΣ 1..1 instant Clinically relevant time / time-period for report.
... result S 0..* Reference(Observation) Observations that are part of this diagnostic report.
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 0..1 string If relevant, description of the referenced resource
... imagingStudy 0..* Reference(ImagingStudy) DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... media Σ 0..* BackboneElement DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... link Σ 1..1 Reference(Media) Reference to the image source
... presentedForm S 0..* Attachment Entire report as issued
.... contentType SΣ 1..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
DiagnosticReport.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DiagnosticReport.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DiagnosticReport.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DiagnosticReport.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DiagnosticReport.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
DiagnosticReport.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DiagnosticReport.identifier:localIdentifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DiagnosticReport.statusrequiredDiagnosticReportStatus
http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1
from the FHIR Standard
DiagnosticReport.categoryrequiredDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
from the FHIR Standard
DiagnosticReport.codepreferredUKCoreReportCode
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/UKCore-ReportCode
from this IG
DiagnosticReport.code.coding:snomedCT.coderequiredUKCoreReportCode
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/UKCore-ReportCode
from this IG
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIPcodes
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-NICIP
from this IG
DiagnosticReport.code.coding:loinc.coderequiredLOINCDiagnosticReportCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/report-codes
from the FHIR Standard
DiagnosticReport.presentedForm.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDiagnosticReportIf 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-4errorDiagnosticReportIf 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-5errorDiagnosticReportIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDiagnosticReportA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..* UKCoreDiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... noteR5 0..* (Complex) Comments about the diagnostic report. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
..... value[x] 1..1 Annotation Comments about the diagnostic report.
.... supportingInfoR5 0..* (Complex) Additional info supporting the diagnostic report. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.supportingInfo
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 0..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
.... identifier:localIdentifier SΣ 0..1 Identifier Business identifier for report
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 1..1 uri The namespace for the identifier value
Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-diagnosticReport-identifier
..... value SΣ 1..1 string The Local diagnosticReport Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
Example General: 123456
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... basedOn 0..* Reference(InterweaveCarePlan | InterweaveMedicationRequest | InterweaveServiceRequest) What was requested
... status ?!SΣ 1..1 code The status of the diagnostic report.
Binding: DiagnosticReportStatus (required): The status of the diagnostic report.

... category SΣ 1..1 CodeableConcept A code that classifies the clinical discipline, department or diagnostic service that created the report.
Binding: DiagnosticServiceSectionCodes (required)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept A code or name that describes this diagnostic report.
Binding: UK Core Report Code (preferred)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:coding.system
..... coding:snomedCT Σ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code SNOMED CT Clinical Procedure Report code
Binding: UK Core Report Code (required)
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:nicip Σ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-NICIP
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code National Interim Clinical Imaging Procedure code
Binding: InterweaveNICIPcodes (required)
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... coding:loinc Σ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code LOINC code
Binding: LOINCDiagnosticReportCodes (required)
...... display SΣ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(InterweavePatient) The subject of the report - usually, but not always, the patient.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 1..1 string Description of the referenced resource
... encounter SΣ 0..1 Reference(InterweaveEncounter) Health care event when test ordered.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 0..1 string If relevant, description of the referenced resource
... effective[x] SΣ 0..1 Clinically relevant time/time-period for report
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued SΣ 1..1 instant Clinically relevant time / time-period for report.
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam) Responsible Diagnostic Service
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... deviceReference 0..1 Reference(Device) A reference to a Device which interprets / performs the results of the DiagnosticReport.
URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeviceReference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... specimen 0..* Reference(Specimen) Specimens this report is based on
... result S 0..* Reference(Observation) Observations that are part of this diagnostic report.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Reference to a resource (could be Contained)
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier If relevant could include an id
.... display Σ 0..1 string If relevant, description of the referenced resource
... imagingStudy 0..* Reference(ImagingStudy) DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... media Σ 0..* BackboneElement DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... comment 0..1 string Comment about the image (e.g. explanation)
.... link Σ 1..1 Reference(Media) Reference to the image source
... conclusion 0..1 string Clinical conclusion (interpretation) of test results
... conclusionCode 0..* CodeableConcept Codes for the clinical conclusion of test results
Binding: SNOMEDCTClinicalFindings (preferred): Diagnosis codes provided as adjuncts to the report.


