DRAFT Implementation Guide

This is for collaboration and discussion purposes and is subject to change.

North West Genomic Medicine Service Alliance - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Content
• Detailed Descriptions
• Examples
• XML
• JSON

Resource Profile: Diagnostic Report

Includes constraints from:

• NHS England Genomics DiagnosticReport use text descriptions only, not the rendered profile.

See also HL7 Europe Laboratory Report - DiagnosticReport: Laboratory Report

Usages:

• Refer to this Profile: ServiceRequest

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 GenomicReport

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	GenomicReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
identifier	S	1..*	CorrelationIdentifier	Business identifier for report
Slices for basedOn		0..*	CodeableReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested Slice: Unordered, Open by value:identifier.type
basedOn:All Slices				Content/Rules for all slices
identifier	S	1..1	CorrelationIdentifier	Logical reference, when literal reference is not known
basedOn:fillerOrderNumber	SO	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab (ORC-3) Obligations Actor SHALL:populate Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	S	1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: ServiceRequest
identifier		1..1	FillerOrderNumber	Logical reference, when literal reference is not known
basedOn:accessionNumber	S	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	S	1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: ServiceRequest
identifier		1..1	AccessionNumber	Logical reference, when literal reference is not known
Slices for category				Content/Rules for all slices
category:Genetics		1..1	CodeableConcept	Service category
coding	S	1..1	Coding	Code defined by a terminology system
code	S	1..1	CodeableConcept	ISSUE. See [National Genomic Test Directory](https://www.england.nhs.uk/wp-content/uploads/2018/08/rare-and-inherited-disease-eligibility-criteria-v2.pdf).
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:GenomicRareAndInheritedDisease	S	0..1	Coding	Code defined by a terminology system Binding: Genomic Rare and Inherited Disease Test Directory (required)
subject		1..1	Reference(Patient)	The subject of the report - usually, but not always, the patient
identifier		1..1	NHSNumber	Logical reference, when literal reference is not known
encounter	S	0..1	Reference(Encounter)	A reference identifier to the episode/stay/visit number in which the report was created. (HL7 v2 PV1-19)
identifier	O	0..1	EpisodeNumber	(HL7v2 PV1-19 Visit Number from OML_O21) Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	SO	0..1	dateTime	Clinically relevant time/time-period for report Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for performer		1..*	Reference(Practitioner | Organization)	Responsible Diagnostic Service Slice: Unordered, Open by pattern:type
performer:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type		1..1	uri	Type the reference refers to (e.g. "Patient")
identifier		1..1	Identifier	Logical reference, when literal reference is not known
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
performer:organisation		1..1	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type		1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: Organization
identifier		1..1	OrganisationCode	Logical reference, when literal reference is not known
performer:operator		0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	(Complex)	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction
value[x]
coding		0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SPRF
type		1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: Practitioner
identifier		1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
Slices for resultsInterpreter		0..*	Reference(Practitioner | PractitionerRole)	Primary result interpreter Slice: Unordered, Open by value:type
resultsInterpreter:All Slices				Content/Rules for all slices
type		1..1	uri	Type the reference refers to (e.g. "Patient")
identifier		1..1	Identifier	Logical reference, when literal reference is not known
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
resultsInterpreter:primaryReporter		0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
type		1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: Practitioner
identifier		1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
specimen	S	0..*	Reference(Specimen)	Specimens this report is based on
Slices for result				Content/Rules for all slices
result:diagnostic-implication	S	0..*	Reference(Observation Diagnostic Implication)	Diagnostic Implication
result:variant	S	0..*	Reference(Observation Variant)	Variant
presentedForm	S	1..*	NWAttachment	a reference to the full report (presentedForm)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DiagnosticReport.code.coding:GenomicRareAndInheritedDisease	required	GenomicRareAndInheritedDisease https://nw-gmsa.github.io/ValueSet/GenomicRareAndInheritedDisease From this IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	GenomicReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:recommended-action		0..*	Reference(Medication Recommendation | Followup Recommendation)	Recommended Action URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action
extension:genomic-risk-assessment		0..*	Reference(RiskAssessment)	Genomic Risk Assessment URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-risk-assessment
extension:coded-note		0..*	CodedAnnotation	Comments about the report that also contain a coded type URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note
extension:supporting-info		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:genomic-study		0..*	Reference(Genomic Study)	Reference to full details of an genomic study associated with the diagnostic report URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference
extension:hla-genotyping-results-allele-database		0..1	CodeableConcept	Allele Database URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database
