Bangladesh Core FHIR Implementation Guide
0.4.6 - Published by DGHS, MoHFW

Bangladesh Core FHIR Implementation Guide - Published by Ministry of Health and Family Welfare. See the Directory of published versions

## Resource Profile: Bangladesh Laboratory Report

Official URL: https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-report | Version: 0.4.6
Standards status: Informative | Maturity Level: 1 | Computable Name: BDLabReportProfile

Profile for laboratory DiagnosticReport in Bangladesh, aligned with IPS (International Patient Summary) DiagnosticReport pattern.

Usage:

- Represents a complete laboratory report for a patient encounter
- DiagnosticReport.result references panel-level Observations (bd-lab-panel-observation) or standalone result Observations (bd-lab-result-observation) where no panel grouping exists
- DiagnosticReport.code is fixed to LOINC 11502-2 (Laboratory report)
- specimen is SHOULD (MS, 0..*)

Report structure: bd-lab-report (DiagnosticReport) ├── result –> bd-lab-panel-observation │ └── hasMember –> bd-lab-result-observation (x N) └── result –> bd-lab-result-observation (standalone, no panel)

Usages:

- This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | 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
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Business identifier for report
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value | Σ | 1..1 | string | The value that is unique Example General: 123456
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
category | S Σ | 1..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
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://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report 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: 11502-2
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory report
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | The subject of the report - usually, but not always, the patient
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
display | S Σ | 1..1 | string | Text alternative for the resource
encounter | S Σ | 1..1 | Reference(Encounter) | Health care event when test ordered
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for effective[x] | S Σ | 1..1 |  | Clinically relevant time/time-period for report Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for report
issued | S Σ | 1..1 | instant | DateTime this version was made
performer | S Σ | 1..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen | S | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 1..* | Reference(Bangladesh Laboratory Panel Observation | Bangladesh Laboratory Result Observation) | Observations
conclusion | S | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode | S | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm | S | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from DiagnosticReport

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
identifier | S | 1..* | Identifier | Business identifier for report
value |  | 1..1 | string | The value that is unique
status |  | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
category | S | 1..* | CodeableConcept | Service category Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory
code | S | 1..1 | CodeableConcept | Name/Code for this diagnostic report Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory report
subject | S | 1..1 | Reference(Patient) | The subject of the report - usually, but not always, the patient
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
display | S | 1..1 | string | Text alternative for the resource
encounter | S | 1..1 | Reference(Encounter) | Health care event when test ordered
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for effective[x] | S | 1..1 | dateTime, Period | Clinically relevant time/time-period for report Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime |  | 0..1 | dateTime | Clinically relevant time/time-period for report
issued | S | 1..1 | instant | DateTime this version was made
performer | S | 1..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen | S | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 1..* | Reference(Bangladesh Laboratory Panel Observation | Bangladesh Laboratory Result Observation) | Observations
conclusion | S | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode | S | 0..* | CodeableConcept | Codes for the clinical conclusion of test results
presentedForm | S | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | 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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Business identifier for report
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 | 0..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)
basedOn |  | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
category | S Σ | 1..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
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://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report 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: 11502-2
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory report
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S 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 | S Σ C | 1..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 | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 1..1 | string | Text alternative for the resource
encounter | S Σ | 1..1 | Reference(Encounter) | Health care event when test ordered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..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 | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
Slices for effective[x] | S Σ | 1..1 |  | Clinically relevant time/time-period for report Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for report
issued | S Σ | 1..1 | instant | DateTime this version was made
performer | S Σ | 1..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen | S | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 1..* | Reference(Bangladesh Laboratory Panel Observation | Bangladesh Laboratory Result Observation) | Observations
imagingStudy |  | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report
media | Σ | 0..* | BackboneElement | Key images associated with this report
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
comment |  | 0..1 | string | Comment about the image (e.g. explanation)
link | Σ | 1..1 | Reference(Media) | Reference to the image source
conclusion | S | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode | S | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm | S | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DiagnosticReport.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DiagnosticReport.identifier.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DiagnosticReport.encounter.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from DiagnosticReport

Summary

Mandatory: 12 elements
Must-Support: 17 elements

Structures

This structure refers to these other structures:

