Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: HCIM OutcomeOfCare

A derived profile on Zib-TextResult to represent the the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) OutcomeOfCare version 3.1, release 2017. The OutcomeOfCare concept describes the determined status of the patient in terms of a certain problem. Comparing the healthcare result with the treatment objective provides insight into the effectively of the nursing interventions/activities carried out for this problem. It is a part of the nursing process, together with nursing diagnoses/problems, the treatment objective and nursing interventions.

Healthcare results are important parameters for evaluating the patient’s health and monitoring the effectivity of the medical treatment and nursing interventions.

Usage:

• Examples for this Resource Profile: DiagnosticReport/zib-outcomeofcare-01 and DiagnosticReport/zib-outcomeofcare-02

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Zib TextResult

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	Zib TextResult	TextResult hicm-outcomeofcare-1: Provide a HealthcareResult text or a reference, not both
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Intervention		0..1	(Complex)	Part of referenced event URL: http://hl7.org/fhir/StructureDefinition/event-partOf
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-partOf"
valueReference:valueReference		0..1	Reference(HCIM NursingIntervention)	Interventie
basedOn		0..*	Reference(nl-core-careplan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	What was requested
code
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:outcomOfCareCode		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 27574-3
display		0..1	string	Representation defined by the system
subject		1..1	Reference(nl-core-patient)	The subject of the report - usually, but not always, the patient
Slices for result		0..1	Reference(Observation)	Observations - simple, or complex nested groups Slice: Unordered, Open by profile:resolve()
result:MeasurementValue		0..1	Reference(HCIM General Measurement)	MeasurementValue
result:HealthCondition		0..1	Reference(HCIM FunctionalOrMentalStatus)	HealthCondition
conclusion		0..1	string	HealthcareResult
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
hicm-outcomeofcare-1	error	DiagnosticReport	Provide a HealthcareResult text or a reference, not both : conclusion.empty() or result.empty()

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	Zib TextResult	TextResult hicm-outcomeofcare-1: Provide a HealthcareResult text or a reference, not both
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Intervention		0..1	(Complex)	Part of referenced event URL: http://hl7.org/fhir/StructureDefinition/event-partOf
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-partOf"
valueReference:valueReference		0..1	Reference(HCIM NursingIntervention)	Interventie
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn		0..*	Reference(nl-core-careplan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	What was requested
status	?!Σ	1..1	code	TextResultStatus Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.
TextResultStatus		0..1	CodeableConcept	Provides the specific HCIM code for TextResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
code	Σ	1..1	CodeableConcept	Test Binding: TekstUitslagTypeCodelijst (extensible)
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:outcomOfCareCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 27574-3
display	Σ	0..1	string	Representation defined by the system
subject	Σ	1..1	Reference(nl-core-patient)	The subject of the report - usually, but not always, the patient
Slices for result		0..1	Reference(Observation)	Observations - simple, or complex nested groups Slice: Unordered, Open by profile:resolve()
result:MeasurementValue		0..1	Reference(HCIM General Measurement)	MeasurementValue
result:HealthCondition		0..1	Reference(HCIM FunctionalOrMentalStatus)	HealthCondition
conclusion		0..1	string	HealthcareResult
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.code	extensible	TekstUitslagTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hicm-outcomeofcare-1	error	DiagnosticReport	Provide a HealthcareResult text or a reference, not both : conclusion.empty() or result.empty()

