MedComCoreDiagnosticReport - Danish MedCom Core v2.3.0

Danish MedCom Core
2.3.0 - Release Denmark flag

This page is part of the DK MedCom Core (v2.3.0: Release) based on FHIR R4. The current version which supercedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: MedComCoreDiagnosticReport

Official URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-diagnosticreport				Version: 2.3.0
Active as of 2023-10-31				Computable Name: MedComCoreDiagnosticReport

Report containing all observation results.

Note: This profile is developed to be part of a production trial of the communication between the general practitioner and municipal acute care team.

Scope and usage

This profile is intended to be uses in MedCom HomeCareObservation and MedCom’s Laboratory standards.

Attachments

In MedComCoreDiagnosticReport it is allowed to include attachments. When sending an attachment diagnosticReport.media shall be used. The DiagnosticReport.media.link reference to MedComCoreMedia resource where the atachment shall be added. It is up to the user to assess when it is relevant to send an attachment. Only an attachment of the permitted formats must be included. Click here to see the permitted formats of an attachment

If a patient gives a negative consent to sharing the observation results with other than the general practitioner a security labe shall be used. This mean that the meta.security.code shall be R, and in the user interface, it shall be clearly stated that consent has been refused.

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 DiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
status	S	1..1	code	registered \| partial \| preliminary \| final \| corrected \| cancelled \| entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required)
code	S	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required)
subject	S	1..1	Reference(MedComCorePatient) {b }	The subject of the report - usually, but not always, the patient
issued	S	1..1	instant	DateTime this version was made
performer	S	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Responsible Diagnostic Service
result	S	0..*	Reference(MedComCoreObservation) {b }	Observations
media	S	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition.
link	S	1..1	Reference(MedComMedia)	Reference to the image source
conclusion	S	0..1	string	A comment relevant for all observations in the report.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
DiagnosticReport.status	required	http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered \| partial \| preliminary \| final \| corrected \| cancelled \| entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required)
code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b }	The subject of the report - usually, but not always, the patient
issued	SΣ	1..1	instant	DateTime this version was made
performer	SΣ	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Responsible Diagnostic Service
result	S	0..*	Reference(MedComCoreObservation) {b }	Observations
media	SΣ	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	SΣ	1..1	Reference(MedComMedia)	Reference to the image source
conclusion	S	0..1	string	A comment relevant for all observations in the report.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
DiagnosticReport.status	required	http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Description & Constraints

DiagnosticReport

0..*

DiagnosticReport

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

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path

Conformance

ValueSet

DiagnosticReport.language

preferred

CommonLanguages

Additional Bindings

Purpose

AllLanguages

Max Binding

DiagnosticReport.status

required

http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status

DiagnosticReport.category

example

DiagnosticServiceSectionCodes

DiagnosticReport.code

required

MedComDiagnosticReportCodesValueset

DiagnosticReport.conclusionCode

example

SNOMEDCTClinicalFindings

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DiagnosticReport

Summary

Mandatory: 2 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from DiagnosticReport

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
status	S	1..1	code	registered \| partial \| preliminary \| final \| corrected \| cancelled \| entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required)
code	S	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required)
subject	S	1..1	Reference(MedComCorePatient) {b }	The subject of the report - usually, but not always, the patient
issued	S	1..1	instant	DateTime this version was made
performer	S	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Responsible Diagnostic Service
result	S	0..*	Reference(MedComCoreObservation) {b }	Observations
media	S	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition.
link	S	1..1	Reference(MedComMedia)	Reference to the image source
conclusion	S	0..1	string	A comment relevant for all observations in the report.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
DiagnosticReport.status	required	http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport		0..*	DiagnosticReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered \| partial \| preliminary \| final \| corrected \| cancelled \| entered-in-error Binding: http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status (required)
code	SΣ	1..1	CodeableConcept	Name/Code for this diagnostic report Binding: MedComDiagnosticReportCodesValueset (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b }	The subject of the report - usually, but not always, the patient
issued	SΣ	1..1	instant	DateTime this version was made
performer	SΣ	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Responsible Diagnostic Service
result	S	0..*	Reference(MedComCoreObservation) {b }	Observations
media	SΣ	0..*	BackboneElement	Attachments that are relevant for assessment of the patient's condition.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	SΣ	1..1	Reference(MedComMedia)	Reference to the image source
conclusion	S	0..1	string	A comment relevant for all observations in the report.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
DiagnosticReport.status	required	http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status
DiagnosticReport.code	required	MedComDiagnosticReportCodesValueset

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Description & Constraints

DiagnosticReport

0..*

DiagnosticReport

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

id

Σ

0..1

id

Logical id of this artifact

Terminology Bindings

Path

Conformance

ValueSet

DiagnosticReport.language

preferred

CommonLanguages

Additional Bindings

Purpose

AllLanguages

Max Binding

DiagnosticReport.status

required

http://medcomfhir.dk/ig/terminology/ValueSet/medcom-corediagnosticrepport-status

DiagnosticReport.category

example

DiagnosticServiceSectionCodes

DiagnosticReport.code

required

MedComDiagnosticReportCodesValueset

DiagnosticReport.conclusionCode

example

SNOMEDCTClinicalFindings

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DiagnosticReport

Summary

Mandatory: 2 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Other representations of profile: CSV, Excel, Schematron

IG © 2021+ MedCom. Package medcom.fhir.dk.core#2.3.0 based on FHIR 4.0.1. Generated 2023-10-31
Links: Table of Contents | QA Report

Resource Profile: MedComCoreDiagnosticReport

Scope and usage

Attachments

Use of security labet on patient consent

Formal Views of Profile Content

Terminology Bindings (Differential)