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        CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
        2.0.0 - Release 2 US

        This page is part of the NHSN Digital Quality Measures (dQM) Content Package Implementation Guide (v2.0.0: Release) based on FHIR (HL7? FHIR? Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

        Resource Profile: ACH Daily Event Diagnostic Report (Lab)

        Official URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/ach-daily-diagnosticreport-lab Version: 2.0.0
        Standards status: Trial-use Maturity Level: 2 Computable Name: AcuteCareHospitalDailyEventLabDiagnosticReport

        This profile contains Required and Must Support data elements for reporting diagnostic report lab information for the NHSN Acute Care Hospital (ACH) Daily Digital Quality Measure. This profile inherits from the QI Core 6.0.0 DiagnosticReport Profile for Laboratory Results Reporting profile, which inherits from the US Core 6.1.0 DiagnosticReport Profile for Laboratory Results Reporting profile.

        Usages:

        You can also check for usages in the FHIR IG Statistics

        Changes since version 1.0.0:

      1. The resource metadata has changed (description)
      2. The data elements list has changed
      3. One or more text definitions, invariants or bindings have changed

        4. Formal Views of Profile Content

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

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. DiagnosticReport C 0..* QICoreDiagnosticReportLab(6.0.0) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
        Constraints: us-core-8, us-core-9
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
        ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
        ... Slices for category SΣ 1..* CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Classification of diagnostic report
        Slice: Unordered, Open by pattern:$this
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
        .... category:LaboratorySlice SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Service category
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.

        Required Pattern: At least the following
        ..... id 0..1 string Unique id for inter-element referencing
        ..... extension 0..* Extension Additional content defined by implementations
        ..... text 0..1 string Plain text representation of the concept
        ..... coding SΣ 0..* Coding
        (NHSN-MS)
        Code defined by a terminology system

        Fixed Value: (Complex)
        ...... id 0..1 string Unique id for inter-element referencing
        ...... extension 0..* Extension Additional content defined by implementations
        ...... system 1..1 uri Identity of the terminology system
        Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
        ...... version 0..1 string Version of the system - if relevant
        ...... code 1..1 code Symbol in syntax defined by the system
        Fixed Value: LAB
        ...... display 0..1 string Representation defined by the system
        ...... userSelected 0..1 boolean If this coding was chosen directly by the user
        ... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) US Core Laboratory Report Order Code
        Binding: US Core Laboratory Test Codes (extensible): LOINC codes
        ... subject SΣ 1..1 Reference(QICore Patient) {b}
        (NHSN-MS)
        (QI-Core)(USCDI) The subject of the report - usually, but not always, the patient
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Health care event when test ordered
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] SΣC 0..1
        (NHSN-MS)
        (QI-Core)(USCDI) Diagnostically relevant time (typically the time of specimen collection)
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣC 0..1 instant
        (NHSN-MS)
        (QI-Core) (USCDI) When the report was released
        ... performer SΣ 0..* Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) (QI-Core)(USCDI) Responsible Diagnostic Service
        ... specimen S 0..* Reference(Specimen) {b}
        (NHSN-MS)
        Specimens this report is based on
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... result S 0..* Reference(QICore Laboratory Result Observation)
        (NHSN-MS)
        (QI-Core)(USCDI) Observations
        ... conclusion S 0..1 string
        (NHSN-MS)
        Clinical conclusion (interpretation) of test results
        ... conclusionCode S 0..* CodeableConcept
        (NHSN-MS)
        Codes for the clinical conclusion of test results
        Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.

        doco Documentation for this format

        Terminology Bindings

        Path Status Usage ValueSet Version Source
        DiagnosticReport.status Base required ACH Daily Diagnostic Report Status ValueSet ??2.0.0 This IG
        DiagnosticReport.category Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.category:LaboratorySlice Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.code Base extensible US Core Laboratory Test Codes ??6.1.0 US Core v6.1
        DiagnosticReport.conclusionCode Base example SNOMED CT Clinical Findings ??4.0.1 FHIR Std.

