Interweave Implementation Guide
0.1.0 - ci-build

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Resource Profile: InterweaveDiagnosticReport

Official URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-DiagnosticReport Version: 0.1.0
Active as of 2024-06-10 Computable Name: InterweaveDiagnosticReport

Interweave Diagnostic Report resource profile.

  Status: Active: Approved (STU)

Introduction

This profile sets minimum expectations for the Diagnostic Report resource. As noted in the FHIR specifications, a Diagnostic Report allows for presenting a combination of:

  • A written report “document”
  • Structured results in the form of Observations
  • Imaging (although this is currently out of scope for the shared care record)

Mandatory fields

The following mandatory fields are defined for a Diagnostic Report:

  1. Status - 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 - 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 - 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 - CareConnect 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” - ie 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. Effective date - important date to provide details of the clinically relevant period, where relevant (eg based on when specimens taken - see FHIR guidance notes for further details)

  3. Context - 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

  4. 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/tiff (no longer supported and is not recommended for web use)
      • 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 (Feb 2022) 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.
  5. 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

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:

  • 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.

  • Coded Diagnosis - this is in effect the “conclusion” in coded form (In FHIR R4 this field is renamed as “conclusionCode”). 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

  • Specimen - if relevant and available then details of the specimen should be provided

  • 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).

Discouraged or Removed fields

  • Image and Imaging Study - the priority for the shared care record is to share results and reports, rather than raw image data. As of this writing (Feb 2022) 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:

Formal Views of Profile Content

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

This structure is derived from CareConnect-DiagnosticReport-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..*CareConnect-DiagnosticReport-1A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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 identifier 0..*IdentifierBusiness identifier for report
Slice: Unordered, Open by value:system
.... identifier:localIdentifier S0..1IdentifierBusiness identifier for report
..... system S1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-diagnostic-report-identifier
..... value S1..1stringThe Local diagnostic-report Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
..... period 0..0
... status S1..1coderegistered | partial | preliminary | final +
... category S1..1CodeableConceptService category
Binding: Diagnostic Service Section Codes (required)
.... coding 0..*CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... code S1..1CodeableConceptName/Code for this diagnostic report
Binding: Care Connect Report Code SnCT (preferred)
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
..... coding:nicip 0..1CodingCode defined by a terminology system
...... system S0..1uriIdentity of the terminology system
Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-NICIP-1
...... code S0..1codeNational Interim Clinical Imaging Procedure code
Binding: InterweaveNICIP codes (required)
...... display S0..1stringRepresentation defined by the system
..... coding:loinc 0..1CodingCode defined by a terminology system
...... system S0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code S0..1codeLOINC code
Binding: LOINC Diagnostic Report Codes (required)
...... display S0..1stringRepresentation defined by the system
... subject S1..1Reference(CareConnectPatient1)The subject of the report - for our purposes the patient
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Health care event when test ordered
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... effective[x] S0..1dateTime, PeriodClinically relevant time/time-period for report
... issued S1..1instantDateTime this version was released
... result S0..*Reference(CareConnect-Observation-1)Observations - simple, or complex nested groups
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... imagingStudy 0..*Reference(ImagingStudy | ImagingManifest)DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... image 0..*BackboneElementDISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... presentedForm S0..*AttachmentEntire report as issued
.... contentType S1..1codeMime type of the content, with charset etc.

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
DiagnosticReport.categoryrequiredDiagnostic Service Section Codes
DiagnosticReport.codepreferredCare Connect Report Code SnCT
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIP codes
DiagnosticReport.code.coding:loinc.coderequiredLOINC Diagnostic Report Codes (a valid code from LOINC)
NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..*CareConnect-DiagnosticReport-1A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - 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 Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier Σ0..*IdentifierBusiness identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ1..1stringThe value that is unique
Example General: 123456
.... identifier:localIdentifier SΣ0..1IdentifierBusiness identifier for report
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-diagnostic-report-identifier
..... value SΣ1..1stringThe Local diagnostic-report Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
Example General: 123456
... status ?!SΣ1..1coderegistered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.