- Bangladesh Laboratory Panel Observation (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-panel-observation)
- Bangladesh Laboratory Result Observation (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-result-observation)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DiagnosticReport.effective[x]

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | 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
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Business identifier for report
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value | Σ | 1..1 | string | The value that is unique Example General: 123456
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
category | S Σ | 1..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
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://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report 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: 11502-2
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory report
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(Patient) | The subject of the report - usually, but not always, the patient
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
display | S Σ | 1..1 | string | Text alternative for the resource
encounter | S Σ | 1..1 | Reference(Encounter) | Health care event when test ordered
reference | S Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for effective[x] | S Σ | 1..1 |  | Clinically relevant time/time-period for report Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for report
issued | S Σ | 1..1 | instant | DateTime this version was made
performer | S Σ | 1..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen | S | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 1..* | Reference(Bangladesh Laboratory Panel Observation | Bangladesh Laboratory Result Observation) | Observations
conclusion | S | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode | S | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm | S | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

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

Differential View

This structure is derived from DiagnosticReport

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
identifier | S | 1..* | Identifier | Business identifier for report
value |  | 1..1 | string | The value that is unique
status |  | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
category | S | 1..* | CodeableConcept | Service category Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory
code | S | 1..1 | CodeableConcept | Name/Code for this diagnostic report Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11502-2
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory report
subject | S | 1..1 | Reference(Patient) | The subject of the report - usually, but not always, the patient
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
display | S | 1..1 | string | Text alternative for the resource
encounter | S | 1..1 | Reference(Encounter) | Health care event when test ordered
reference | S | 1..1 | string | Literal reference, Relative, internal or absolute URL
Slices for effective[x] | S | 1..1 | dateTime, Period | Clinically relevant time/time-period for report Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime |  | 0..1 | dateTime | Clinically relevant time/time-period for report
issued | S | 1..1 | instant | DateTime this version was made
performer | S | 1..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen | S | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 1..* | Reference(Bangladesh Laboratory Panel Observation | Bangladesh Laboratory Result Observation) | Observations
conclusion | S | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode | S | 0..* | CodeableConcept | Codes for the clinical conclusion of test results
presentedForm | S | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | DiagnosticReport | 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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..* | Identifier | Business identifier for report
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 | 0..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)
basedOn |  | 0..* | Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | What was requested
status | ?!Σ | 1..1 | code | registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
category | S Σ | 1..* | CodeableConcept | Service category Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
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://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Name/Code for this diagnostic report 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: 11502-2
display |  | 1..1 | string | Representation defined by the system Fixed Value: Laboratory report
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S 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 | S Σ C | 1..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 | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 1..1 | string | Text alternative for the resource
encounter | S Σ | 1..1 | Reference(Encounter) | Health care event when test ordered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | S Σ C | 1..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 | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
Slices for effective[x] | S Σ | 1..1 |  | Clinically relevant time/time-period for report Slice: Unordered, Open by type:$this
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effective[x]:effectiveDateTime | Σ | 0..1 | dateTime | Clinically relevant time/time-period for report
issued | S Σ | 1..1 | instant | DateTime this version was made
performer | S Σ | 1..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Responsible Diagnostic Service
resultsInterpreter | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen | S | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 1..* | Reference(Bangladesh Laboratory Panel Observation | Bangladesh Laboratory Result Observation) | Observations
imagingStudy |  | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report
media | Σ | 0..* | BackboneElement | Key images associated with this report
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
comment |  | 0..1 | string | Comment about the image (e.g. explanation)
link | Σ | 1..1 | Reference(Media) | Reference to the image source
conclusion | S | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode | S | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm | S | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DiagnosticReport.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DiagnosticReport.identifier.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | example | Diagnostic Service Section Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.code | Base | preferred | LOINC Diagnostic Report Codes | 📍4.0.1 | FHIR Std.
DiagnosticReport.subject.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DiagnosticReport.encounter.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
DiagnosticReport.conclusionCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from DiagnosticReport

Summary

Mandatory: 12 elements
Must-Support: 17 elements

Structures

This structure refers to these other structures:

- Bangladesh Laboratory Panel Observation (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-panel-observation)
- Bangladesh Laboratory Result Observation (https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-result-observation)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DiagnosticReport.effective[x]

Maturity: 1

Other representations of profile: CSV, Excel, Schematron