        Constraints

        Id Grade Path(s) Description Expression
        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()
        us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
        us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

        This structure is derived from QICoreDiagnosticReportLab

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. DiagnosticReport 0..* QICoreDiagnosticReportLab(6.0.0) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
        ... id S 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta
        .... Slices for extension Content/Rules for all slices
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        ... status 1..1 code (NHSN-MS) final | registered | preliminary | partial
        Binding: ACH Daily Diagnostic Report Status ValueSet (required)
        ... Slices for category Content/Rules for all slices
        .... category:LaboratorySlice 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Service category
        ..... coding S 0..* Coding
        (NHSN-MS)
        Code defined by a terminology system
        ... code 1..1 CodeableConcept (NHSN-MS)(USCDI) US Core Laboratory Report Order Code
        ... subject 1..1 Reference(QICore Patient) {b} (NHSN-MS)(QI-Core)(USCDI) The subject of the report - usually, but not always, the patient
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter S 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Health care event when test ordered
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] 0..1 dateTime, Period (NHSN-MS)(QI-Core)(USCDI) Diagnostically relevant time (typically the time of specimen collection)
        ... issued 0..1 instant (NHSN-MS)(QI-Core) (USCDI) When the report was released
        ... specimen S 0..* Reference(Specimen) {b}
        (NHSN-MS)
        Specimens this report is based on
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... result 0..* Reference(QICore Laboratory Result Observation) (NHSN-MS)(QI-Core)(USCDI) Observations
        ... conclusion S 0..1 string
        (NHSN-MS)
        Clinical conclusion (interpretation) of test results
        ... conclusionCode S 0..* CodeableConcept
        (NHSN-MS)
        Codes for the clinical conclusion of test results

        doco Documentation for this format

        Terminology Bindings (Differential)

        Path Status Usage ValueSet Version Source
        DiagnosticReport.status Base required ACH Daily Diagnostic Report Status ValueSet ??2.0.0 This IG
        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. DiagnosticReport C 0..* QICoreDiagnosticReportLab(6.0.0) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
        Constraints: us-core-8, us-core-9
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta Σ 0..1 Meta Metadata about the resource
        .... 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
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        .... versionId Σ 0..1 id Version specific identifier
        .... lastUpdated Σ 0..1 instant When the resource version last changed
        .... source Σ 0..1 uri Identifies where the resource comes from
        .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
        .... security Σ 0..* Coding Security Labels applied to this resource
        Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
        .... tag Σ 0..* Coding Tags applied to this resource
        Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
        ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
        ... text 0..1 Narrative Text summary of the resource, for human interpretation
        This profile does not constrain the narrative in regard to content, language, or traceability to data elements
        ... contained 0..* Resource Contained, inline Resources
        ... extension 0..* Extension Additional content defined by implementations
        ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
        ... identifier Σ 0..* Identifier Business identifier for report
        ... basedOn 0..* Reference(QICore CarePlan | QICore ImmunizationRecommendation | QICore MedicationRequest | QICore NutritionOrder | QICore ServiceRequest) What was requested
        ... status ?!SΣC 1..1 code
        (NHSN-MS)
        final | registered | preliminary | partial
        Binding: ACH Daily Diagnostic Report Status ValueSet (required)
        ... Slices for category SΣ 1..* CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Classification of diagnostic report
        Slice: Unordered, Open by pattern:$this
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
        .... category:LaboratorySlice SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Service category
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.

        Required Pattern: At least the following
        ..... 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 SΣ 0..* Coding
        (NHSN-MS)
        Code defined by a terminology system

        Fixed Value: (Complex)
        ...... id 0..1 string Unique id for inter-element referencing
        ...... extension 0..* Extension Additional content defined by implementations
        ...... system 1..1 uri Identity of the terminology system
        Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
        ...... version 0..1 string Version of the system - if relevant
        ...... code 1..1 code Symbol in syntax defined by the system
        Fixed Value: LAB
        ...... display 0..1 string Representation defined by the system
        ...... userSelected 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
        (NHSN-MS)
        (USCDI) US Core Laboratory Report Order Code
        Binding: US Core Laboratory Test Codes (extensible): LOINC codes
        ... subject SΣ 1..1 Reference(QICore Patient) {b}
        (NHSN-MS)
        (QI-Core)(USCDI) 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 SΣC 1..1 string
        (NHSN-MS)
        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
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        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 SΣC 1..1 string
        (NHSN-MS)
        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
        ... effective[x] SΣC 0..1
        (NHSN-MS)
        (QI-Core)(USCDI) Diagnostically relevant time (typically the time of specimen collection)
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣC 0..1 instant
        (NHSN-MS)
        (QI-Core) (USCDI) When the report was released
        ... performer SΣ 0..* Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) (QI-Core)(USCDI) Responsible Diagnostic Service
        ... resultsInterpreter Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam) Primary result interpreter
        ... specimen S 0..* Reference(Specimen) {b}
        (NHSN-MS)
        Specimens this report is based on
        .... 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 SΣC 1..1 string
        (NHSN-MS)
        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
        ... result S 0..* Reference(QICore Laboratory Result Observation)
        (NHSN-MS)
        (QI-Core)(USCDI) 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
        .... 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 S 0..1 string
        (NHSN-MS)
        Clinical conclusion (interpretation) of test results
        ... conclusionCode S 0..* CodeableConcept
        (NHSN-MS)
        Codes for the clinical conclusion of test results
        Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
        ... presentedForm 0..* Attachment Entire report as issued