extension:hla-genotyping-results-glstring		0..1	(Complex)	glstring URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring
extension:workflow-relatedArtifact		0..*	RelatedArtifact	Documentation relevant to the 'parent' resource URL: http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	CorrelationIdentifier	Business identifier for report
Slices for basedOn		0..*	CodeableReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested Slice: Unordered, Open by value:identifier.type
basedOn:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:concept		0..1	CodeableConcept	ExtCodeableReference URL: https://nw-gmsa.github.io/StructureDefinition/ext-codeable-reference
identifier	SΣ	1..1	CorrelationIdentifier	Logical reference, when literal reference is not known
basedOn:fillerOrderNumber	SO	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab (ORC-3) Obligations Actor SHALL:populate Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	FillerOrderNumber	Logical reference, when literal reference is not known
basedOn:accessionNumber	S	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	AccessionNumber	Logical reference, when literal reference is not known
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category	Σ	1..*	CodeableConcept	Service category Slice: Unordered, Open by value:coding Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:Genetics	Σ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
coding	SΣ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GE
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	SΣ	1..1	CodeableConcept	ISSUE. See [National Genomic Test Directory](https://www.england.nhs.uk/wp-content/uploads/2018/08/rare-and-inherited-disease-eligibility-criteria-v2.pdf). Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 51969-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:GenomicRareAndInheritedDisease	SΣ	0..1	Coding	Code defined by a terminology system Binding: Genomic Rare and Inherited Disease Test Directory (required)
subject	Σ	1..1	Reference(Patient)	The subject of the report - usually, but not always, the patient
identifier	Σ	1..1	NHSNumber	Logical reference, when literal reference is not known
encounter	SΣ	0..1	Reference(Encounter)	A reference identifier to the episode/stay/visit number in which the report was created. (HL7 v2 PV1-19)
identifier	OΣ	0..1	EpisodeNumber	(HL7v2 PV1-19 Visit Number from OML_O21) Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	SOΣ	0..1	dateTime	Clinically relevant time/time-period for report Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for performer	Σ	1..*	Reference(Practitioner | Organization)	Responsible Diagnostic Service Slice: Unordered, Open by pattern:type
performer:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
performer:organisation	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Organization
identifier	Σ	1..1	OrganisationCode	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/ods-organization-code
value	Σ	1..1	string	The value that is unique Example General: 123456
performer:operator	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	(Complex)	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
value[x]		1..1	CodeableConcept	Value of extension Binding: Performer Function Codes (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SPRF
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
Slices for resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole)	Primary result interpreter Slice: Unordered, Open by value:type
resultsInterpreter:All Slices				Content/Rules for all slices
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
resultsInterpreter:primaryReporter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
specimen	S	0..*	Reference(Specimen)	Specimens this report is based on
Slices for result		0..*	Reference(Observation)	Observations Slice: Unordered, Open by profile:resolve()
result:diagnostic-implication	S	0..*	Reference(Observation Diagnostic Implication)	Diagnostic Implication
result:therapeutic-implication		0..*	Reference(Therapeutic Implication)	Therapeutic Implication
result:molecular-consequence		0..*	Reference(Molecular Consequence)	Molecular Consequence
result:variant	S	0..*	Reference(Observation Variant)	Variant
result:sequence-phase-relation		0..*	Reference(Sequence Phase Relationship)	Sequence Phase Relationship
result:genotype		0..*	Reference(Genotype)	Genotype
result:haplotype		0..*	Reference(Haplotype)	Haplotype
result:biomarker		0..*	Reference(Molecular Biomarker)	MolecularBiomarker
presentedForm	S	1..*	NWAttachment	a reference to the full report (presentedForm)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.basedOn:fillerOrderNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.basedOn:accessionNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 From the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.category:Genetics	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.code	preferred	Pattern Value: LOINC Code 51969-4 http://hl7.org/fhir/ValueSet/report-codes From the FHIR Standard
DiagnosticReport.code.coding:GenomicRareAndInheritedDisease	required	GenomicRareAndInheritedDisease https://nw-gmsa.github.io/ValueSet/GenomicRareAndInheritedDisease From this IG
DiagnosticReport.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:organisation.type	extensible	Pattern Value: Organization http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:organisation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:operator.extension:performerFunction.value[x]	extensible	Performer Function Codes http://hl7.org/fhir/ValueSet/performer-function From the FHIR Standard
DiagnosticReport.performer:operator.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:operator.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:operator.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG
DiagnosticReport.resultsInterpreter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG

