HL7 FHIR JP Core ImplementationGuide
2.0.0-dev - ci-build Japan flag

HL7 FHIR JP Core ImplementationGuide - Local Development build (v2.0.0-dev) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: JP_DiagnosticReport_LabResult - Detailed Descriptions

Active as of 2023-10-31

Definitions for the jp-diagnosticreport-labresult resource profile.

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

0. DiagnosticReport
Definition

患者、患者のグループ、デバイス、場所、これらから派生した検体に対して実行された診断的検査の結果と解釈。レポートには、依頼情報や依頼者情報などの臨床コンテキスト(文脈)、および1項目単位の結果、画像、テキストとコード化された解釈、および診断レポートのフォーマットされた表現のいくつかの組み合わせが含まれる。
【JP Core仕様】検体検査結果レポートのプロフィール


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

Short診断レポート-依頼情報、1項目単位の結果、画像、解釈、およびフォーマットされたレポートの組み合わせ 【JP Core仕様】検体検査結果レポートのプロフィールA Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Comments

これは単一のレポートをキャプチャすることを目的としており、複数のレポートをカバーする要約情報の表示に使用するのには適していない。たとえば、このリソースは、検査結果の累積レポート形式やシーケンスの詳細な構造化レポート用に作られていない。
【JP Core仕様】DiagnosticReportリソースの共通プロフィール


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

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate NamesReport, Test, Result, Results, Labs, Laboratory
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. DiagnosticReport.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DiagnosticReport.modifierExtension
Definition

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. DiagnosticReport.identifier
Definition

実施者または他のシステムによってこのレポートに割り当てられた識別子。


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

Shortレポートを識別するビジネス識別子Business identifier for report
Comments

発生源の検査室からこのレポートについてクエリを作成するとき、およびFHIRコンテキスト外のレポートにリンクするときに使用する識別子を知る必要がある。
【JP Core仕様】レポートをユニークに識別する識別子。依頼者オーダ番号と関連付ける場合が多い。
検体検査の特性として、複数の容器の結果を含む。容器ごと(厳密には項目ごと)に結果のタイミングは異なる場合がある。


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

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

発生源の検査室からこのレポートについてクエリを作成するとき、およびFHIRコンテキスト外のレポートにリンクするときに使用する識別子を知る必要がある。


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

Alternate NamesReportID, Filler ID, Placer ID
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. DiagnosticReport.basedOn
Definition

元になった検査や診断の依頼に関する情報


Details concerning a service requested.

Short元になった検査や診断の依頼に関する情報What was requested
Comments

通常、1結果ごとに1つの検査依頼があるが、状況によっては、複数の検査要求に対して1レポートがある場合がある。また 1つの検査依頼に対して複数のレポートが作成される場合もあることに注意。
【JP Core仕様】ServiceRequestリソースを参照(ObservationLabResultと同様)


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

Control0..*
TypeReference(CarePlan, ImmunizationRecommendation, JP Core MedicationRequest Profile, JP Core MedicationRequest Injection Profile, NutritionOrder, ServiceRequest, MedicationRequest)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

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

Alternate NamesRequest
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. DiagnosticReport.status
Definition

診断レポートのステータス。


The status of the diagnostic report.

Short診断レポートのステータスregistered | partial | preliminary | final +
Comments

有れば:ORC-5
もしくは
無ければ:OBR-25("F")のAND結果
 例:全部"F"なら"F"、それ以外の場合は要検討
設定する値は、DiagnosticReportStatus(コード)から1つ選ぶ
コード体系:HL7 Table 0038のコードと定義

Control1..1
BindingThe codes SHALL be taken from DiagnosticReportStatushttp://hl7.org/fhir/ValueSet/diagnostic-report-status|4.3.0
(required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.3.0)

The status of the diagnostic report.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

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

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. DiagnosticReport.category
Definition

診断レポートを作成した臨床分野、部門、または診断サービスを分類するコード。検体査では、LoincコードのLP29693-6 検体検査/LAB を使用する。


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

Short診断レポートを作成した臨床分野、部門、または診断サービスを分類するコード。検体査では、LoincコードのLP29693-6 検体検査/LAB を使用する。Service category
Comments

これは、検索、並べ替え、および表示の目的で使用される。


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

Control10..*
BindingFor example codes, see DiagnosticServiceSectionCodeshttp://hl7.org/fhir/ValueSet/diagnostic-service-sections
(example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

HL7 V2 table 0074

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Alternate NamesDepartment, Sub-department, Service, Discipline
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • 14. DiagnosticReport.category:laboratory
    Slice Namelaboratory
    Definition

    診断レポートを作成した臨床分野、部門、または診断サービス(心臓病学、生化学、血液学、放射線医学など)を分類するコード


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

    Short診断レポートを作成した臨床分野、部門、または診断サービス(心臓病学、生化学、血液学、放射線医学など)を分類するコードService category
    Comments

    【JP Core仕様】レポートカテゴリーとして、LoincコードのLP29693-6(検体検査/LAB)を使用する。


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

    Control10..1*
    BindingThe codes SHALL be taken from For example codes, see JP Core Diagnostic Report Category ValueSethttp://hl7.org/fhir/ValueSet/diagnostic-service-sections
    (required to http://jpfhir.jp/fhir/core/ValueSet/JP_DiagnosticReportCategory_VS)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Alternate NamesDepartment, Sub-department, Service, Discipline
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. DiagnosticReport.code
    Definition

    診断レポートを説明するコードまたは名前


    A code or name that describes this diagnostic report.