        doco Documentation for this format

        Terminology Bindings

        Path Status Usage ValueSet Version Source
        DiagnosticReport.meta.?security Base extensible SecurityLabels ??4.0.1 FHIR Std.
        DiagnosticReport.meta.?tag Base example Common Tags ??4.0.1 FHIR Std.
        DiagnosticReport.language Base preferred Common Languages ??4.0.1 FHIR Std.
        DiagnosticReport.status Base required ACH Daily Diagnostic Report Status ValueSet ??2.0.0 This IG
        DiagnosticReport.category Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.category:LaboratorySlice Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.code Base extensible US Core Laboratory Test Codes ??6.1.0 US Core v6.1
        DiagnosticReport.subject.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        DiagnosticReport.encounter.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        DiagnosticReport.specimen.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        DiagnosticReport.conclusionCode Base example SNOMED CT Clinical Findings ??4.0.1 FHIR Std.

        Constraints

        Id Grade Path(s) Description Expression
        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()
        us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
        us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

        This structure is derived from QICoreDiagnosticReportLab

        Summary

        Mandatory: 2 elements(2 nested mandatory elements)
        Must-Support: 9 elements

        Structures

        This structure refers to these other structures:

        Extensions

        This structure refers to these extensions:

        Maturity: 2

        Key Elements View

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. DiagnosticReport C 0..* QICoreDiagnosticReportLab(6.0.0) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
        Constraints: us-core-8, us-core-9
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
        ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
        ... Slices for category SΣ 1..* CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Classification of diagnostic report
        Slice: Unordered, Open by pattern:$this
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
        .... category:LaboratorySlice SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Service category
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.

        Required Pattern: At least the following
        ..... id 0..1 string Unique id for inter-element referencing
        ..... extension 0..* Extension Additional content defined by implementations
        ..... text 0..1 string Plain text representation of the concept
        ..... coding SΣ 0..* Coding
        (NHSN-MS)
        Code defined by a terminology system

        Fixed Value: (Complex)
        ...... id 0..1 string Unique id for inter-element referencing
        ...... extension 0..* Extension Additional content defined by implementations
        ...... system 1..1 uri Identity of the terminology system
        Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
        ...... version 0..1 string Version of the system - if relevant
        ...... code 1..1 code Symbol in syntax defined by the system
        Fixed Value: LAB
        ...... display 0..1 string Representation defined by the system
        ...... userSelected 0..1 boolean If this coding was chosen directly by the user
        ... code SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (USCDI) US Core Laboratory Report Order Code
        Binding: US Core Laboratory Test Codes (extensible): LOINC codes
        ... subject SΣ 1..1 Reference(QICore Patient) {b}
        (NHSN-MS)
        (QI-Core)(USCDI) The subject of the report - usually, but not always, the patient
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Health care event when test ordered
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] SΣC 0..1
        (NHSN-MS)
        (QI-Core)(USCDI) Diagnostically relevant time (typically the time of specimen collection)
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣC 0..1 instant
        (NHSN-MS)
        (QI-Core) (USCDI) When the report was released
        ... performer SΣ 0..* Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) (QI-Core)(USCDI) Responsible Diagnostic Service
        ... specimen S 0..* Reference(Specimen) {b}
        (NHSN-MS)
        Specimens this report is based on
        .... reference SΣC 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... result S 0..* Reference(QICore Laboratory Result Observation)
        (NHSN-MS)
        (QI-Core)(USCDI) Observations
        ... conclusion S 0..1 string
        (NHSN-MS)
        Clinical conclusion (interpretation) of test results
        ... conclusionCode S 0..* CodeableConcept
        (NHSN-MS)
        Codes for the clinical conclusion of test results
        Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.