... category SΣ1..1CodeableConceptService category
Binding: Diagnostic Service Section Codes (required)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... system Σ1..1uriIdentity of the terminology system
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
... code SΣ1..1CodeableConceptName/Code for this diagnostic report
Binding: Care Connect Report Code SnCT (preferred)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... system Σ1..1uriIdentity of the terminology system
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
Binding: Care Connect Report Code SnCT (extensible): A code from the SNOMED Clinical Terminology UK


...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:nicip Σ0..1CodingCode defined by a terminology system
...... system SΣ0..1uriIdentity of the terminology system
Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-NICIP-1
...... code SΣ0..1codeNational Interim Clinical Imaging Procedure code
Binding: InterweaveNICIP codes (required)
...... display SΣ0..1stringRepresentation defined by the system
..... coding:loinc Σ0..1CodingCode defined by a terminology system
...... system SΣ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code SΣ0..1codeLOINC code
Binding: LOINC Diagnostic Report Codes (required)
...... display SΣ0..1stringRepresentation defined by the system
... subject SΣ1..1Reference(CareConnectPatient1)The subject of the report - for our purposes the patient
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context SΣ0..1Reference(CareConnect-Encounter-1)Health care event when test ordered
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
... effective[x] SΣ0..1Clinically relevant time/time-period for report
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued SΣ1..1instantDateTime this version was released
... result S0..*Reference(CareConnect-Observation-1)Observations - simple, or complex nested groups
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
... imagingStudy 0..*Reference(ImagingStudy | ImagingManifest)DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... image Σ0..*BackboneElementDISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... link Σ1..1Reference(Media)Reference to the image source
... presentedForm S0..*AttachmentEntire report as issued
.... contentType SΣ1..1codeMime type of the content, with charset etc.
Binding: mimetypes (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

PathConformanceValueSet
DiagnosticReport.meta.securityextensibleAll Security Labels
DiagnosticReport.meta.tagexampleCommon Tags
DiagnosticReport.meta.tag:SourceexampleCommon Tags
DiagnosticReport.meta.tag:ProvenanceexampleCommon Tags
DiagnosticReport.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
DiagnosticReport.identifier.userequiredIdentifierUse
DiagnosticReport.identifier:localIdentifier.userequiredIdentifierUse
DiagnosticReport.statusrequiredDiagnosticReportStatus
DiagnosticReport.categoryrequiredDiagnostic Service Section Codes
DiagnosticReport.codepreferredCare Connect Report Code SnCT
DiagnosticReport.code.coding:snomedCTextensibleCare Connect Report Code SnCT
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIP codes
DiagnosticReport.code.coding:loinc.coderequiredLOINC Diagnostic Report Codes (a valid code from LOINC)
DiagnosticReport.presentedForm.contentTyperequiredhttp://hl7.org/fhir/ValueSet/mimetypes

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
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
: contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..*CareConnect-DiagnosticReport-1A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - 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 Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier Σ0..*IdentifierBusiness identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription 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 Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
.... identifier:localIdentifier SΣ0..1IdentifierBusiness identifier for report
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription 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 SΣ1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-diagnostic-report-identifier
..... value SΣ1..1stringThe Local diagnostic-report Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
Example General: 123456
..... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... basedOn 0..*Reference(CareConnect-CarePlan-1 | CareConnect-MedicationRequest-1 | CareConnect-ReferralRequest-1 | CareConnect-ProcedureRequest-1)What was requested
... status ?!SΣ1..1coderegistered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.

... category SΣ1..1CodeableConceptService category
Binding: Diagnostic Service Section Codes (required)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptName/Code for this diagnostic report
Binding: Care Connect Report Code SnCT (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
Binding: Care Connect Report Code SnCT (extensible): A code from the SNOMED Clinical Terminology UK