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	Zib TextResult	TextResult hicm-outcomeofcare-1: Provide a HealthcareResult text or a reference, not both
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Intervention		0..1	(Complex)	Part of referenced event URL: http://hl7.org/fhir/StructureDefinition/event-partOf
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-partOf"
valueReference:valueReference		0..1	Reference(HCIM NursingIntervention)	Interventie
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier
basedOn		0..*	Reference(nl-core-careplan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	What was requested
status	?!Σ	1..1	code	TextResultStatus Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
TextResultStatus		0..1	CodeableConcept	Provides the specific HCIM code for TextResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
value		0..1	code	Primitive value for code
category	Σ	0..1	CodeableConcept	Service category Binding: Diagnostic Service Section Codes (example): Codes for diagnostic service sections.
code	Σ	1..1	CodeableConcept	Test Binding: TekstUitslagTypeCodelijst (extensible)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:outcomOfCareCode	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 27574-3
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(nl-core-patient)	The subject of the report - usually, but not always, the patient
context	Σ	0..1	Reference(nl-core-episodeofcare | HCIM Encounter | gp-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 released
performer	Σ	0..*	BackboneElement	Participants in producing the report
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role	Σ	0..1	CodeableConcept	Type of performer Binding: Procedure Performer Role Codes (example): Indicate a role of diagnostic report performer
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:healthProfessionalRole	Σ	0..*	Coding	HealthProfessionalRole Binding: ZorgverlenerRolCodelijst (extensible)
text	Σ	0..1	string	Plain text representation of the concept
actor	Σ	1..1	Reference(nl-core-organization | nl-core-practitioner)	Practitioner or Organization participant
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
specimen		0..*	Reference(Specimen)	Specimens this report is based on
Slices for result		0..1	Reference(Observation)	Observations - simple, or complex nested groups Slice: Unordered, Open by profile:resolve()
result:MeasurementValue		0..1	Reference(HCIM General Measurement)	MeasurementValue
result:HealthCondition		0..1	Reference(HCIM FunctionalOrMentalStatus)	HealthCondition
imagingStudy		0..*	Reference(ImagingStudy | ImagingManifest)	Reference to full details of imaging associated with the diagnostic report
image	Σ	0..*	BackboneElement	Key images associated with this report
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
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	HealthcareResult
codedDiagnosis		0..*	CodeableConcept	Codes for the conclusion Binding: SNOMED CT Clinical Findings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.category	example	Diagnostic Service Section Codes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	extensible	TekstUitslagTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000 from this IG
DiagnosticReport.performer.role	example	Procedure Performer Role Codes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
DiagnosticReport.performer.role.coding:healthProfessionalRole	extensible	ZorgverlenerRolCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20171231000000 from this IG
DiagnosticReport.codedDiagnosis	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hicm-outcomeofcare-1	error	DiagnosticReport	Provide a HealthcareResult text or a reference, not both : conclusion.empty() or result.empty()

This structure is derived from Zib TextResult

Summary

Mandatory: 5 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

• HCIM NursingIntervention (http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention)
• nl-core-careplan (http://fhir.nl/fhir/StructureDefinition/nl-core-careplan)
• HCIM General Measurement (http://nictiz.nl/fhir/StructureDefinition/zib-GeneralMeasurement)
• HCIM FunctionalOrMentalStatus (http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/event-partOf

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DiagnosticReport.code.coding
• The element 1 is sliced based on the value of DiagnosticReport.result