    Short診断レポートを説明するコードまたは名前Name/Code for this diagnostic report
    Control1..1
    BindingThe codes SHOULD be taken from JP Core Document Codes DiagnosticReport ValueSethttp://hl7.org/fhir/ValueSet/report-codes
    (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_DocumentCodes_DiagnosticReport_VS)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Alternate NamesType
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. DiagnosticReport.code.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

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

    Control0..*
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on DiagnosticReport.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 20. DiagnosticReport.code.coding:laboratoryCode
      Slice NamelaboratoryCode
      Definition

      検体検査レポート項目コード。本ユースケースにおける項目コード推奨値をスライスにて示している。


      A reference to a code defined by a terminology system.

      Short検体検査レポート項目コード。本ユースケースにおける項目コード推奨値をスライスにて示している【詳細参照】Code defined by a terminology system
      Comments

      推奨コードは必須ではない、派生先によるコード体系を作成し割り振ることを否定しない


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

      Control0..1*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. DiagnosticReport.code.coding:laboratoryCode.system
      Definition

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to be unambiguous about the source of the definition of the symbol.

      Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_DocumentCodes_CS
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. DiagnosticReport.code.coding:laboratoryCode.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control10..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Fixed Value11502-2
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. DiagnosticReport.code.coding:laboratoryCode.display
      Definition

      A representation of the meaning of the code in the system, following the rules of the system.

      ShortRepresentation defined by the system
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

      Pattern Value検体検査報告書
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. DiagnosticReport.subject
      Definition

      診断レポートの対象患者に関する情報


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

      Shortレポートの対象、常にではないが、通常は患者The subject of the report - usually, but not always, the patient
      Comments

      参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。
      【JP Core仕様】Patientリソースを参照

      Control0..1
      TypeReference(JP Core Patient Profile, Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      SHALL know the subject context.

      Alternate NamesPatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. DiagnosticReport.encounter
      Definition

      診断レポートが関係するヘルスケアイベントに関する情報


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

      Short診断レポートが関係するヘルスケアイベントに関する情報Health care event when test ordered
      Comments

      【JP Core仕様】入院外来の区別や所在場所、担当診療科の情報に使用する。
      ※このプロファイルの用途では通常は必須と考えられるが、ユースケースにより使用されない場合を考慮し、1..1に制約しない。


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

      Control0..1
      TypeReference(JP Core Encounter Profile, Encounter)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Links the request to the Encounter context.

      Alternate NamesContext
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. DiagnosticReport.effective[x]
      Definition

      診断レポートの作成日時


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

      Short診断レポートの作成日時Clinically relevant time/time-period for report
      Comments

      診断手順が患者に対して実行された場合、これは実施された時刻。対象が検体である場合は、検体採取時間から診断関連時刻を導き出すことができるが、検体情報が常に入手できるとは限らず、検体と診断関連時刻の正確な関係は必ずしも自明ではない。
      【JP Core仕様】検体採取時間


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

      Control0..1
      TypeChoice of: dateTime, Period
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

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

      Alternate NamesObservation time, Effective Time, Occurrence
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. DiagnosticReport.issued
      Definition

      このバージョンの診断レポートが医療者に提供/確定された日時


      The date and time that this version of the report was made available to providers, typically after the report was reviewed and verified.

      Shortこのバージョンの診断レポートが医療者に提供/確定された日時DateTime this version was made
      Comments

      リソース自体の更新時刻とは異なる場合がある。これは、レポートの実際の提供時刻ではなく、リソース自体の更新時刻はレコード(場合によってはセカンダリコピー)のステータスの更新時刻となるため。
      【JP Core仕様】このデータが出来た時間


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

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

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

      Alternate NamesDate published, Date Issued, Date Verified
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. DiagnosticReport.performer
      Definition

      診断レポートの作成発行に責任をもつ診断サービス/担当者に関する情報


      The diagnostic service that is responsible for issuing the report.

      Short診断レポートの作成発行に責任をもつ診断サービス/担当者に関する情報Responsible Diagnostic Service
      Comments

      必ずしも1項目データ単位のデータソースまたは結果を解釈した主体でなない。臨床レポートに責任をもつ主体のこと。
      【JP Core仕様】検査に関わった人もしくは組織


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

      Control0..*
      TypeReference(JP Core Practitioner Profile, JP Core PractitionerRole Profile, JP Core Organization Profile, CareTeam, Practitioner, PractitionerRole, Organization)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

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

      Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. DiagnosticReport.resultsInterpreter
      Definition

      診断レポートの結論と解釈に責任を持つ医療者/組織に関する情報


      The practitioner or organization that is responsible for the report's conclusions and interpretations.

