Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

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

Resource Profile: Zib TextResult - Detailed Descriptions

Active as of 2024-04-09

Definitions for the zib-TextResult resource profile.

Guidance on how to interpret the contents of this table can be found here

0. DiagnosticReport
Definition

Textual results describe the findings and interpretation of diagnostic or therapeutic procedures carried out on patients or on specimens from the patient. Recording the results of diagnostic procedures for the purpose of communicating these with the person requesting the procedure and documenting the findings resulting from therapeutic procedures.

ShortTextResult
Alternate NamesTekstUitslag
2. DiagnosticReport.identifier
ShortIdentifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Alternate NamesIdentificatie
4. DiagnosticReport.status
ShortTextResultStatus
Alternate NamesTekstUitslagStatus
6. DiagnosticReport.status.extension
SlicingThis element introduces a set of slices on DiagnosticReport.status.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. DiagnosticReport.status.extension:TextResultStatus
    Slice NameTextResultStatus
    Definition

    Defines a more specific value to a code. Especially useful for FHIRs required ValueSets.

    ShortProvides the specific HCIM code for TextResultStatus
    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from TekstStatusCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.2--20171231000000)
    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
    Alternate NamesTekstUitslagStatus
    10. DiagnosticReport.code
    ShortTest
    BindingUnless not suitable, these codes SHALL be taken from TekstUitslagTypeCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000)
    Alternate NamesOnderzoek
    12. DiagnosticReport.subject
    TypeReference(nl-core-patient)
    14. DiagnosticReport.context
    TypeReference(nl-core-episodeofcare, HCIM Encounter, gp-Encounter)
    16. DiagnosticReport.effective[x]
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    18. DiagnosticReport.performer
    20. DiagnosticReport.performer.role
    22. DiagnosticReport.performer.role.coding
    SlicingThis element introduces a set of slices on DiagnosticReport.performer.role.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 24. DiagnosticReport.performer.role.coding:healthProfessionalRole
      Slice NamehealthProfessionalRole
      Definition

      The role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner.

      ShortHealthProfessionalRole
      BindingUnless not suitable, these codes SHALL be taken from ZorgverlenerRolCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20171231000000)
      Alternate NamesZorgverlenerRol
      26. DiagnosticReport.performer.actor
      TypeReference(nl-core-organization, nl-core-practitioner)
      28. DiagnosticReport.performer.actor.extension
      SlicingThis element introduces a set of slices on DiagnosticReport.performer.actor.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 30. DiagnosticReport.performer.actor.extension:practitionerRole
        Slice NamepractitionerRole
        Control0..1
        TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
        32. DiagnosticReport.conclusion

        Guidance on how to interpret the contents of this table can be found here

        0. DiagnosticReport
        Definition

        Textual results describe the findings and interpretation of diagnostic or therapeutic procedures carried out on patients or on specimens from the patient. Recording the results of diagnostic procedures for the purpose of communicating these with the person requesting the procedure and documenting the findings resulting from therapeutic procedures.


        The findings and interpretation of diagnostic tests performed on patients, groups of patients, devices, and locations, and/or specimens derived from these. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretations, and formatted representation of diagnostic reports.

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

        This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.

        Control0..*
        Alternate NamesReport, Test, Result, Results, Labs, Laboratory, TekstUitslag
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
        dom-4: 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-3: 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-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
        dom-4: 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-3: 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())
        2. DiagnosticReport.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

        This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

        Control0..1
        Typeuri
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        4. DiagnosticReport.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Alternate Namesextensions, user content
        6. DiagnosticReport.identifier
        Definition

        Identifiers assigned to this report by the performer or other systems.

        ShortIdentifierBusiness identifier for report
        Comments

        Usually assigned by the Information System of the diagnostic service provider (filler id).

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Summarytrue
        Requirements

        Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.

        Alternate NamesReportID, Filler ID, Placer ID, Identificatie
        8. DiagnosticReport.status
        Definition

        The status of the diagnostic report as a whole.

        ShortTextResultStatusregistered | partial | preliminary | final +
        Comments

        This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn.

        Control1..1
        BindingThe codes SHALL be taken from DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status
        (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status)

        The status of the diagnostic report as a whole.

        Typecode
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

        Alternate NamesTekstUitslagStatus
        10. DiagnosticReport.status.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional Content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on DiagnosticReport.status.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 12. DiagnosticReport.status.extension:TextResultStatus
          Slice NameTextResultStatus
          Definition

          Defines a more specific value to a code. Especially useful for FHIRs required ValueSets.

          ShortProvides the specific HCIM code for TextResultStatus
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
          Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., TekstUitslagStatus
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          14. DiagnosticReport.code
          Definition

          A code or name that describes this diagnostic report.