...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:nicip Σ0..1CodingCode defined by a terminology system
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ0..1uriIdentity of the terminology system
Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-NICIP-1
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ0..1codeNational Interim Clinical Imaging Procedure code
Binding: InterweaveNICIP codes (required)
...... display SΣ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:loinc Σ0..1CodingCode defined by a terminology system
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ0..1codeLOINC code
Binding: LOINC Diagnostic Report Codes (required)
...... display SΣ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(CareConnectPatient1)The subject of the report - for our purposes the patient
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context SΣ0..1Reference(CareConnect-Encounter-1)Health care event when test ordered
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
... effective[x] SΣ0..1Clinically relevant time/time-period for report
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued SΣ1..1instantDateTime this version was released
... performer Σ0..*BackboneElementParticipants in producing the report
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... role Σ0..1CodeableConceptType of performer
Binding: Procedure Performer Role Codes (example): Indicate a role of diagnostic report performer

.... actor Σ1..1Reference(CareConnect-Organization-1 | CareConnect-Practitioner-1)Practitioner or Organization participant
... specimen 0..*Reference(CareConnect-Specimen-1)Specimens this report is based on
... result S0..*Reference(CareConnect-Observation-1)Observations - simple, or complex nested groups
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
... imagingStudy 0..*Reference(ImagingStudy | ImagingManifest)DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... image Σ0..*BackboneElementDISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... comment 0..1stringComment about the image (e.g. explanation)
.... link Σ1..1Reference(Media)Reference to the image source
... conclusion 0..1stringClinical Interpretation of test results
... codedDiagnosis 0..*CodeableConceptCodes for the conclusion
Binding: Care Connect Finding Code (preferred): A SNOMED Coded finding for the test report.


.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
Binding: Care Connect Finding Code (extensible): A code from the SNOMED Clinical Terminology UK


...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... presentedForm S0..*AttachmentEntire report as issued
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... contentType SΣ1..1codeMime type of the content, with charset etc.
Binding: mimetypes (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
.... language Σ0..1codeHuman language of the content (BCP-47)
Binding: Common Languages (extensible): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding

Example General: en-AU
.... data 0..1base64BinaryData inline, base64ed
.... url Σ0..1uriUri where the data can be found
Example General: http://www.acme.com/logo-small.png
.... size Σ0..1unsignedIntNumber of bytes of content (if url provided)
.... hash Σ0..1base64BinaryHash of the data (sha-1, base64ed)
.... title Σ0..1stringLabel to display in place of the data
Example General: Official Corporate Logo
.... creation Σ0..1dateTimeDate attachment was first created

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
DiagnosticReport.meta.securityextensibleAll Security Labels
DiagnosticReport.meta.tagexampleCommon Tags
DiagnosticReport.meta.tag:SourceexampleCommon Tags
DiagnosticReport.meta.tag:ProvenanceexampleCommon Tags
DiagnosticReport.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
DiagnosticReport.identifier.userequiredIdentifierUse
DiagnosticReport.identifier.typeextensibleIdentifier Type Codes
DiagnosticReport.identifier:localIdentifier.userequiredIdentifierUse
DiagnosticReport.identifier:localIdentifier.typeextensibleIdentifier Type Codes
DiagnosticReport.statusrequiredDiagnosticReportStatus
DiagnosticReport.categoryrequiredDiagnostic Service Section Codes
DiagnosticReport.codepreferredCare Connect Report Code SnCT
DiagnosticReport.code.coding:snomedCTextensibleCare Connect Report Code SnCT
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIP codes
DiagnosticReport.code.coding:loinc.coderequiredLOINC Diagnostic Report Codes (a valid code from LOINC)
DiagnosticReport.performer.roleexampleProcedure Performer Role Codes
DiagnosticReport.codedDiagnosispreferredCare Connect Finding Code
DiagnosticReport.codedDiagnosis.coding:snomedCTextensibleCare Connect Finding Code
DiagnosticReport.presentedForm.contentTyperequiredhttp://hl7.org/fhir/ValueSet/mimetypes
DiagnosticReport.presentedForm.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())