.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code Σ 1..1 code Symbol in syntax defined by the system
..... display Σ 1..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... presentedForm S 0..* Attachment Entire report as issued
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... contentType SΣ 1..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
.... language Σ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
.... data 0..1 base64Binary Data inline, base64ed
.... url Σ 0..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
.... size Σ 0..1 unsignedInt Number of bytes of content (if url provided)
.... hash Σ 0..1 base64Binary Hash of the data (sha-1, base64ed)
.... title Σ 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
.... creation Σ 0..1 dateTime Date attachment was first created

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
DiagnosticReport.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DiagnosticReport.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DiagnosticReport.meta.tag:SourceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DiagnosticReport.meta.tag:ProvenanceexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DiagnosticReport.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
DiagnosticReport.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DiagnosticReport.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DiagnosticReport.identifier:localIdentifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DiagnosticReport.identifier:localIdentifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DiagnosticReport.statusrequiredDiagnosticReportStatus
http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1
from the FHIR Standard
DiagnosticReport.categoryrequiredDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
from the FHIR Standard
DiagnosticReport.codepreferredUKCoreReportCode
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/UKCore-ReportCode
from this IG
DiagnosticReport.code.coding:snomedCT.coderequiredUKCoreReportCode
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/UKCore-ReportCode
from this IG
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIPcodes
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-NICIP
from this IG
DiagnosticReport.code.coding:loinc.coderequiredLOINCDiagnosticReportCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/report-codes
from the FHIR Standard
DiagnosticReport.subject.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DiagnosticReport.encounter.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DiagnosticReport.performer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DiagnosticReport.resultsInterpreter.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DiagnosticReport.result.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DiagnosticReport.conclusionCodepreferredSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
DiagnosticReport.presentedForm.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard
DiagnosticReport.presentedForm.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDiagnosticReportIf 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-4errorDiagnosticReportIf 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-5errorDiagnosticReportIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDiagnosticReportA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from UKCoreDiagnosticReport

Summary

Mandatory: 5 elements(26 nested mandatory elements)
Must-Support: 25 elements
Fixed: 6 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DiagnosticReport.meta.tag
  • The element 1 is sliced based on the value of DiagnosticReport.identifier
  • The element 1 is sliced based on the value of DiagnosticReport.code.coding

Differential View

This structure is derived from UKCoreDiagnosticReport

NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..* UKCoreDiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id S 0..1 id Logical id of this artifact
... meta
.... id 0..0
.... versionId S 0..1 id Version specific identifier
.... lastUpdated S 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... version 0..0
...... code S 1..1 code The Data Provider Id of the system supplying the data
...... display S 1..1 string Name of the system supplying the data
..... tag:Provenance S 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... id 0..0
...... system 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... version 0..0
...... code S 1..1 code The ODS Code of the organisation responsible for the data
...... display S 1..1 string Name of the organisation supplying the data
... implicitRules 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... extension:compositionReferenceR5 0..0
... Slices for identifier 0..* Identifier Business identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... assigner 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
.... identifier:localIdentifier S 0..1 Identifier Business identifier for report
..... system S 1..1 uri The namespace for the identifier value
Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-diagnosticReport-identifier
..... value S 1..1 string The Local diagnosticReport Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
..... period 0..0
... basedOn 0..* Reference(InterweaveCarePlan | InterweaveMedicationRequest | InterweaveServiceRequest) What was requested
... category 1..1 CodeableConcept A code that classifies the clinical discipline, department or diagnostic service that created the report.
Binding: DiagnosticServiceSectionCodes (required)
.... coding
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... code
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:coding.system
..... coding:snomedCT 0..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code S 1..1 code SNOMED CT Clinical Procedure Report code
Binding: UK Core Report Code (required)
...... display S 1..1 string Representation defined by the system
..... coding:nicip 0..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-NICIP
...... code S 1..1 code National Interim Clinical Imaging Procedure code
Binding: InterweaveNICIPcodes (required)
...... display S 1..1 string Representation defined by the system
..... coding:loinc 0..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code S 1..1 code LOINC code
Binding: LOINCDiagnosticReportCodes (required)
...... display S 1..1 string Representation defined by the system
... subject 1..1 Reference(InterweavePatient) The subject of the report - usually, but not always, the patient.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 1..1 string Description of the referenced resource
... encounter 0..1 Reference(InterweaveEncounter) Health care event when test ordered.
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 0..1 string If relevant, description of the referenced resource
... effective[x] S 0..1 dateTime, Period Clinically relevant time/time-period for report
... issued 1..1 instant Clinically relevant time / time-period for report.
... resultsInterpreter 0..0
... result
.... reference 1..1 string Reference to a resource (could be Contained)
.... identifier 0..1 Identifier If relevant could include an id
.... display 0..1 string If relevant, description of the referenced resource
... imagingStudy 0..* Reference(ImagingStudy) DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... media 0..* BackboneElement DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... conclusionCode
.... coding
..... system 1..1 uri Identity of the terminology system
..... code 1..1 code Symbol in syntax defined by the system
..... display 1..1 string Representation defined by the system
... presentedForm S 0..* Attachment Entire report as issued
.... contentType S 1..1 code Mime type of the content, with charset etc.