          ShortTestName/Code for this diagnostic report
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from TekstUitslagTypeCodelijsthttp://hl7.org/fhir/ValueSet/report-codes
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000)
          TypeCodeableConcept
          Summarytrue
          Alternate NamesType, Onderzoek
          16. DiagnosticReport.subject
          Definition

          The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.

          ShortThe subject of the report - usually, but not always, the patient
          Control0..1
          TypeReference(nl-core-patient, Patient, Group, Device, Location)
          Summarytrue
          Requirements

          SHALL know the subject context.

          Alternate NamesPatient
          18. DiagnosticReport.context
          Definition

          The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.

          ShortHealth care event when test ordered
          Comments

          This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).

          Control0..1
          TypeReference(nl-core-episodeofcare, HCIM Encounter, gp-Encounter, Encounter, EpisodeOfCare)
          Summarytrue
          Requirements

          Links the request to the Encounter context.

          Alternate NamesEncounter
          20. DiagnosticReport.effective[x]
          Definition

          The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

          ShortClinically relevant time/time-period for report
          Comments

          If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

          Control0..1
          TypeChoice of: dateTime, Period
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to know where in the patient history to file/present this report.

          Alternate NamesObservation time, Effective Time, Occurrence
          22. DiagnosticReport.performer
          Definition

          Indicates who or what participated in producing the report.

          ShortParticipants in producing the report
          Control0..*
          TypeBackboneElement
          Summarytrue
          Alternate NamesLaboratory, Service, Practitioner, Department, Company
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          24. DiagnosticReport.performer.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Summarytrue
          Alternate Namesextensions, user content, modifiers
          26. DiagnosticReport.performer.actor
          Definition

          The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.

          ShortPractitioner or Organization participant
          Comments

          This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.

          Control1..1
          TypeReference(nl-core-organization, nl-core-practitioner, Practitioner, Organization)
          Summarytrue
          Requirements

          Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.

          28. DiagnosticReport.performer.actor.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional Content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on DiagnosticReport.performer.actor.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 30. DiagnosticReport.performer.actor.extension:practitionerRole
            Slice NamepractitionerRole
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..1
            TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
            32. DiagnosticReport.conclusion
            Definition

            Concise and clinically contextualized impression / summary of the diagnostic report.

            ShortClinical Interpretation of test results
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Requirements

            Need to be able to provide a conclusion that is not lost among the basic result data.

            Alternate NamesReport

            Guidance on how to interpret the contents of this table can be found here

            0. DiagnosticReport
            Definition

            Textual results describe the findings and interpretation of diagnostic or therapeutic procedures carried out on patients or on specimens from the patient. Recording the results of diagnostic procedures for the purpose of communicating these with the person requesting the procedure and documenting the findings resulting from therapeutic procedures.

            ShortTextResult
            Comments

            This is intended to capture a single report, and is not suitable for use in displaying summary information that covers multiple reports. For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing.

            Control0..*
            Alternate NamesReport, Test, Result, Results, Labs, Laboratory, TekstUitslag
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
            dom-4: 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-3: 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())
            2. DiagnosticReport.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            4. DiagnosticReport.meta
            Definition

            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Summarytrue
            6. DiagnosticReport.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

            ShortA set of rules under which this content was created
            Comments

            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

            This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

            Control0..1
            Typeuri
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            8. DiagnosticReport.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Common Languages
            (extensible to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            10. DiagnosticReport.text
            Definition

            A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

            ShortText summary of the resource, for human interpretation
            Comments

            Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

            Control0..1
            This element is affected by the following invariants: dom-1
            TypeNarrative
            Alternate Namesnarrative, html, xhtml, display
            12. DiagnosticReport.contained
            Definition

            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

            ShortContained, inline Resources
            Comments

            This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

            Control0..*
            TypeResource
            Alternate Namesinline resources, anonymous resources, contained resources
            14. DiagnosticReport.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            16. DiagnosticReport.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Alternate Namesextensions, user content
            18. DiagnosticReport.identifier
            Definition

            Identifiers assigned to this report by the performer or other systems.

            ShortIdentifier
            Comments

            Usually assigned by the Information System of the diagnostic service provider (filler id).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Summarytrue
            Requirements

            Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context.

            Alternate NamesReportID, Filler ID, Placer ID, Identificatie
            20. DiagnosticReport.basedOn
            Definition

            Details concerning a test or procedure requested.

            ShortWhat was requested
            Comments

            Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports.

            Control0..*
            TypeReference(CarePlan, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ProcedureRequest, ReferralRequest)
            Requirements

            This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon.

            Alternate NamesRequest
            22. DiagnosticReport.status
            Definition

            The status of the diagnostic report as a whole.

            ShortTextResultStatus
            Comments

            This is labeled as "Is Modifier" because applications need to take appropriate action if a report is withdrawn.

            Control1..1
            BindingThe codes SHALL be taken from DiagnosticReportStatus
            (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status)

            The status of the diagnostic report as a whole.