        doco Documentation for this format

        Terminology Bindings

        Path Status Usage ValueSet Version Source
        DiagnosticReport.status Base required ACH Daily Diagnostic Report Status ValueSet ??2.0.0 This IG
        DiagnosticReport.category Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.category:LaboratorySlice Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.code Base extensible US Core Laboratory Test Codes ??6.1.0 US Core v6.1
        DiagnosticReport.conclusionCode Base example SNOMED CT Clinical Findings ??4.0.1 FHIR Std.

        Constraints

        Id Grade Path(s) Description Expression
        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()
        us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
        us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

        Differential View

        This structure is derived from QICoreDiagnosticReportLab

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. DiagnosticReport 0..* QICoreDiagnosticReportLab(6.0.0) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
        ... id S 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta
        .... Slices for extension Content/Rules for all slices
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        ... status 1..1 code (NHSN-MS) final | registered | preliminary | partial
        Binding: ACH Daily Diagnostic Report Status ValueSet (required)
        ... Slices for category Content/Rules for all slices
        .... category:LaboratorySlice 1..1 CodeableConcept (NHSN-MS)(QI-Core)(USCDI) Service category
        ..... coding S 0..* Coding
        (NHSN-MS)
        Code defined by a terminology system
        ... code 1..1 CodeableConcept (NHSN-MS)(USCDI) US Core Laboratory Report Order Code
        ... subject 1..1 Reference(QICore Patient) {b} (NHSN-MS)(QI-Core)(USCDI) The subject of the report - usually, but not always, the patient
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... encounter S 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        Health care event when test ordered
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... effective[x] 0..1 dateTime, Period (NHSN-MS)(QI-Core)(USCDI) Diagnostically relevant time (typically the time of specimen collection)
        ... issued 0..1 instant (NHSN-MS)(QI-Core) (USCDI) When the report was released
        ... specimen S 0..* Reference(Specimen) {b}
        (NHSN-MS)
        Specimens this report is based on
        .... reference S 1..1 string
        (NHSN-MS)
        Literal reference, Relative, internal or absolute URL
        ... result 0..* Reference(QICore Laboratory Result Observation) (NHSN-MS)(QI-Core)(USCDI) Observations
        ... conclusion S 0..1 string
        (NHSN-MS)
        Clinical conclusion (interpretation) of test results
        ... conclusionCode S 0..* CodeableConcept
        (NHSN-MS)
        Codes for the clinical conclusion of test results

        doco Documentation for this format

        Terminology Bindings (Differential)

        Path Status Usage ValueSet Version Source
        DiagnosticReport.status Base required ACH Daily Diagnostic Report Status ValueSet ??2.0.0 This IG

        Snapshot View

        Name Flags Card. Type Description & Constraints????Filter: Filtersdoco
        .. DiagnosticReport C 0..* QICoreDiagnosticReportLab(6.0.0) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
        Constraints: us-core-8, us-core-9
        ... id SΣ 1..1 id
        (NHSN-MS)
        Logical id of this artifact
        ... meta Σ 0..1 Meta Metadata about the resource
        .... 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
        ..... extension:link-received-date-extension 0..1 dateTime Received Date
        URL: http://www.cy118119.com/nhsn/fhirportal/dqm/ig/StructureDefinition/link-received-date-extension
        .... versionId Σ 0..1 id Version specific identifier
        .... lastUpdated Σ 0..1 instant When the resource version last changed
        .... source Σ 0..1 uri Identifies where the resource comes from
        .... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
        .... security Σ 0..* Coding Security Labels applied to this resource
        Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
        .... tag Σ 0..* Coding Tags applied to this resource
        Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
        ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
        ... text 0..1 Narrative Text summary of the resource, for human interpretation
        This profile does not constrain the narrative in regard to content, language, or traceability to data elements
        ... contained 0..* Resource Contained, inline Resources
        ... extension 0..* Extension Additional content defined by implementations
        ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
        ... identifier Σ 0..* Identifier Business identifier for report
        ... basedOn 0..* Reference(QICore CarePlan | QICore ImmunizationRecommendation | QICore MedicationRequest | QICore NutritionOrder | QICore ServiceRequest) What was requested
        ... status ?!SΣC 1..1 code
        (NHSN-MS)
        final | registered | preliminary | partial
        Binding: ACH Daily Diagnostic Report Status ValueSet (required)
        ... Slices for category SΣ 1..* CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Classification of diagnostic report
        Slice: Unordered, Open by pattern:$this
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
        .... category:LaboratorySlice SΣ 1..1 CodeableConcept
        (NHSN-MS)
        (QI-Core)(USCDI) Service category
        Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.