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
DiagnosticReport.categoryrequiredDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
from the FHIR Standard
DiagnosticReport.code.coding:snomedCT.coderequiredUKCoreReportCode
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/UKCore-ReportCode
from this IG
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIPcodes
https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-NICIP
from this IG
DiagnosticReport.code.coding:loinc.coderequiredLOINCDiagnosticReportCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/report-codes
from the FHIR Standard

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..* UKCoreDiagnosticReport A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id SΣ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... versionId SΣ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant MANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
.... security Σ 0..* Coding DISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ 0..* Coding Tags applied to this resource
Slice: Unordered, Open by value:system
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


..... tag:Source SΣ 0..1 Coding MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
...... code SΣ 1..1 code The Data Provider Id of the system supplying the data
...... display SΣ 1..1 string Name of the system supplying the data
..... tag:Provenance SΣ 0..1 Coding MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


...... system Σ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
...... code SΣ 1..1 code The ODS Code of the organisation responsible for the data
...... display SΣ 1..1 string Name of the organisation supplying the data
... implicitRules ?!Σ 0..1 uri DISCOURAGED - may not be honoured by Data Consumers
... text 0..1 Narrative DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... Slices for extension Content/Rules for all slices
.... noteR5 0..* (Complex) Comments about the diagnostic report. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note
..... extension 0..0
..... url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"
..... value[x] 1..1 Annotation Comments about the diagnostic report.
.... supportingInfoR5 0..* (Complex) Additional info supporting the diagnostic report. This is a R5 backport.
URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.supportingInfo
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... assigner Σ 0..1 Reference(InterweaveOrganization) Organization that issued id (may be just text)
.... identifier:localIdentifier SΣ 0..1 Identifier Business identifier for report
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system SΣ 1..1 uri The namespace for the identifier value
Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-diagnosticReport-identifier
..... value SΣ 1..1 string The Local diagnosticReport Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
Example General: 123456
... basedOn 0..* Reference(InterweaveCarePlan | InterweaveMedicationRequest | InterweaveServiceRequest) What was requested
... status ?!SΣ 1..1 code The status of the diagnostic report.
Binding: DiagnosticReportStatus (required): The status of the diagnostic report.

... category SΣ 1..1 CodeableConcept A code that classifies the clinical discipline, department or diagnostic service that created the report.
Binding: DiagnosticServiceSectionCodes (required)
... code SΣ 1..1 CodeableConcept A code or name that describes this diagnostic report.
Binding: UK Core Report Code (preferred)
.... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:coding.system
..... coding:snomedCT Σ 0..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
...... code SΣ 1..1 code SNOMED CT Clinical Procedure Report code
Binding: UK Core Report Code (required)
...... display SΣ 1..1 string Representation defined by the system
..... coding:nicip Σ 0..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-NICIP
...... code SΣ 1..1 code National Interim Clinical Imaging Procedure code
Binding: InterweaveNICIPcodes (required)
...... display SΣ 1..1 string Representation defined by the system
..... coding:loinc Σ 0..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
......