      Short診断レポートの結論と解釈に責任を持つ医療者/組織に関する情報Primary result interpreter
      Comments

      レポートに責任を持つ主体とは異なる場合がある。
      【JP Core仕様】検査責任者


      Might not be the same entity that takes responsibility for the clinical report.

      Control0..*
      TypeReference(JP Core Practitioner Profile, JP Core PractitionerRole Profile, JP Core Organization Profile, CareTeam, Practitioner, PractitionerRole, Organization)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

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

      Alternate NamesAnalyzed by, Reported by
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. DiagnosticReport.specimen
      Definition

      診断レポートのもとになった検体に関する情報


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

      Short診断レポートのもとになった検体に関する情報Specimens this report is based on
      Comments

      検査結果名称のコードを見れば検体情報が十分に判明するような場合には、この検体情報は冗長になる。複数の検体が関与する場合には、検査や検査グループごとに検体情報が記述されることがある。
      【JP Core仕様】該当するspecimenを設定


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

      Control0..*
      TypeReference(Specimen)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. DiagnosticReport.result
      Definition

      診断レポートの一部


      Observations that are part of this diagnostic report.

      Short診断レポートの一部となるObservationsに関する情報Observations
      Comments

      Observationはobservationを含みうる。
      【JP Core仕様】該当するObservationを設定


      Observations can contain observations.

      Control0..*
      TypeReference(JP Core Observation LabResult Profile, Observation)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

      個々の結果または結果のグループをサポートする必要がある。結果のグループ化は任意だが、意味がある場合にグループ化される。


      Need to support individual results, or groups of results, where the result grouping is arbitrary, but meaningful.

      Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. DiagnosticReport.imagingStudy
      Definition

      診断レポートに関連づけれられたDICOM検査画像に関する情報


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

      Short診断レポートに関連づけれられたDICOM検査画像に関する情報Reference to full details of imaging associated with the diagnostic report
      Comments

      ImagingStudyと画像要素は多少重複する。通常、画像要素内の画像参照のリストは、画像検査リソースのひとつにも存在する。ただし、それぞれがさまざまなタイプの目的のためにさまざまなタイプのディスプレイに対応している。どちらも、どちらか、または両方を提供することはできない。
      【JP Core仕様】使わない


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

      Control0..*
      TypeReference(ImagingStudy)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. DiagnosticReport.media
      Definition

      診断レポートに関連づけられたメディアに関する情報


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

      Short診断レポートに関連づけられたメディアに関する情報Key images associated with this report
      Comments

      【JP Core仕様】レポート1つに対して、複数の画像・コメントがぶら下がる

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      多くの診断業務では提供情報の一部としてレポートに画像を含む。


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

      Alternate NamesDICOM, Slides, Scans
      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
      48. DiagnosticReport.media.modifierExtension
      Definition

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

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      50. DiagnosticReport.media.comment
      Definition

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

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

      【JP Core仕様】画像に対するコメント


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

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. DiagnosticReport.media.link
      Definition

      Reference to the image source.

      ShortReference to the image source
      Comments

      【JP Core仕様】画像に対するリンク

      Control1..1
      TypeReference(Media)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. DiagnosticReport.conclusion
      Definition

      診断レポートの簡潔で臨床的に文脈化された要約結論(解釈/印象)。


      Concise and clinically contextualized summary conclusion (interpretation/impression) of the diagnostic report.

      Short簡潔かつ臨床的な文脈で表現した診断レポートの要約結論(解釈、インプレッション)Clinical conclusion (interpretation) of test results
      Comments

      【JP Core仕様】原則使わない

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Requirements

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

      Alternate NamesReport
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. DiagnosticReport.conclusionCode
      Definition

      診断レポートの要約結論(解釈、インプレッション)を表すコード


      One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report.

      Short診断レポートの要約結論(解釈、インプレッション)を表すコードCodes for the clinical conclusion of test results
      Comments

      【JP Core仕様】原則使わない

      Control0..*
      BindingFor example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings
      (example to http://hl7.org/fhir/ValueSet/clinical-findings)

      SNOMED CT Clinical Findings

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. DiagnosticReport.presentedForm
      Definition

      診断サービス/担当者によって発行された診断レポート全体のコンテンツ(例えばPDFファイルなど)


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

      Short診断サービス/担当者によって発行された診断レポート全体のコンテンツ(例えばPDFファイルなど)Entire report as issued
      Comments

      application/pdfがこのコンテキストで最も信頼でき相互運用可能なものとして推奨される。
      【JP Core仕様】原則使わない


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

      Control0..*
      TypeAttachment
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

      0. DiagnosticReport
      Definition

      患者、患者のグループ、デバイス、場所、これらから派生した検体に対して実行された診断的検査の結果と解釈。レポートには、依頼情報や依頼者情報などの臨床コンテキスト(文脈)、および1項目単位の結果、画像、テキストとコード化された解釈、および診断レポートのフォーマットされた表現のいくつかの組み合わせが含まれる。
      【JP Core仕様】検体検査結果レポートのプロフィール

      Short診断レポート-依頼情報、1項目単位の結果、画像、解釈、およびフォーマットされたレポートの組み合わせ 【JP Core仕様】検体検査結果レポートのプロフィール
      2. DiagnosticReport.identifier
      Definition