Constraints

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	GenomicReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id	Σ	0..1	id	Logical id of this artifact
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: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recommended-action		0..*	Reference(Medication Recommendation | Followup Recommendation)	Recommended Action URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action
extension:genomic-risk-assessment		0..*	Reference(RiskAssessment)	Genomic Risk Assessment URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-risk-assessment
extension:coded-note		0..*	CodedAnnotation	Comments about the report that also contain a coded type URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note
extension:supporting-info		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:genomic-study		0..*	Reference(Genomic Study)	Reference to full details of an genomic study associated with the diagnostic report URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference
extension:hla-genotyping-results-allele-database		0..1	CodeableConcept	Allele Database URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database
extension:hla-genotyping-results-glstring		0..1	(Complex)	glstring URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring
extension:workflow-relatedArtifact		0..*	RelatedArtifact	Documentation relevant to the 'parent' resource URL: http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	CorrelationIdentifier	Business identifier for report
Slices for basedOn		0..*	CodeableReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested Slice: Unordered, Open by value:identifier.type
basedOn:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:concept		0..1	CodeableConcept	ExtCodeableReference URL: https://nw-gmsa.github.io/StructureDefinition/ext-codeable-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	1..1	CorrelationIdentifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
basedOn:fillerOrderNumber	SO	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab (ORC-3) Obligations Actor SHALL:populate Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:concept		0..*	Extension	Extension
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	FillerOrderNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
basedOn:accessionNumber	S	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:concept		0..*	Extension	Extension
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	AccessionNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category	Σ	1..*	CodeableConcept	Service category Slice: Unordered, Open by value:coding Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:Genetics	Σ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GE
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	ISSUE. See [National Genomic Test Directory](https://www.england.nhs.uk/wp-content/uploads/2018/08/rare-and-inherited-disease-eligibility-criteria-v2.pdf). Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 51969-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:GenomicRareAndInheritedDisease	SΣ	0..1	Coding	Code defined by a terminology system Binding: Genomic Rare and Inherited Disease Test Directory (required)
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient)	The subject of the report - usually, but not always, the patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	NHSNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	SΣ	0..1	Reference(Encounter)	A reference identifier to the episode/stay/visit number in which the report was created. (HL7 v2 PV1-19)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	OΣ	0..1	EpisodeNumber	(HL7v2 PV1-19 Visit Number from OML_O21) Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
display	Σ	0..1	string	Text alternative for the resource
effective[x]	SOΣ	0..1	dateTime	Clinically relevant time/time-period for report Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
issued	Σ	0..1	instant	DateTime this version was made
Slices for performer	Σ	1..*	Reference(Practitioner | Organization)	Responsible Diagnostic Service Slice: Unordered, Open by pattern:type
performer:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
performer:organisation	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Organization
identifier	Σ	1..1	OrganisationCode	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/ods-organization-code
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
performer:operator	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	(Complex)	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
value[x]		1..1	CodeableConcept	Value of extension Binding: Performer Function Codes (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SPRF
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Fixed Value: As shown (License number)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LN
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
Slices for resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole)	Primary result interpreter Slice: Unordered, Open by value:type
resultsInterpreter:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
resultsInterpreter:primaryReporter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Fixed Value: As shown (License number)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LN
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
specimen	S	0..*	Reference(Specimen)	Specimens this report is based on
Slices for result		0..*	Reference(Observation)	Observations Slice: Unordered, Open by profile:resolve()
result:diagnostic-implication	S	0..*	Reference(Observation Diagnostic Implication)	Diagnostic Implication
result:therapeutic-implication		0..*	Reference(Therapeutic Implication)	Therapeutic Implication
result:molecular-consequence		0..*	Reference(Molecular Consequence)	Molecular Consequence
result:variant	S	0..*	Reference(Observation Variant)	Variant
result:sequence-phase-relation		0..*	Reference(Sequence Phase Relationship)	Sequence Phase Relationship
result:genotype		0..*	Reference(Genotype)	Genotype
result:haplotype		0..*	Reference(Haplotype)	Haplotype
result:biomarker		0..*	Reference(Molecular Biomarker)	MolecularBiomarker
imagingStudy		0..*	Reference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
media	Σ	0..*	BackboneElement	Key images associated with this report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
comment		0..1	string	Comment about the image (e.g. explanation)
link	Σ	1..1	Reference(Media)	Reference to the image source
conclusion		0..1	string	Assessment of overall results
conclusionCode		0..*	CodeableConcept	Coarse overall interpretation of the genomic results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm	S	1..*	NWAttachment	a reference to the full report (presentedForm)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.basedOn.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.basedOn:fillerOrderNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.basedOn:accessionNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 From the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.category:Genetics	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.code	preferred	Pattern Value: LOINC Code 51969-4 http://hl7.org/fhir/ValueSet/report-codes From the FHIR Standard
DiagnosticReport.code.coding:GenomicRareAndInheritedDisease	required	GenomicRareAndInheritedDisease https://nw-gmsa.github.io/ValueSet/GenomicRareAndInheritedDisease From this IG
DiagnosticReport.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.encounter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.performer:organisation.type	extensible	Pattern Value: Organization http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:organisation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:organisation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.performer:operator.extension:performerFunction.value[x]	extensible	Performer Function Codes http://hl7.org/fhir/ValueSet/performer-function From the FHIR Standard
DiagnosticReport.performer:operator.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:operator.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:operator.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.performer:operator.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG
DiagnosticReport.resultsInterpreter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG
DiagnosticReport.conclusionCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings From the FHIR Standard

