Diagnostic Data Services

DDS-Report-1-0

The Diagnostic Report (result) resource describes the findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations and/or specimens derived from these. A diagnostic report is the set of information that is typically provided by a diagnostic service when investigations are complete. The information can include a mix of atomic results, text reports, images, and codes. Report conclusions can be expressed as a simple text blob, structured coded data or as an attached fully formatted report such as a PDF.

Follow this link to view examples for DDS-Report-1-0: Examples
NameCard.TypeDescription & Constraints
..DiagnosticReportDiagnosticReportA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports

...identifier0..1IdentifierId for external references to this report

....use0..1Codeusual | official | temp | secondary (If known)
Binding: Identifies the purpose for this identifier, if known . (http://hl7.org/fhir/ValueSet/identifier-use)
Binding Strength: Required
Example Value: official

....type0..1CodeableConceptDescription of identifier
Binding: A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. (http://hl7.org/fhir/ValueSet/identifier-type)
Binding Strength: Extensible

.....coding0..1CodingCode defined by a terminology system

......system1..1UriIdentity of the terminology system
Example Value: http://hl7.org/fhir/ValueSet/identifier-type

......version0..1StringVersion of the system - if relevant

......code1..1CodeSymbol in syntax defined by the system

......display1..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....system1..1UriThe namespace for the identifier
Example Value: http://www.sampleth.nhs.uk/pathology/report-identifier

....value1..1StringThe value that is unique
Example Value: STHTPATH89000000003

....period0..1PeriodTime period when id is/was valid for use

.....start1..1DateTimeStarting time with inclusive boundary

.....end0..1DateTimeEnd time with inclusive boundary, if not ongoing

....assigner0..1OrganizationOrganization that issued id (may be just text)

.....reference1..1StringRelative URL reference
Example Value: Organization/223F5C66-66BF-4CEA-A5D7-25AB9348B448

.....display0..1StringText alternative for the resource
Example Value: Sampletown Teaching Hospitals, Pathology Services

...status1..1Coderegistered | partial | final | corrected | appended | cancelled | entered-in-error
Binding: The status of the diagnostic report as a whole. (http://hl7.org/fhir/ValueSet/diagnostic-report-status)
Binding Strength: Required
Example Value: final

...category0..1CodeableConceptService category
Binding: Codes for diagnostic service sections. (http://snomed.info/sct)
Binding Strength: Example

....coding0..1CodingCode defined by a terminology system

.....system1..1UriIdentity of the terminology system
Example Value: http://snomed.info/sct

.....version0..1StringVersion of the system - if relevant

.....code1..1CodeSymbol in syntax defined by the system
Example Value: 15220000

.....display1..1StringRepresentation defined by the system
Example Value: Laboratory test

.....userSelected0..1BooleanIf this coding was chosen directly by the user

....text0..1StringPlain text representation of the concept

...code1..1CodeableConceptName/Code for this diagnostic report
Binding: Codes that describe Diagnostic Reports. (http://hl7.org/fhir/ValueSet/diagnostic-service-sections)
Binding Strength: Preferred

....coding0..1CodingCode defined by a terminology system

.....system1..1UriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/ValueSet/diagnostic-service-sections

.....version0..1StringVersion of the system - if relevant

.....code1..1CodeSymbol in syntax defined by the system
Example Value: MB

.....display1..1StringRepresentation defined by the system
Example Value: Micorbiology

.....userSelected0..1BooleanIf this coding was chosen directly by the user

....text0..1StringPlain text representation of the concept

...subject1..1dds-report-patient-1-0, Group, Device, LocationThe subject of the report which is the patient

...effective[x]1..1DateTime, PeriodClinically Relevant time/time-period for report

...issued1..1InstantDateTime this version was released

...performer1..1Organization, dds-report-health-care-professional-1-0Responsible Diagnostic Service

...request0..*DiagnosticOrder, ProcedureRequest, ReferralRequestWhat was requested

...specimen0..*StructureDefinition/dds-report-specimen-1-0Specimens this report is based on

....reference1..1StringRelative URL reference
Example Value: Specimen/B603CEDE-8C3F-4909-9CB1-D47C0FDE9F8A

....display0..1StringText alternative for the resource

...result0..*ObservationObservations - simple, or complex nested groups

....reference1..1StringRelative URL reference
Example Value: Observation/F1349F62-D2CC-4384-A86E-ABD2A654C571

....display0..1StringText alternative for the resource
Example Value: Results for Hepatitis B antigen screening

...imagingStudy0..*ImagingStudy, ImagingObjectSelectionReference to full details of imaging associated with the diagnostic report

...image0..*BackboneElementKey images associated with this report

....comment0..1StringComment about the image (e.g. explanation)

....link1..1MediaReference to the image source

.....reference1..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

...conclusion0..1StringClinical Interpretation of test results
Example Value: Immune to Hepatitis B. Immunity due to vaccination.

...codedDiagnosis0..*CodeableConceptCodes for the conclusion
Binding: Diagnoses codes provided as adjuncts to the report. (http://hl7.org/fhir/ValueSet/clinical-findings)
Binding Strength: Example

....coding0..1CodingCode defined by a terminology system

.....system1..1UriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/ValueSet/clinical-findings

.....version0..1StringVersion of the system - if relevant

.....code1..1CodeSymbol in syntax defined by the system
Example Value: 271511000

.....display1..1StringRepresentation defined by the system
Example Value: Hepatitis B immune

.....userSelected0..1BooleanIf this coding was chosen directly by the user

....text0..1StringPlain text representation of the concept

...presentedForm0..*AttachmentEntire report as issued

....contentType0..1CodeMime type of the content, with charset etc.
Binding: The mime type of an attachment. Any valid mime type is allowed. (http://www.rfc-editor.org/bcp/bcp13.txt)
Binding Strength: Required
Example Value: text/plain; charset=UTF-8, image/png

....language0..1CodeHuman language of the content (BCP-47)
Binding: A human language. (http://fhir.nhs.net/ValueSet/human-language-1-0)
Binding Strength: Required
Example Value: English

....data0..1Base64BinaryData inline, base64ed

....url0..1UriUri where the data can be found
Example Value: http://www.sampleth.nhs.uk/pathology/logo-small.png

....size0..1UnsignedIntNumber of bytes of content (if url provided)

....hash0..1Base64BinaryHash of the data (sha-1, base64ed)

....title0..1StringLabel to display in place of the data
Example Value: Official Corporate Logo

....creation0..1DateTimeDate attachment was first created