      実施者または他のシステムによってこのレポートに割り当てられた識別子。

      Shortレポートを識別するビジネス識別子
      Comments

      発生源の検査室からこのレポートについてクエリを作成するとき、およびFHIRコンテキスト外のレポートにリンクするときに使用する識別子を知る必要がある。
      【JP Core仕様】レポートをユニークに識別する識別子。依頼者オーダ番号と関連付ける場合が多い。
      検体検査の特性として、複数の容器の結果を含む。容器ごと(厳密には項目ごと)に結果のタイミングは異なる場合がある。

      NoteThis is a business identifier, not a resource identifier (see discussion)
      4. DiagnosticReport.basedOn
      Comments

      通常、1結果ごとに1つの検査依頼があるが、状況によっては、複数の検査要求に対して1レポートがある場合がある。また 1つの検査依頼に対して複数のレポートが作成される場合もあることに注意。
      【JP Core仕様】ServiceRequestリソースを参照(ObservationLabResultと同様)

      6. DiagnosticReport.status
      Definition

      診断レポートのステータス。

      Comments

      有れば:ORC-5
      もしくは
      無ければ:OBR-25("F")のAND結果
       例:全部"F"なら"F"、それ以外の場合は要検討
      設定する値は、DiagnosticReportStatus(コード)から1つ選ぶ
      コード体系:HL7 Table 0038のコードと定義

      8. DiagnosticReport.category
      Definition

      診断レポートを作成した臨床分野、部門、または診断サービスを分類するコード。検体査では、LoincコードのLP29693-6 検体検査/LAB を使用する。

      Short診断レポートを作成した臨床分野、部門、または診断サービスを分類するコード。検体査では、LoincコードのLP29693-6 検体検査/LAB を使用する。
      Control1..?
      SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ $this
      • 10. DiagnosticReport.category:laboratory
        Slice Namelaboratory
        Comments

        【JP Core仕様】レポートカテゴリーとして、LoincコードのLP29693-6(検体検査/LAB)を使用する。

        Control1..1
        BindingThe codes SHALL be taken from JP Core Diagnostic Report Category ValueSet
        (required to http://jpfhir.jp/fhir/core/ValueSet/JP_DiagnosticReportCategory_VS)
        12. DiagnosticReport.category:laboratory.coding
        14. DiagnosticReport.category:laboratory.coding.system
        Fixed Valuehttp://loinc.org
        16. DiagnosticReport.category:laboratory.coding.code
        Control1..?
        Fixed ValueLP29693-6
        18. DiagnosticReport.code
        20. DiagnosticReport.code.coding
        SlicingThis element introduces a set of slices on DiagnosticReport.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ system
        • 22. DiagnosticReport.code.coding:laboratoryCode
          Slice NamelaboratoryCode
          Definition

          検体検査レポート項目コード。本ユースケースにおける項目コード推奨値をスライスにて示している。

          Short検体検査レポート項目コード。本ユースケースにおける項目コード推奨値をスライスにて示している【詳細参照】
          Comments

          推奨コードは必須ではない、派生先によるコード体系を作成し割り振ることを否定しない

          Control0..1
          24. DiagnosticReport.code.coding:laboratoryCode.system
          Control1..?
          Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_DocumentCodes_CS
          26. DiagnosticReport.code.coding:laboratoryCode.code
          Control1..?
          Fixed Value11502-2
          28. DiagnosticReport.code.coding:laboratoryCode.display
          Pattern Value検体検査報告書
          30. DiagnosticReport.subject
          Shortレポートの対象、常にではないが、通常は患者
          Comments

          参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。
          【JP Core仕様】Patientリソースを参照

          TypeReference(JP Core Patient Profile)
          32. DiagnosticReport.encounter
          Comments

          【JP Core仕様】入院外来の区別や所在場所、担当診療科の情報に使用する。
          ※このプロファイルの用途では通常は必須と考えられるが、ユースケースにより使用されない場合を考慮し、1..1に制約しない。

          34. DiagnosticReport.effective[x]
          Comments

          診断手順が患者に対して実行された場合、これは実施された時刻。対象が検体である場合は、検体採取時間から診断関連時刻を導き出すことができるが、検体情報が常に入手できるとは限らず、検体と診断関連時刻の正確な関係は必ずしも自明ではない。
          【JP Core仕様】検体採取時間

          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          36. DiagnosticReport.issued
          Comments

          リソース自体の更新時刻とは異なる場合がある。これは、レポートの実際の提供時刻ではなく、リソース自体の更新時刻はレコード(場合によってはセカンダリコピー)のステータスの更新時刻となるため。
          【JP Core仕様】このデータが出来た時間

          38. DiagnosticReport.performer
          Comments

          必ずしも1項目データ単位のデータソースまたは結果を解釈した主体でなない。臨床レポートに責任をもつ主体のこと。
          【JP Core仕様】検査に関わった人もしくは組織

