Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
DiagnosticReport | TU | DomainResource | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports Элементы, определённые в родительском элементе: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | Σ | 0..* | Identifier | Business identifier for report |
basedOn | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested | |
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + DiagnosticReportStatus (Required) |
category | Σ | 0..* | CodeableConcept | Service category Diagnostic Service Section Codes (Example) |
code | Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report LOINC Diagnostic Report Codes (Preferred) |
subject | Σ | 0..1 | Reference(Patient | Group | Device | Location) | The subject of the report - usually, but not always, the patient |
encounter | Σ | 0..1 | Reference(Encounter) | Health care event when test ordered |
effective[x] | Σ | 0..1 | Clinically relevant time/time-period for report | |
effectiveDateTime | dateTime | |||
effectivePeriod | Period | |||
issued | Σ | 0..1 | instant | DateTime this version was made |
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service |
resultsInterpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter |
specimen | 0..* | Reference(Specimen) | Specimens this report is based on | |
result | 0..* | Reference(Observation) | Observations | |
imagingStudy | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report | |
media | Σ | 0..* | BackboneElement | Key images associated with this report |
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 SNOMED CT Clinical Findings (Example) | |
presentedForm | 0..* | Attachment | Entire report as issued | |
Documentation for this format |