Constraints

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

This structure is derived from GenomicReport

Summary

Mandatory: 9 elements(9 nested mandatory elements)
Must-Support: 16 elements

Structures

This structure refers to these other structures:

• Correlation Identifier (https://nw-gmsa.github.io/StructureDefinition/CorrelationIdentifier)
• CodeableReference (https://nw-gmsa.github.io/StructureDefinition/CodeableReference)
• Filler Order Number (https://nw-gmsa.github.io/StructureDefinition/FillerOrderNumber)
• Accession Number (https://nw-gmsa.github.io/StructureDefinition/AccessionNumber)
• Patient (https://nw-gmsa.github.io/StructureDefinition/Patient)
• NHS Number (https://nw-gmsa.github.io/StructureDefinition/NHSNumber)
• Encounter (https://nw-gmsa.github.io/StructureDefinition/Encounter)
• Episode Number (https://nw-gmsa.github.io/StructureDefinition/EpisodeNumber)
• Practitioner (https://nw-gmsa.github.io/StructureDefinition/Practitioner)
• Organization (https://nw-gmsa.github.io/StructureDefinition/Organization)
• Organisation Code (https://nw-gmsa.github.io/StructureDefinition/OrganisationCode)
• England Practitioner Identifier (https://nw-gmsa.github.io/StructureDefinition/EnglandPractitionerIdentifier)
• PractitionerRole (https://nw-gmsa.github.io/StructureDefinition/PractitionerRole)
• Observation Diagnostic Implication (https://nw-gmsa.github.io/StructureDefinition/Observation-DiagnosticImplication)
• Observation Variant (https://nw-gmsa.github.io/StructureDefinition/Observation-Variant)
• Attachment (https://nw-gmsa.github.io/StructureDefinition/NWAttachment)

Extensions

This structure refers to these extensions:

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

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DiagnosticReport.basedOn
• The element 1 is sliced based on the value of DiagnosticReport.code.coding
• The element 1 is sliced based on the value of DiagnosticReport.performer
• The element 1 is sliced based on the value of DiagnosticReport.resultsInterpreter