          40. DiagnosticReport.resultsInterpreter
          Comments

          レポートに責任を持つ主体とは異なる場合がある。
          【JP Core仕様】検査責任者

          42. DiagnosticReport.specimen
          Comments

          検査結果名称のコードを見れば検体情報が十分に判明するような場合には、この検体情報は冗長になる。複数の検体が関与する場合には、検査や検査グループごとに検体情報が記述されることがある。
          【JP Core仕様】該当するspecimenを設定

          44. DiagnosticReport.result
          Definition

          診断レポートの一部

          Comments

          Observationはobservationを含みうる。
          【JP Core仕様】該当するObservationを設定

          TypeReference(JP Core Observation LabResult Profile)
          46. DiagnosticReport.imagingStudy
          Comments

          ImagingStudyと画像要素は多少重複する。通常、画像要素内の画像参照のリストは、画像検査リソースのひとつにも存在する。ただし、それぞれがさまざまなタイプの目的のためにさまざまなタイプのディスプレイに対応している。どちらも、どちらか、または両方を提供することはできない。
          【JP Core仕様】使わない

          48. DiagnosticReport.media
          Comments

          【JP Core仕様】レポート1つに対して、複数の画像・コメントがぶら下がる

          50. DiagnosticReport.media.comment
          Comments

          【JP Core仕様】画像に対するコメント

          52. DiagnosticReport.media.link
          Comments

          【JP Core仕様】画像に対するリンク

          54. DiagnosticReport.conclusion
          Definition

          診断レポートの簡潔で臨床的に文脈化された要約結論(解釈/印象)。

          Comments

          【JP Core仕様】原則使わない

          56. DiagnosticReport.conclusionCode
          Comments

          【JP Core仕様】原則使わない

          58. DiagnosticReport.presentedForm
          Comments

          application/pdfがこのコンテキストで最も信頼でき相互運用可能なものとして推奨される。
          【JP Core仕様】原則使わない

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

          0. DiagnosticReport
          Definition

          患者、患者のグループ、デバイス、場所、これらから派生した検体に対して実行された診断的検査の結果と解釈。レポートには、依頼情報や依頼者情報などの臨床コンテキスト(文脈)、および1項目単位の結果、画像、テキストとコード化された解釈、および診断レポートのフォーマットされた表現のいくつかの組み合わせが含まれる。
          【JP Core仕様】検体検査結果レポートのプロフィール

          Short診断レポート-依頼情報、1項目単位の結果、画像、解釈、およびフォーマットされたレポートの組み合わせ 【JP Core仕様】検体検査結果レポートのプロフィール
          Comments

          これは単一のレポートをキャプチャすることを目的としており、複数のレポートをカバーする要約情報の表示に使用するのには適していない。たとえば、このリソースは、検査結果の累積レポート形式やシーケンスの詳細な構造化レポート用に作られていない。
          【JP Core仕様】DiagnosticReportリソースの共通プロフィール

          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate NamesReport, Test, Result, Results, Labs, Laboratory
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. DiagnosticReport.id
          Definition

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

          ShortLogical id of this artifact
          Comments

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

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          4. DiagnosticReport.meta
          Definition

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

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. DiagnosticReport.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. DiagnosticReport.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          IETF language tag

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. DiagnosticReport.text
          Definition

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

          ShortText summary of the resource, for human interpretation
          Comments

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

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. DiagnosticReport.contained
          Definition

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

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
          14. DiagnosticReport.extension
          Definition

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

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. DiagnosticReport.modifierExtension
          Definition

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

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Must Supportfalse
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. DiagnosticReport.identifier
          Definition

          実施者または他のシステムによってこのレポートに割り当てられた識別子。

          Shortレポートを識別するビジネス識別子
          Comments

          発生源の検査室からこのレポートについてクエリを作成するとき、およびFHIRコンテキスト外のレポートにリンクするときに使用する識別子を知る必要がある。
          【JP Core仕様】レポートをユニークに識別する識別子。依頼者オーダ番号と関連付ける場合が多い。
          検体検査の特性として、複数の容器の結果を含む。容器ごと(厳密には項目ごと)に結果のタイミングは異なる場合がある。

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

          発生源の検査室からこのレポートについてクエリを作成するとき、およびFHIRコンテキスト外のレポートにリンクするときに使用する識別子を知る必要がある。

          Alternate NamesReportID, Filler ID, Placer ID
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. DiagnosticReport.basedOn
          Definition

          元になった検査や診断の依頼に関する情報

          Short元になった検査や診断の依頼に関する情報
          Comments

          通常、1結果ごとに1つの検査依頼があるが、状況によっては、複数の検査要求に対して1レポートがある場合がある。また 1つの検査依頼に対して複数のレポートが作成される場合もあることに注意。
          【JP Core仕様】ServiceRequestリソースを参照(ObservationLabResultと同様)

          Control0..*
          TypeReference(CarePlan, ImmunizationRecommendation, JP Core MedicationRequest Profile, JP Core MedicationRequest Injection Profile, NutritionOrder, ServiceRequest)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

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

          Alternate NamesRequest
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. DiagnosticReport.status
          Definition

          診断レポートのステータス。

          Short診断レポートのステータス
          Comments

          有れば:ORC-5
          もしくは
          無ければ:OBR-25("F")のAND結果
           例:全部"F"なら"F"、それ以外の場合は要検討
          設定する値は、DiagnosticReportStatus(コード)から1つ選ぶ
          コード体系:HL7 Table 0038のコードと定義