            Typecode
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports.

            Alternate NamesTekstUitslagStatus
            24. DiagnosticReport.status.id
            Definition

            unique id for the element within a resource (for internal references)

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            26. DiagnosticReport.status.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            SlicingThis element introduces a set of slices on DiagnosticReport.status.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 28. DiagnosticReport.status.extension:TextResultStatus
              Slice NameTextResultStatus
              Definition

              Defines a more specific value to a code. Especially useful for FHIRs required ValueSets.

              ShortProvides the specific HCIM code for TextResultStatus
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
              Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., TekstUitslagStatus
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              30. DiagnosticReport.status.value
              Definition

              Primitive value for code

              ShortPrimitive value for code
              Control0..1
              Typecode
              XML FormatIn the XML format, this property is represented as an attribute.
              32. DiagnosticReport.category
              Definition

              A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes.

              ShortService category
              Comments

              The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in DiagnosticReport.code.

              Control0..1
              BindingFor example codes, see Diagnostic Service Section Codes
              (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

              Codes for diagnostic service sections.

              TypeCodeableConcept
              Summarytrue
              Alternate NamesDepartment, Sub-department, Service, Discipline
              34. DiagnosticReport.code
              Definition

              A code or name that describes this diagnostic report.

              ShortTest
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from TekstUitslagTypeCodelijst
              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.2.1--20171231000000)
              TypeCodeableConcept
              Summarytrue
              Alternate NamesType, Onderzoek
              36. DiagnosticReport.subject
              Definition

              The subject of the report. Usually, but not always, this is a patient. However diagnostic services also perform analyses on specimens collected from a variety of other sources.

              ShortThe subject of the report - usually, but not always, the patient
              Control0..1
              TypeReference(nl-core-patient)
              Summarytrue
              Requirements

              SHALL know the subject context.

              Alternate NamesPatient
              38. DiagnosticReport.context
              Definition

              The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport per is about.

              ShortHealth care event when test ordered
              Comments

              This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission lab tests).

              Control0..1
              TypeReference(nl-core-episodeofcare, HCIM Encounter, gp-Encounter)
              Summarytrue
              Requirements

              Links the request to the Encounter context.

              Alternate NamesEncounter
              40. DiagnosticReport.effective[x]
              Definition

              The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself.

              ShortClinically relevant time/time-period for report
              Comments

              If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic.

              Control0..1
              TypeChoice of: dateTime, Period
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to know where in the patient history to file/present this report.

              Alternate NamesObservation time, Effective Time, Occurrence
              42. DiagnosticReport.issued
              Definition

              The date and time that this version of the report was released from the source diagnostic service.

              ShortDateTime this version was released
              Comments

              May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report.

              Control0..1
              Typeinstant
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Clinicians need to be able to check the date that the report was released.

              Alternate NamesDate Created, Date published, Date Issued
              44. DiagnosticReport.performer
              Definition

              Indicates who or what participated in producing the report.

              ShortParticipants in producing the report
              Control0..*
              TypeBackboneElement
              Summarytrue
              Alternate NamesLaboratory, Service, Practitioner, Department, Company
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
              46. DiagnosticReport.performer.id
              Definition

              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              48. DiagnosticReport.performer.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional Content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              50. DiagnosticReport.performer.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              ShortExtensions that cannot be ignored
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Summarytrue
              Alternate Namesextensions, user content, modifiers
              52. DiagnosticReport.performer.role
              Definition

              Describes the type of participation (e.g. a responsible party, author, or verifier).

              ShortType of performer
              Control0..1
              BindingFor example codes, see Procedure Performer Role Codes
              (example to http://hl7.org/fhir/ValueSet/performer-role)

              Indicate a role of diagnostic report performer

              TypeCodeableConcept
              Summarytrue
              54. DiagnosticReport.performer.role.id
              Definition

              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              56. DiagnosticReport.performer.role.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional Content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on DiagnosticReport.performer.role.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 58. DiagnosticReport.performer.role.coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..*
                TypeCoding
                Summarytrue
                Requirements

                Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                SlicingThis element introduces a set of slices on DiagnosticReport.performer.role.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ system
                • 60. DiagnosticReport.performer.role.coding:healthProfessionalRole
                  Slice NamehealthProfessionalRole
                  Definition

                  The role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner.

                  ShortHealthProfessionalRole
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  BindingUnless not suitable, these codes SHALL be taken from ZorgverlenerRolCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20171231000000)
                  TypeCoding
                  Summarytrue
                  Requirements

                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                  Alternate NamesZorgverlenerRol
                  62. DiagnosticReport.performer.role.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  64. DiagnosticReport.performer.actor
                  Definition

                  The reference to the practitioner or organization involved in producing the report. For example, the diagnostic service that is responsible for issuing the report.