Differential View

This structure is derived from GenomicReport

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	GenomicReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
identifier	S	1..*	CorrelationIdentifier	Business identifier for report
Slices for basedOn		0..*	CodeableReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested Slice: Unordered, Open by value:identifier.type
basedOn:All Slices				Content/Rules for all slices
identifier	S	1..1	CorrelationIdentifier	Logical reference, when literal reference is not known
basedOn:fillerOrderNumber	SO	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab (ORC-3) Obligations Actor SHALL:populate Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	S	1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: ServiceRequest
identifier		1..1	FillerOrderNumber	Logical reference, when literal reference is not known
basedOn:accessionNumber	S	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	S	1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: ServiceRequest
identifier		1..1	AccessionNumber	Logical reference, when literal reference is not known
Slices for category				Content/Rules for all slices
category:Genetics		1..1	CodeableConcept	Service category
coding	S	1..1	Coding	Code defined by a terminology system
code	S	1..1	CodeableConcept	ISSUE. See [National Genomic Test Directory](https://www.england.nhs.uk/wp-content/uploads/2018/08/rare-and-inherited-disease-eligibility-criteria-v2.pdf).
Slices for coding	S	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:GenomicRareAndInheritedDisease	S	0..1	Coding	Code defined by a terminology system Binding: Genomic Rare and Inherited Disease Test Directory (required)
subject		1..1	Reference(Patient)	The subject of the report - usually, but not always, the patient
identifier		1..1	NHSNumber	Logical reference, when literal reference is not known
encounter	S	0..1	Reference(Encounter)	A reference identifier to the episode/stay/visit number in which the report was created. (HL7 v2 PV1-19)
identifier	O	0..1	EpisodeNumber	(HL7v2 PV1-19 Visit Number from OML_O21) Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	SO	0..1	dateTime	Clinically relevant time/time-period for report Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for performer		1..*	Reference(Practitioner | Organization)	Responsible Diagnostic Service Slice: Unordered, Open by pattern:type
performer:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type		1..1	uri	Type the reference refers to (e.g. "Patient")
identifier		1..1	Identifier	Logical reference, when literal reference is not known
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
performer:organisation		1..1	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type		1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: Organization
identifier		1..1	OrganisationCode	Logical reference, when literal reference is not known
performer:operator		0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	(Complex)	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction
value[x]
coding		0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SPRF
type		1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: Practitioner
identifier		1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
Slices for resultsInterpreter		0..*	Reference(Practitioner | PractitionerRole)	Primary result interpreter Slice: Unordered, Open by value:type
resultsInterpreter:All Slices				Content/Rules for all slices
type		1..1	uri	Type the reference refers to (e.g. "Patient")
identifier		1..1	Identifier	Logical reference, when literal reference is not known
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
resultsInterpreter:primaryReporter		0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
type		1..1	uri	Type the reference refers to (e.g. "Patient") Required Pattern: Practitioner
identifier		1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
specimen	S	0..*	Reference(Specimen)	Specimens this report is based on
Slices for result				Content/Rules for all slices
result:diagnostic-implication	S	0..*	Reference(Observation Diagnostic Implication)	Diagnostic Implication
result:variant	S	0..*	Reference(Observation Variant)	Variant
presentedForm	S	1..*	NWAttachment	a reference to the full report (presentedForm)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DiagnosticReport.code.coding:GenomicRareAndInheritedDisease	required	GenomicRareAndInheritedDisease https://nw-gmsa.github.io/ValueSet/GenomicRareAndInheritedDisease From this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	GenomicReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:recommended-action		0..*	Reference(Medication Recommendation | Followup Recommendation)	Recommended Action URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action
extension:genomic-risk-assessment		0..*	Reference(RiskAssessment)	Genomic Risk Assessment URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-risk-assessment
extension:coded-note		0..*	CodedAnnotation	Comments about the report that also contain a coded type URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note
extension:supporting-info		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:genomic-study		0..*	Reference(Genomic Study)	Reference to full details of an genomic study associated with the diagnostic report URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference
extension:hla-genotyping-results-allele-database		0..1	CodeableConcept	Allele Database URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database
extension:hla-genotyping-results-glstring		0..1	(Complex)	glstring URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring
extension:workflow-relatedArtifact		0..*	RelatedArtifact	Documentation relevant to the 'parent' resource URL: http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	CorrelationIdentifier	Business identifier for report