        Required Pattern: At least the following
        ..... 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 SΣ 0..* Coding
        (NHSN-MS)
        Code defined by a terminology system

        Fixed Value: (Complex)
        ...... id 0..1 string Unique id for inter-element referencing
        ...... extension 0..* Extension Additional content defined by implementations
        ...... system 1..1 uri Identity of the terminology system
        Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
        ...... version 0..1 string Version of the system - if relevant
        ...... code 1..1 code Symbol in syntax defined by the system
        Fixed Value: LAB
        ...... display 0..1 string Representation defined by the system
        ...... userSelected 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
        (NHSN-MS)
        (USCDI) US Core Laboratory Report Order Code
        Binding: US Core Laboratory Test Codes (extensible): LOINC codes
        ... subject SΣ 1..1 Reference(QICore Patient) {b}
        (NHSN-MS)
        (QI-Core)(USCDI) 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 SΣC 1..1 string
        (NHSN-MS)
        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
        ... encounter SΣ 0..1 Reference(Encounter) {b}
        (NHSN-MS)
        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 SΣC 1..1 string
        (NHSN-MS)
        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
        ... effective[x] SΣC 0..1
        (NHSN-MS)
        (QI-Core)(USCDI) Diagnostically relevant time (typically the time of specimen collection)
        .... effectiveDateTime dateTime S
        .... effectivePeriod Period
        ... issued SΣC 0..1 instant
        (NHSN-MS)
        (QI-Core) (USCDI) When the report was released
        ... performer SΣ 0..* Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) (QI-Core)(USCDI) Responsible Diagnostic Service
        ... resultsInterpreter Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam) Primary result interpreter
        ... specimen S 0..* Reference(Specimen) {b}
        (NHSN-MS)
        Specimens this report is based on
        .... 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 SΣC 1..1 string
        (NHSN-MS)
        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
        ... result S 0..* Reference(QICore Laboratory Result Observation)
        (NHSN-MS)
        (QI-Core)(USCDI) 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
        .... 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 S 0..1 string
        (NHSN-MS)
        Clinical conclusion (interpretation) of test results
        ... conclusionCode S 0..* CodeableConcept
        (NHSN-MS)
        Codes for the clinical conclusion of test results
        Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
        ... presentedForm 0..* Attachment Entire report as issued

        doco Documentation for this format

        Terminology Bindings

        Path Status Usage ValueSet Version Source
        DiagnosticReport.meta.?security Base extensible SecurityLabels ??4.0.1 FHIR Std.
        DiagnosticReport.meta.?tag Base example Common Tags ??4.0.1 FHIR Std.
        DiagnosticReport.language Base preferred Common Languages ??4.0.1 FHIR Std.
        DiagnosticReport.status Base required ACH Daily Diagnostic Report Status ValueSet ??2.0.0 This IG
        DiagnosticReport.category Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.category:LaboratorySlice Base preferred Diagnostic Service Section Codes ??4.0.1 FHIR Std.
        DiagnosticReport.code Base extensible US Core Laboratory Test Codes ??6.1.0 US Core v6.1
        DiagnosticReport.subject.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        DiagnosticReport.encounter.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        DiagnosticReport.specimen.?type Base extensible ResourceType ??4.0.1 FHIR Std.
        DiagnosticReport.conclusionCode Base example SNOMED CT Clinical Findings ??4.0.1 FHIR Std.

        Constraints

        Id Grade Path(s) Description Expression
        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()
        us-core-8 error DiagnosticReport effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()
        us-core-9 error DiagnosticReport issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()

        This structure is derived from QICoreDiagnosticReportLab

        Summary

        Mandatory: 2 elements(2 nested mandatory elements)
        Must-Support: 9 elements

        Structures

        This structure refers to these other structures:

        Extensions

        This structure refers to these extensions:

        Maturity: 2

        ?

        Other representations of profile: CSV, Excel, Schematron


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