                  ShortPractitioner or Organization participant
                  Comments

                  This is not necessarily the source of the atomic data items. It is the entity that takes responsibility for the clinical report.

                  Control1..1
                  TypeReference(nl-core-organization, nl-core-practitioner)
                  Summarytrue
                  Requirements

                  Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis.

                  66. DiagnosticReport.performer.actor.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  68. DiagnosticReport.performer.actor.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  SlicingThis element introduces a set of slices on DiagnosticReport.performer.actor.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 70. DiagnosticReport.performer.actor.extension:practitionerRole
                    Slice NamepractitionerRole
                    Definition

                    Optional Extension Element - found in all resources.

                    ShortOptional Extensions Element
                    Control0..1
                    TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                    72. DiagnosticReport.performer.actor.reference
                    Definition

                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                    ShortLiteral reference, Relative, internal or absolute URL
                    Comments

                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                    Control0..1
                    This element is affected by the following invariants: ref-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    74. DiagnosticReport.performer.actor.identifier
                    Definition

                    An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                    ShortLogical reference, when literal reference is not known
                    Comments

                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    TypeIdentifier
                    Summarytrue
                    76. DiagnosticReport.performer.actor.display
                    Definition

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    ShortText alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    78. DiagnosticReport.specimen
                    Definition

                    Details about the specimens on which this diagnostic report is based.

                    ShortSpecimens this report is based on
                    Comments

                    If the specimen is sufficiently specified with a code in the test result name, then this additional data may be redundant. If there are multiple specimens, these may be represented per observation or group.

                    Control0..*
                    TypeReference(Specimen)
                    Requirements

                    Need to be able to report information about the collected specimens on which the report is based.

                    80. DiagnosticReport.result
                    Definition

                    Observations that are part of this diagnostic report. Observations can be simple name/value pairs (e.g. "atomic" results), or they can be grouping observations that include references to other members of the group (e.g. "panels").

                    ShortObservations - simple, or complex nested groups
                    Control0..*
                    TypeReference(Observation)
                    Requirements

                    Need to support individual results, or report groups of results, where the result grouping is arbitrary, but meaningful. This structure is recursive - observations can contain observations.

                    Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                    82. DiagnosticReport.imagingStudy
                    Definition

                    One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images.

                    ShortReference to full details of imaging associated with the diagnostic report
                    Comments

                    ImagingStudy and ImageManifest and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However each caters to different types of displays for different types of purposes. Neither, either, or both may be provided.

                    Control0..*
                    TypeReference(ImagingStudy, ImagingManifest)
                    84. DiagnosticReport.image
                    Definition

                    A list of key images associated with this report. The images are generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).

                    ShortKey images associated with this report
                    Control0..*
                    TypeBackboneElement
                    Summarytrue
                    Requirements

                    Many diagnostic services include images in the report as part of their service.

                    Alternate NamesDICOM, Slides, Scans
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    86. DiagnosticReport.image.id
                    Definition

                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    88. DiagnosticReport.image.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional Content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Alternate Namesextensions, user content
                    90. DiagnosticReport.image.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    ShortExtensions that cannot be ignored
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                    Summarytrue
                    Alternate Namesextensions, user content, modifiers
                    92. DiagnosticReport.image.comment
                    Definition

                    A comment about the image. Typically, this is used to provide an explanation for why the image is included, or to draw the viewer's attention to important features.

                    ShortComment about the image (e.g. explanation)
                    Comments

                    The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion.

                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Requirements

                    The provider of the report should make a comment about each image included in the report.

                    94. DiagnosticReport.image.link
                    Definition

                    Reference to the image source.

                    ShortReference to the image source
                    Control1..1
                    TypeReference(Media)
                    Summarytrue
                    96. DiagnosticReport.conclusion
                    Definition

                    Concise and clinically contextualized impression / summary of the diagnostic report.

                    ShortClinical Interpretation of test results
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Requirements

                    Need to be able to provide a conclusion that is not lost among the basic result data.

                    Alternate NamesReport
                    98. DiagnosticReport.codedDiagnosis
                    Definition

                    Codes for the conclusion.

                    ShortCodes for the conclusion
                    Control0..*
                    BindingFor example codes, see SNOMED CT Clinical Findings
                    (example to http://hl7.org/fhir/ValueSet/clinical-findings)

                    Diagnosis codes provided as adjuncts to the report.

                    TypeCodeableConcept
                    100. DiagnosticReport.presentedForm
                    Definition

                    Rich text representation of the entire result as issued by the diagnostic service. Multiple formats are allowed but they SHALL be semantically equivalent.

                    ShortEntire report as issued
                    Comments

                    "application/pdf" is recommended as the most reliable and interoperable in this context.

                    Control0..*
                    TypeAttachment
                    Requirements

                    Gives laboratory the ability to provide its own fully formatted report for clinical fidelity.