          Control1..1
          BindingThe codes SHALL be taken from DiagnosticReportStatus
          (required to http://hl7.org/fhir/ValueSet/diagnostic-report-status|4.3.0)

          The status of the diagnostic report.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. DiagnosticReport.category
          Definition

          診断レポートを作成した臨床分野、部門、または診断サービスを分類するコード。検体査では、LoincコードのLP29693-6 検体検査/LAB を使用する。

          Short診断レポートを作成した臨床分野、部門、または診断サービスを分類するコード。検体査では、LoincコードのLP29693-6 検体検査/LAB を使用する。
          Comments

          これは、検索、並べ替え、および表示の目的で使用される。

          Control1..*
          BindingFor example codes, see DiagnosticServiceSectionCodes
          (example to http://hl7.org/fhir/ValueSet/diagnostic-service-sections)

          HL7 V2 table 0074

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Alternate NamesDepartment, Sub-department, Service, Discipline
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on DiagnosticReport.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ $this
          • 26. DiagnosticReport.category.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typeid
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            28. DiagnosticReport.category.extension
            Definition

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

            ShortAdditional content defined by implementations
            Comments

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

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on DiagnosticReport.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 30. DiagnosticReport.category.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

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

              Control0..*
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. DiagnosticReport.category.coding.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              34. DiagnosticReport.category.coding.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on DiagnosticReport.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 36. DiagnosticReport.category.coding.system
                Definition

                カテゴリーコードシステムの識別URL

                Shortカテゴリーコードシステムの識別URL
                Comments

                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                Need to be unambiguous about the source of the definition of the symbol.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. DiagnosticReport.category.coding.version
                Definition

                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                ShortVersion of the system - if relevant
                Comments

                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. DiagnosticReport.category.coding.code
                Definition

                カテゴリーコード

                Shortカテゴリーコード
                Control0..1
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to refer to a particular code in the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. DiagnosticReport.category.coding.display
                Definition

                カテゴリー表示名

                Shortカテゴリー表示名
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. DiagnosticReport.category.coding.userSelected
                Definition

                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                ShortIf this coding was chosen directly by the user
                Comments

                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. DiagnosticReport.category.text
                Definition

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

                ShortPlain text representation of the concept
                Comments

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

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

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                48. DiagnosticReport.category:laboratory
                Slice Namelaboratory
                Definition

                診断レポートを作成した臨床分野、部門、または診断サービス(心臓病学、生化学、血液学、放射線医学など)を分類するコード

                Short診断レポートを作成した臨床分野、部門、または診断サービス(心臓病学、生化学、血液学、放射線医学など)を分類するコード
                Comments

                【JP Core仕様】レポートカテゴリーとして、LoincコードのLP29693-6(検体検査/LAB)を使用する。

                Control1..1
                BindingThe codes SHALL be taken from JP Core Diagnostic Report Category ValueSet
                (required to http://jpfhir.jp/fhir/core/ValueSet/JP_DiagnosticReportCategory_VS)
                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Alternate NamesDepartment, Sub-department, Service, Discipline
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. DiagnosticReport.category:laboratory.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                52. DiagnosticReport.category:laboratory.extension
                Definition

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

                ShortAdditional content defined by implementations
                Comments

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

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on DiagnosticReport.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 54. DiagnosticReport.category:laboratory.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

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

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. DiagnosticReport.category:laboratory.coding.id
                  Definition

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  58. DiagnosticReport.category:laboratory.coding.extension
                  Definition

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

                  ShortAdditional content defined by implementations
                  Comments

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

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on DiagnosticReport.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 60. DiagnosticReport.category:laboratory.coding.system
                    Definition

                    カテゴリーコードシステムの識別URL

                    Shortカテゴリーコードシステムの識別URL
                    Comments

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                    Need to be unambiguous about the source of the definition of the symbol.

                    Fixed Valuehttp://loinc.org
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. DiagnosticReport.category:laboratory.coding.version
                    Definition

                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                    ShortVersion of the system - if relevant
                    Comments

                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                    NoteThis is a business version Id, not a resource version Id (see discussion)
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. DiagnosticReport.category:laboratory.coding.code
                    Definition

                    カテゴリーコード

                    Shortカテゴリーコード
                    Control1..1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to refer to a particular code in the system.