Slices for basedOn		0..*	CodeableReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested Slice: Unordered, Open by value:identifier.type
basedOn:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:concept		0..1	CodeableConcept	ExtCodeableReference URL: https://nw-gmsa.github.io/StructureDefinition/ext-codeable-reference
identifier	SΣ	1..1	CorrelationIdentifier	Logical reference, when literal reference is not known
basedOn:fillerOrderNumber	SO	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab (ORC-3) Obligations Actor SHALL:populate Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	FillerOrderNumber	Logical reference, when literal reference is not known
basedOn:accessionNumber	S	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab
Slices for extension				Content/Rules for all slices
extension:concept		0..*	Extension	Extension
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	AccessionNumber	Logical reference, when literal reference is not known
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category	Σ	1..*	CodeableConcept	Service category Slice: Unordered, Open by value:coding Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:Genetics	Σ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
coding	SΣ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GE
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	SΣ	1..1	CodeableConcept	ISSUE. See [National Genomic Test Directory](https://www.england.nhs.uk/wp-content/uploads/2018/08/rare-and-inherited-disease-eligibility-criteria-v2.pdf). Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 51969-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:GenomicRareAndInheritedDisease	SΣ	0..1	Coding	Code defined by a terminology system Binding: Genomic Rare and Inherited Disease Test Directory (required)
subject	Σ	1..1	Reference(Patient)	The subject of the report - usually, but not always, the patient
identifier	Σ	1..1	NHSNumber	Logical reference, when literal reference is not known
encounter	SΣ	0..1	Reference(Encounter)	A reference identifier to the episode/stay/visit number in which the report was created. (HL7 v2 PV1-19)
identifier	OΣ	0..1	EpisodeNumber	(HL7v2 PV1-19 Visit Number from OML_O21) Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
effective[x]	SOΣ	0..1	dateTime	Clinically relevant time/time-period for report Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
Slices for performer	Σ	1..*	Reference(Practitioner | Organization)	Responsible Diagnostic Service Slice: Unordered, Open by pattern:type
performer:All Slices				Content/Rules for all slices
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
performer:organisation	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Organization
identifier	Σ	1..1	OrganisationCode	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/ods-organization-code
value	Σ	1..1	string	The value that is unique Example General: 123456
performer:operator	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
Slices for extension				Content/Rules for all slices
extension:performerFunction		0..1	(Complex)	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
value[x]		1..1	CodeableConcept	Value of extension Binding: Performer Function Codes (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SPRF
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
Slices for resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole)	Primary result interpreter Slice: Unordered, Open by value:type
resultsInterpreter:All Slices				Content/Rules for all slices
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
resultsInterpreter:primaryReporter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
specimen	S	0..*	Reference(Specimen)	Specimens this report is based on
Slices for result		0..*	Reference(Observation)	Observations Slice: Unordered, Open by profile:resolve()
result:diagnostic-implication	S	0..*	Reference(Observation Diagnostic Implication)	Diagnostic Implication
result:therapeutic-implication		0..*	Reference(Therapeutic Implication)	Therapeutic Implication
result:molecular-consequence		0..*	Reference(Molecular Consequence)	Molecular Consequence
result:variant	S	0..*	Reference(Observation Variant)	Variant
result:sequence-phase-relation		0..*	Reference(Sequence Phase Relationship)	Sequence Phase Relationship
result:genotype		0..*	Reference(Genotype)	Genotype
result:haplotype		0..*	Reference(Haplotype)	Haplotype
result:biomarker		0..*	Reference(Molecular Biomarker)	MolecularBiomarker
presentedForm	S	1..*	NWAttachment	a reference to the full report (presentedForm)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.basedOn:fillerOrderNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.basedOn:accessionNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 From the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.category:Genetics	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.code	preferred	Pattern Value: LOINC Code 51969-4 http://hl7.org/fhir/ValueSet/report-codes From the FHIR Standard
DiagnosticReport.code.coding:GenomicRareAndInheritedDisease	required	GenomicRareAndInheritedDisease https://nw-gmsa.github.io/ValueSet/GenomicRareAndInheritedDisease From this IG
DiagnosticReport.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:organisation.type	extensible	Pattern Value: Organization http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:organisation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:operator.extension:performerFunction.value[x]	extensible	Performer Function Codes http://hl7.org/fhir/ValueSet/performer-function From the FHIR Standard
DiagnosticReport.performer:operator.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:operator.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:operator.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG
DiagnosticReport.resultsInterpreter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG

Constraints

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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	GenomicReport	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id	Σ	0..1	id	Logical id of this artifact
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: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:recommended-action		0..*	Reference(Medication Recommendation | Followup Recommendation)	Recommended Action URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/recommended-action
extension:genomic-risk-assessment		0..*	Reference(RiskAssessment)	Genomic Risk Assessment URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-risk-assessment
extension:coded-note		0..*	CodedAnnotation	Comments about the report that also contain a coded type URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note
extension:supporting-info		0..*	Reference(Resource)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension:genomic-study		0..*	Reference(Genomic Study)	Reference to full details of an genomic study associated with the diagnostic report URL: http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-study-reference
extension:hla-genotyping-results-allele-database		0..1	CodeableConcept	Allele Database URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-allele-database
extension:hla-genotyping-results-glstring		0..1	(Complex)	glstring URL: http://hl7.org/fhir/StructureDefinition/hla-genotyping-results-glstring
extension:workflow-relatedArtifact		0..*	RelatedArtifact	Documentation relevant to the 'parent' resource URL: http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	CorrelationIdentifier	Business identifier for report
Slices for basedOn		0..*	CodeableReference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	What was requested Slice: Unordered, Open by value:identifier.type
basedOn:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:concept		0..1	CodeableConcept	ExtCodeableReference URL: https://nw-gmsa.github.io/StructureDefinition/ext-codeable-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	1..1	CorrelationIdentifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
basedOn:fillerOrderNumber	SO	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab (ORC-3) Obligations Actor SHALL:populate Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:concept		0..*	Extension	Extension
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	FillerOrderNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
basedOn:accessionNumber	S	0..1	Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Identifier assigned by the lab
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:concept		0..*	Extension	Extension
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	SΣ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: ServiceRequest
identifier	SΣ	1..1	AccessionNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
status	?!Σ	1..1	code	registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category	Σ	1..*	CodeableConcept	Service category Slice: Unordered, Open by value:coding Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:Genetics	Σ	1..1	CodeableConcept	Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GE
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	ISSUE. See [National Genomic Test Directory](https://www.england.nhs.uk/wp-content/uploads/2018/08/rare-and-inherited-disease-eligibility-criteria-v2.pdf). Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 51969-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:GenomicRareAndInheritedDisease	SΣ	0..1	Coding	Code defined by a terminology system Binding: Genomic Rare and Inherited Disease Test Directory (required)
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient)	The subject of the report - usually, but not always, the patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	NHSNumber	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	SΣ	0..1	Reference(Encounter)	A reference identifier to the episode/stay/visit number in which the report was created. (HL7 v2 PV1-19)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	OΣ	0..1	EpisodeNumber	(HL7v2 PV1-19 Visit Number from OML_O21) Obligations Actor SHALL:populate-if-known Order Filler SHALL:populate-if-known Order Placer SHALL:populate-if-known Automation Manager
display	Σ	0..1	string	Text alternative for the resource
effective[x]	SOΣ	0..1	dateTime	Clinically relevant time/time-period for report Obligations Actor SHOULD:populate-if-known Order Filler SHOULD:populate-if-known Order Placer SHOULD:populate-if-known Automation Manager
issued	Σ	0..1	instant	DateTime this version was made
Slices for performer	Σ	1..*	Reference(Practitioner | Organization)	Responsible Diagnostic Service Slice: Unordered, Open by pattern:type
performer:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
performer:organisation	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	CodeableConcept	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction Binding: Performer Function Codes (extensible)
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Organization
identifier	Σ	1..1	OrganisationCode	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.nhs.uk/Id/ods-organization-code
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
performer:operator	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Responsible Diagnostic Service
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:performerFunction		0..1	(Complex)	Type of performance URL: http://hl7.org/fhir/StructureDefinition/event-performerFunction
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/event-performerFunction"
value[x]		1..1	CodeableConcept	Value of extension Binding: Performer Function Codes (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: SPRF
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Fixed Value: As shown (License number)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LN
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
Slices for resultsInterpreter	Σ	0..*	Reference(Practitioner | PractitionerRole)	Primary result interpreter Slice: Unordered, Open by value:type
resultsInterpreter:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
resultsInterpreter:primaryReporter	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam)	Primary result interpreter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	1..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). Required Pattern: Practitioner
identifier	Σ	1..1	EnglandPractitionerIdentifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Fixed Value: As shown (License number)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LN
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Binding: Practitioner Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
specimen	S	0..*	Reference(Specimen)	Specimens this report is based on
Slices for result		0..*	Reference(Observation)	Observations Slice: Unordered, Open by profile:resolve()
result:diagnostic-implication	S	0..*	Reference(Observation Diagnostic Implication)	Diagnostic Implication
result:therapeutic-implication		0..*	Reference(Therapeutic Implication)	Therapeutic Implication
result:molecular-consequence		0..*	Reference(Molecular Consequence)	Molecular Consequence
result:variant	S	0..*	Reference(Observation Variant)	Variant
result:sequence-phase-relation		0..*	Reference(Sequence Phase Relationship)	Sequence Phase Relationship
result:genotype		0..*	Reference(Genotype)	Genotype
result:haplotype		0..*	Reference(Haplotype)	Haplotype
result:biomarker		0..*	Reference(Molecular Biomarker)	MolecularBiomarker
imagingStudy		0..*	Reference(ImagingStudy)	Reference to full details of imaging associated with the diagnostic report
media	Σ	0..*	BackboneElement	Key images associated with this report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
comment		0..1	string	Comment about the image (e.g. explanation)
link	Σ	1..1	Reference(Media)	Reference to the image source
conclusion		0..1	string	Assessment of overall results
conclusionCode		0..*	CodeableConcept	Coarse overall interpretation of the genomic results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm	S	1..*	NWAttachment	a reference to the full report (presentedForm)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DiagnosticReport.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DiagnosticReport.basedOn.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.basedOn:fillerOrderNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.basedOn:accessionNumber.type	extensible	Pattern Value: ServiceRequest http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.status	required	DiagnosticReportStatus http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.0.1 From the FHIR Standard
DiagnosticReport.category	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.category:Genetics	example	DiagnosticServiceSectionCodes http://hl7.org/fhir/ValueSet/diagnostic-service-sections From the FHIR Standard
DiagnosticReport.code	preferred	Pattern Value: LOINC Code 51969-4 http://hl7.org/fhir/ValueSet/report-codes From the FHIR Standard
DiagnosticReport.code.coding:GenomicRareAndInheritedDisease	required	GenomicRareAndInheritedDisease https://nw-gmsa.github.io/ValueSet/GenomicRareAndInheritedDisease From this IG
DiagnosticReport.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.encounter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.performer:organisation.type	extensible	Pattern Value: Organization http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:organisation.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:organisation.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.performer:operator.extension:performerFunction.value[x]	extensible	Performer Function Codes http://hl7.org/fhir/ValueSet/performer-function From the FHIR Standard
DiagnosticReport.performer:operator.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.performer:operator.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.performer:operator.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.performer:operator.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG
DiagnosticReport.resultsInterpreter.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.type	extensible	Pattern Value: Practitioner http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DiagnosticReport.resultsInterpreter:primaryReporter.identifier.system	required	PractitionerIdentifiers(a valid code from UK Professional License) https://nw-gmsa.github.io/ValueSet/PractitionerIdentifiers From this IG
DiagnosticReport.conclusionCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings From the FHIR Standard