Differential View

This structure is derived from Zib TextResult

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	Zib TextResult	TextResult hicm-outcomeofcare-1: Provide a HealthcareResult text or a reference, not both
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Intervention		0..1	(Complex)	Part of referenced event URL: http://hl7.org/fhir/StructureDefinition/event-partOf
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-partOf"
valueReference:valueReference		0..1	Reference(HCIM NursingIntervention)	Interventie
basedOn		0..*	Reference(nl-core-careplan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	What was requested
code
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:outcomOfCareCode		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 27574-3
display		0..1	string	Representation defined by the system
subject		1..1	Reference(nl-core-patient)	The subject of the report - usually, but not always, the patient
Slices for result		0..1	Reference(Observation)	Observations - simple, or complex nested groups Slice: Unordered, Open by profile:resolve()
result:MeasurementValue		0..1	Reference(HCIM General Measurement)	MeasurementValue
result:HealthCondition		0..1	Reference(HCIM FunctionalOrMentalStatus)	HealthCondition
conclusion		0..1	string	HealthcareResult
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
hicm-outcomeofcare-1	error	DiagnosticReport	Provide a HealthcareResult text or a reference, not both : conclusion.empty() or result.empty()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	Zib TextResult	TextResult hicm-outcomeofcare-1: Provide a HealthcareResult text or a reference, not both
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Intervention		0..1	(Complex)	Part of referenced event URL: http://hl7.org/fhir/StructureDefinition/event-partOf
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-partOf"
valueReference:valueReference		0..1	Reference(HCIM NursingIntervention)	Interventie
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn		0..*	Reference(nl-core-careplan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	What was requested
status	?!Σ	1..1	code	TextResultStatus Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.
TextResultStatus		0..1	CodeableConcept	Provides the specific HCIM code for TextResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
code	Σ	1..1	CodeableConcept	Test Binding: TekstUitslagTypeCodelijst (extensible)
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:outcomOfCareCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 27574-3
display	Σ	0..1	string	Representation defined by the system
subject	Σ	1..1	Reference(nl-core-patient)	The subject of the report - usually, but not always, the patient
Slices for result		0..1	Reference(Observation)	Observations - simple, or complex nested groups Slice: Unordered, Open by profile:resolve()
result:MeasurementValue		0..1	Reference(HCIM General Measurement)	MeasurementValue
result:HealthCondition		0..1	Reference(HCIM FunctionalOrMentalStatus)	HealthCondition
conclusion		0..1	string	HealthcareResult
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.code	extensible	TekstUitslagTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hicm-outcomeofcare-1	error	DiagnosticReport	Provide a HealthcareResult text or a reference, not both : conclusion.empty() or result.empty()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DiagnosticReport	C	0..*	Zib TextResult	TextResult hicm-outcomeofcare-1: Provide a HealthcareResult text or a reference, not both
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Intervention		0..1	(Complex)	Part of referenced event URL: http://hl7.org/fhir/StructureDefinition/event-partOf
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-partOf"
valueReference:valueReference		0..1	Reference(HCIM NursingIntervention)	Interventie
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier
basedOn		0..*	Reference(nl-core-careplan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	What was requested
status	?!Σ	1..1	code	TextResultStatus Binding: DiagnosticReportStatus (required): The status of the diagnostic report as a whole.
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
TextResultStatus		0..1	CodeableConcept	Provides the specific HCIM code for TextResultStatus URL: http://nictiz.nl/fhir/StructureDefinition/code-specification
value		0..1	code	Primitive value for code
category	Σ	0..1	CodeableConcept	Service category Binding: Diagnostic Service Section Codes (example): Codes for diagnostic service sections.
code	Σ	1..1	CodeableConcept	Test Binding: TekstUitslagTypeCodelijst (extensible)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:outcomOfCareCode	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 27574-3
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(nl-core-patient)	The subject of the report - usually, but not always, the patient
context	Σ	0..1	Reference(nl-core-episodeofcare | HCIM Encounter | gp-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 released
performer	Σ	0..*	BackboneElement	Participants in producing the report
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role	Σ	0..1	CodeableConcept	Type of performer Binding: Procedure Performer Role Codes (example): Indicate a role of diagnostic report performer
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:healthProfessionalRole	Σ	0..*	Coding	HealthProfessionalRole Binding: ZorgverlenerRolCodelijst (extensible)
text	Σ	0..1	string	Plain text representation of the concept
actor	Σ	1..1	Reference(nl-core-organization | nl-core-practitioner)	Practitioner or Organization participant
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
specimen		0..*	Reference(Specimen)	Specimens this report is based on
Slices for result		0..1	Reference(Observation)	Observations - simple, or complex nested groups Slice: Unordered, Open by profile:resolve()
result:MeasurementValue		0..1	Reference(HCIM General Measurement)	MeasurementValue
result:HealthCondition		0..1	Reference(HCIM FunctionalOrMentalStatus)	HealthCondition
imagingStudy		0..*	Reference(ImagingStudy | ImagingManifest)	Reference to full details of imaging associated with the diagnostic report
image	Σ	0..*	BackboneElement	Key images associated with this report
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
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	HealthcareResult
codedDiagnosis		0..*	CodeableConcept	Codes for the conclusion Binding: SNOMED CT Clinical Findings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm		0..*	Attachment	Entire report as issued
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DiagnosticReport.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status from the FHIR Standard
DiagnosticReport.category	example	Diagnostic Service Section Codes http://hl7.org/fhir/ValueSet/diagnostic-service-sections from the FHIR Standard
DiagnosticReport.code	extensible	TekstUitslagTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000 from this IG
DiagnosticReport.performer.role	example	Procedure Performer Role Codes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
DiagnosticReport.performer.role.coding:healthProfessionalRole	extensible	ZorgverlenerRolCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20171231000000 from this IG
DiagnosticReport.codedDiagnosis	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
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 : contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hicm-outcomeofcare-1	error	DiagnosticReport	Provide a HealthcareResult text or a reference, not both : conclusion.empty() or result.empty()

This structure is derived from Zib TextResult

Summary

Mandatory: 5 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

• HCIM NursingIntervention (http://nictiz.nl/fhir/StructureDefinition/zib-NursingIntervention)
• nl-core-careplan (http://fhir.nl/fhir/StructureDefinition/nl-core-careplan)
• HCIM General Measurement (http://nictiz.nl/fhir/StructureDefinition/zib-GeneralMeasurement)
• HCIM FunctionalOrMentalStatus (http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/event-partOf

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DiagnosticReport.code.coding
• The element 1 is sliced based on the value of DiagnosticReport.result

Other representations of profile: CSV, Excel, Schematron