                    Fixed ValueLP29693-6
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. DiagnosticReport.category:laboratory.coding.display
                    Definition

                    カテゴリー表示名

                    Shortカテゴリー表示名
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. DiagnosticReport.category:laboratory.coding.userSelected
                    Definition

                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                    ShortIf this coding was chosen directly by the user
                    Comments

                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. DiagnosticReport.category:laboratory.text
                    Definition

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

                    ShortPlain text representation of the concept
                    Comments

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

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

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    72. DiagnosticReport.code
                    Definition

                    診断レポートを説明するコードまたは名前

                    Short診断レポートを説明するコードまたは名前
                    Control1..1
                    BindingThe codes SHOULD be taken from JP Core Document Codes DiagnosticReport ValueSet
                    (preferred to http://jpfhir.jp/fhir/core/ValueSet/JP_DocumentCodes_DiagnosticReport_VS)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Alternate NamesType
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. DiagnosticReport.code.id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    76. DiagnosticReport.code.extension
                    Definition

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

                    ShortAdditional content defined by implementations
                    Comments

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

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on DiagnosticReport.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 78. DiagnosticReport.code.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

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

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows for alternative encodings within a code system, and translations to other code systems.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on DiagnosticReport.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ system
                      • 80. DiagnosticReport.code.coding:laboratoryCode
                        Slice NamelaboratoryCode
                        Definition

                        検体検査レポート項目コード。本ユースケースにおける項目コード推奨値をスライスにて示している。

                        Short検体検査レポート項目コード。本ユースケースにおける項目コード推奨値をスライスにて示している【詳細参照】
                        Comments

                        推奨コードは必須ではない、派生先によるコード体系を作成し割り振ることを否定しない

                        Control0..1
                        TypeCoding
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        82. DiagnosticReport.code.coding:laboratoryCode.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typeid
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        84. DiagnosticReport.code.coding:laboratoryCode.extension
                        Definition

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

                        ShortAdditional content defined by implementations
                        Comments

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

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on DiagnosticReport.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 86. DiagnosticReport.code.coding:laboratoryCode.system
                          Definition

                          The identification of the code system that defines the meaning of the symbol in the code.

                          ShortIdentity of the terminology system
                          Comments

                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                          Control1..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be unambiguous about the source of the definition of the symbol.

                          Fixed Valuehttp://jpfhir.jp/fhir/core/CodeSystem/JP_DocumentCodes_CS
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          88. DiagnosticReport.code.coding:laboratoryCode.version
                          Definition

                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                          ShortVersion of the system - if relevant
                          Comments

                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                          NoteThis is a business version Id, not a resource version Id (see discussion)
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          90. DiagnosticReport.code.coding:laboratoryCode.code
                          Definition

                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                          ShortSymbol in syntax defined by the system
                          Control1..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to refer to a particular code in the system.

                          Fixed Value11502-2
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          92. DiagnosticReport.code.coding:laboratoryCode.display
                          Definition

                          A representation of the meaning of the code in the system, following the rules of the system.

                          ShortRepresentation defined by the system
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                          Pattern Value検体検査報告書
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          94. DiagnosticReport.code.coding:laboratoryCode.userSelected
                          Definition

                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                          ShortIf this coding was chosen directly by the user
                          Comments

                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          96. DiagnosticReport.code.text
                          Definition

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

                          ShortPlain text representation of the concept
                          Comments

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

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

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. DiagnosticReport.subject
                          Definition

                          診断レポートの対象患者に関する情報

                          Shortレポートの対象、常にではないが、通常は患者
                          Comments

                          参照は、実際のFHIRリソースへの参照である必要があり、内容に辿り着ける(解決できる)必要がある(アクセス制御、一時的な使用不可などを考慮に入れる)。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。
                          【JP Core仕様】Patientリソースを参照

                          Control0..1
                          TypeReference(JP Core Patient Profile)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          SHALL know the subject context.

                          Alternate NamesPatient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          100. DiagnosticReport.encounter
                          Definition

                          診断レポートが関係するヘルスケアイベントに関する情報

                          Short診断レポートが関係するヘルスケアイベントに関する情報
                          Comments

                          【JP Core仕様】入院外来の区別や所在場所、担当診療科の情報に使用する。
                          ※このプロファイルの用途では通常は必須と考えられるが、ユースケースにより使用されない場合を考慮し、1..1に制約しない。

                          Control0..1
                          TypeReference(JP Core Encounter Profile)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          Links the request to the Encounter context.

                          Alternate NamesContext
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          102. DiagnosticReport.effective[x]
                          Definition

                          診断レポートの作成日時

                          Short診断レポートの作成日時
                          Comments

                          診断手順が患者に対して実行された場合、これは実施された時刻。対象が検体である場合は、検体採取時間から診断関連時刻を導き出すことができるが、検体情報が常に入手できるとは限らず、検体と診断関連時刻の正確な関係は必ずしも自明ではない。
                          【JP Core仕様】検体採取時間

                          Control0..1
                          TypeChoice of: dateTime, Period
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

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

                          Alternate NamesObservation time, Effective Time, Occurrence
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          104. DiagnosticReport.issued
                          Definition

                          このバージョンの診断レポートが医療者に提供/確定された日時

                          Shortこのバージョンの診断レポートが医療者に提供/確定された日時
                          Comments

                          リソース自体の更新時刻とは異なる場合がある。これは、レポートの実際の提供時刻ではなく、リソース自体の更新時刻はレコード(場合によってはセカンダリコピー)のステータスの更新時刻となるため。
                          【JP Core仕様】このデータが出来た時間

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

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

                          Alternate NamesDate published, Date Issued, Date Verified
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          106. DiagnosticReport.performer
                          Definition