Constraints

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

This structure is derived from GenomicReport

Summary

Mandatory: 9 elements(9 nested mandatory elements)
Must-Support: 16 elements

Structures

This structure refers to these other structures:

• Correlation Identifier (https://nw-gmsa.github.io/StructureDefinition/CorrelationIdentifier)
• CodeableReference (https://nw-gmsa.github.io/StructureDefinition/CodeableReference)
• Filler Order Number (https://nw-gmsa.github.io/StructureDefinition/FillerOrderNumber)
• Accession Number (https://nw-gmsa.github.io/StructureDefinition/AccessionNumber)
• Patient (https://nw-gmsa.github.io/StructureDefinition/Patient)
• NHS Number (https://nw-gmsa.github.io/StructureDefinition/NHSNumber)
• Encounter (https://nw-gmsa.github.io/StructureDefinition/Encounter)
• Episode Number (https://nw-gmsa.github.io/StructureDefinition/EpisodeNumber)
• Practitioner (https://nw-gmsa.github.io/StructureDefinition/Practitioner)
• Organization (https://nw-gmsa.github.io/StructureDefinition/Organization)
• Organisation Code (https://nw-gmsa.github.io/StructureDefinition/OrganisationCode)
• England Practitioner Identifier (https://nw-gmsa.github.io/StructureDefinition/EnglandPractitionerIdentifier)
• PractitionerRole (https://nw-gmsa.github.io/StructureDefinition/PractitionerRole)
• Observation Diagnostic Implication (https://nw-gmsa.github.io/StructureDefinition/Observation-DiagnosticImplication)
• Observation Variant (https://nw-gmsa.github.io/StructureDefinition/Observation-Variant)
• Attachment (https://nw-gmsa.github.io/StructureDefinition/NWAttachment)

Extensions

This structure refers to these extensions:

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

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DiagnosticReport.basedOn
• The element 1 is sliced based on the value of DiagnosticReport.code.coding
• The element 1 is sliced based on the value of DiagnosticReport.performer
• The element 1 is sliced based on the value of DiagnosticReport.resultsInterpreter