This structure is derived from CareConnect-DiagnosticReport-1

Summary

Mandatory: 4 elements (15 nested mandatory elements)
Must-Support: 29 elements
Fixed Value: 5 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from CareConnect-DiagnosticReport-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..*CareConnect-DiagnosticReport-1A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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 identifier 0..*IdentifierBusiness identifier for report
Slice: Unordered, Open by value:system
.... identifier:localIdentifier S0..1IdentifierBusiness identifier for report
..... system S1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-diagnostic-report-identifier
..... value S1..1stringThe Local diagnostic-report Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
..... period 0..0
... status S1..1coderegistered | partial | preliminary | final +
... category S1..1CodeableConceptService category
Binding: Diagnostic Service Section Codes (required)
.... coding 0..*CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
..... display 1..1stringRepresentation defined by the system
... code S1..1CodeableConceptName/Code for this diagnostic report
Binding: Care Connect Report Code SnCT (preferred)
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
..... coding:nicip 0..1CodingCode defined by a terminology system
...... system S0..1uriIdentity of the terminology system
Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-NICIP-1
...... code S0..1codeNational Interim Clinical Imaging Procedure code
Binding: InterweaveNICIP codes (required)
...... display S0..1stringRepresentation defined by the system
..... coding:loinc 0..1CodingCode defined by a terminology system
...... system S0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code S0..1codeLOINC code
Binding: LOINC Diagnostic Report Codes (required)
...... display S0..1stringRepresentation defined by the system
... subject S1..1Reference(CareConnectPatient1)The subject of the report - for our purposes the patient
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... context S0..1Reference(CareConnect-Encounter-1)Health care event when test ordered
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... effective[x] S0..1dateTime, PeriodClinically relevant time/time-period for report
... issued S1..1instantDateTime this version was released
... result S0..*Reference(CareConnect-Observation-1)Observations - simple, or complex nested groups
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 0..1stringIf relevant, description of the referenced resource
... imagingStudy 0..*Reference(ImagingStudy | ImagingManifest)DISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... image 0..*BackboneElementDISCOURAGED: Intention is primarily to share reports and results, not raw images. Will be ignored if populated.
... presentedForm S0..*AttachmentEntire report as issued
.... contentType S1..1codeMime type of the content, with charset etc.

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
DiagnosticReport.categoryrequiredDiagnostic Service Section Codes
DiagnosticReport.codepreferredCare Connect Report Code SnCT
DiagnosticReport.code.coding:nicip.coderequiredInterweaveNICIP codes
DiagnosticReport.code.coding:loinc.coderequiredLOINC Diagnostic Report Codes (a valid code from LOINC)

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DiagnosticReport 0..*CareConnect-DiagnosticReport-1A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - 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 Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - 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
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier Σ0..*IdentifierBusiness identifier for report
Slice: Unordered, Open by value:system
.... identifier:All Slices Content/Rules for all slices
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ1..1stringThe value that is unique
Example General: 123456
.... identifier:localIdentifier SΣ0..1IdentifierBusiness identifier for report
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system SΣ1..1uriThe namespace for the identifier value
Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-diagnostic-report-identifier
..... value SΣ1..1stringThe Local diagnostic-report Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
Example General: 123456
... status ?!SΣ1..1coderegistered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.

... category SΣ1..1CodeableConceptService category
Binding: Diagnostic Service Section Codes (required)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... system Σ1..1uriIdentity of the terminology system
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
... code SΣ1..1CodeableConceptName/Code for this diagnostic report
Binding: Care Connect Report Code SnCT (preferred)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:All Slices Content/Rules for all slices
...... system Σ1..1uriIdentity of the terminology system
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:snomedCT Σ0..*CodingCode defined by a terminology system
Binding: Care Connect Report Code SnCT (extensible): A code from the SNOMED Clinical Terminology UK


...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
..... coding:nicip Σ0..1CodingCode defined by a terminology system
...... system SΣ0..1uriIdentity of the terminology system
Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-NICIP-1
...... code SΣ0..1codeNational Interim Clinical Imaging Procedure code
Binding: InterweaveNICIP codes (required)
...... display SΣ0..1stringRepresentation defined by the system
..... coding:loinc Σ0..1CodingCode defined by a terminology system
...... system SΣ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code SΣ0..1codeLOINC code
Binding: LOINC Diagnostic Report Codes (required)
...... display SΣ0..1stringRepresentation defined by the system
... subject SΣ1..1Reference(CareConnectPatient1)The subject of the report - for our purposes the patient
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... context SΣ0..1Reference(CareConnect-Encounter-1)Health care event when test ordered
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ0..1stringIf relevant, description of the referenced resource
...