                          診断レポートの作成発行に責任をもつ診断サービス/担当者に関する情報

                          Short診断レポートの作成発行に責任をもつ診断サービス/担当者に関する情報
                          Comments

                          必ずしも1項目データ単位のデータソースまたは結果を解釈した主体でなない。臨床レポートに責任をもつ主体のこと。
                          【JP Core仕様】検査に関わった人もしくは組織

                          Control0..*
                          TypeReference(JP Core Practitioner Profile, JP Core PractitionerRole Profile, JP Core Organization Profile, CareTeam)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

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

                          Alternate NamesLaboratory, Service, Practitioner, Department, Company, Authorized by, Director
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. DiagnosticReport.resultsInterpreter
                          Definition

                          診断レポートの結論と解釈に責任を持つ医療者/組織に関する情報

                          Short診断レポートの結論と解釈に責任を持つ医療者/組織に関する情報
                          Comments

                          レポートに責任を持つ主体とは異なる場合がある。
                          【JP Core仕様】検査責任者

                          Control0..*
                          TypeReference(JP Core Practitioner Profile, JP Core PractitionerRole Profile, JP Core Organization Profile, CareTeam)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

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

                          Alternate NamesAnalyzed by, Reported by
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          110. DiagnosticReport.specimen
                          Definition

                          診断レポートのもとになった検体に関する情報

                          Short診断レポートのもとになった検体に関する情報
                          Comments

                          検査結果名称のコードを見れば検体情報が十分に判明するような場合には、この検体情報は冗長になる。複数の検体が関与する場合には、検査や検査グループごとに検体情報が記述されることがある。
                          【JP Core仕様】該当するspecimenを設定

                          Control0..*
                          TypeReference(Specimen)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          112. DiagnosticReport.result
                          Definition

                          診断レポートの一部

                          Short診断レポートの一部となるObservationsに関する情報
                          Comments

                          Observationはobservationを含みうる。
                          【JP Core仕様】該当するObservationを設定

                          Control0..*
                          TypeReference(JP Core Observation LabResult Profile)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          個々の結果または結果のグループをサポートする必要がある。結果のグループ化は任意だが、意味がある場合にグループ化される。

                          Alternate NamesData, Atomic Value, Result, Atomic result, Data, Test, Analyte, Battery, Organizer
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. DiagnosticReport.imagingStudy
                          Definition

                          診断レポートに関連づけれられたDICOM検査画像に関する情報

                          Short診断レポートに関連づけれられたDICOM検査画像に関する情報
                          Comments

                          ImagingStudyと画像要素は多少重複する。通常、画像要素内の画像参照のリストは、画像検査リソースのひとつにも存在する。ただし、それぞれがさまざまなタイプの目的のためにさまざまなタイプのディスプレイに対応している。どちらも、どちらか、または両方を提供することはできない。
                          【JP Core仕様】使わない

                          Control0..*
                          TypeReference(ImagingStudy)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. DiagnosticReport.media
                          Definition

                          診断レポートに関連づけられたメディアに関する情報

                          Short診断レポートに関連づけられたメディアに関する情報
                          Comments

                          【JP Core仕様】レポート1つに対して、複数の画像・コメントがぶら下がる

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          多くの診断業務では提供情報の一部としてレポートに画像を含む。

                          Alternate NamesDICOM, Slides, Scans
                          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                          118. DiagnosticReport.media.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          120. DiagnosticReport.media.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          122. DiagnosticReport.media.modifierExtension
                          Definition

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

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          124. DiagnosticReport.media.comment
                          Definition

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

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

                          【JP Core仕様】画像に対するコメント

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          126. DiagnosticReport.media.link
                          Definition

                          Reference to the image source.

                          ShortReference to the image source
                          Comments

                          【JP Core仕様】画像に対するリンク

                          Control1..1
                          TypeReference(Media)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          128. DiagnosticReport.conclusion
                          Definition

                          診断レポートの簡潔で臨床的に文脈化された要約結論(解釈/印象)。

                          Short簡潔かつ臨床的な文脈で表現した診断レポートの要約結論(解釈、インプレッション)
                          Comments

                          【JP Core仕様】原則使わない

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

                          Alternate NamesReport
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          130. DiagnosticReport.conclusionCode
                          Definition

                          診断レポートの要約結論(解釈、インプレッション)を表すコード

                          Short診断レポートの要約結論(解釈、インプレッション)を表すコード
                          Comments

                          【JP Core仕様】原則使わない

                          Control0..*
                          BindingFor example codes, see SNOMEDCTClinicalFindings
                          (example to http://hl7.org/fhir/ValueSet/clinical-findings)

                          SNOMED CT Clinical Findings

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          132. DiagnosticReport.presentedForm
                          Definition

                          診断サービス/担当者によって発行された診断レポート全体のコンテンツ(例えばPDFファイルなど)

                          Short診断サービス/担当者によって発行された診断レポート全体のコンテンツ(例えばPDFファイルなど)
                          Comments

                          application/pdfがこのコンテキストで最も信頼でき相互運用可能なものとして推奨される。
                          【JP Core仕様】原則使わない

                          Control0..*
                          TypeAttachment
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          本実装ガイドへのご質問・ご指摘については、GitHub IssueおよびGitHub PullRequestにて受け付けております。