Overview
Clinical Tests addresses to the DiagnosticReport HL7® FHIR® resource. The DiagnosticReport resource represents a resulted, patient-related, non-medication order and data associated with the order and the patient. This resource returns textual results and discrete result components. It can return lab, imaging, and cardiology results. It can also return micro and EKG and pathology results that are not a scan. Scans filed into Epic are not returned by this resource. This implementation SHALL support, at minimum, these three DiagnosticReport categories:- Cardiology (LP29708-2)
- Pathology (LP7839-6)
- Radiology (LP29684-5)
- Query for a specific clinical test result such as electrocardiogram (ECG)
- Query for a specific imaging test result
- Query for a specific Radiology note (e.g., 84178-3 Interventional Radiology Note)
- Query for category of reports (e.g. all Cardiology reports)
- a status
- a category
- a code describing the type of report
- a patient
- the diagnostically relevant time (known as the “effective time” and typically the time of the procedure)
- the encounter the report occurred within
- an instant the report was released
- an author (actor) producing the report
- a reference to one or more test results
- a reference to one or more images
- a reference to the full report (presentedForm)
- See Clinical Notes Guidance
-
The
DiagnosticReport.categorybinding must support at a minimum the US Core DiagnosticReport Category Codes of Cardiology, Radiology, and Pathology. Other categories may be supported. - A server will return how a customer has categorized their reports at a particular site. Categorization of reports is not consistent across sites. (e.g. a system may categorize an orthopedic note as cardiology.)
- For Diagnostic Imaging Reports systems SHOULD support using the subset of LOINC codes defined in CONF-DIR-19 in HL7 Implementation Guide for CDA Release 2: Imaging Integration, Levels 1, 2, and 3, Basic Imaging Reports in CDA and DICOM Diagnostic Imaging Reports (DIR) - Universal Realm, Release 1.0.
-
Diagnostic imaging results in visual images requiring interpretation and clinical test results/reports may also reference images as part of the report. The DiagnosticReport resource links to both Media which represents a specific kind of Observation whose value is image data and ImagingStudy which represents the content in a DICOM imaging study.
- Only Media is marked as must support in this profile
- The imagingStudy element MAY be used by systems to reference ImagingStudy. However, it is not supported by the majority of systems and its inclusion would be an unnecessary barrier to adoption.
Must support elements, mandatory and optional search parameters
DiagnosticReportmust support these elements:statuscategorycodesubjectencountereffective[x]issuedperformerresultmediapresentedForm
patient search parameter:
GET [base]/DiagnosticReport?patient={Type/}[id]
SHALL support searching using the combination of the patient and category search parameters:
GET [base]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]
SHALL support searching using the combination of the patient and code search parameters:
- including optional support for OR search on code (e.g.
code={system|}[code],{system|}[code],...)
GET [base]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}
SHALL support searching using the combination of the patient and category and date search parameters:
- including support for these date comparators:
gt,lt,ge,le - including optional support for AND search on date (e.g.
date=[date]&date=[date]]&...)
GET [base]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
The following search parameters and search parameter combinations SHOULD be supported:
SHOULD support searching using the combination of the patient and status search parameters:
- including support for OR search on status (e.g.
status={system|}[code],{system|}[code],...)
GET [base]/DiagnosticReport?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}
SHOULD support searching using the combination of the patient and code and date search parameters:
- including optional support for OR search on
code(e.g.code={system|}[code],{system|}[code],...) - including support for these date comparators:
gt,lt,ge,le - including optional support for AND search on
date(e.g.date=[date]&date=[date]]&...)
GET [base]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
The response to any search operation is always a list of resources in a Bundle or an Operation Outcome.
Diagnostic Report by Patient id
Search for DiagnosticReports by patient. METHOD GET
RESPONSES
EXAMPLE:
Diagnostic Report by Patient and Category
Search for DiagnosticReports by combination patient and category. METHOD GET
RESPONSES
EXAMPLE:
Diagnostic Report by Patient and Code
Search for DiagnosticReports by combination patient and code. METHOD GET
RESPONSES
EXAMPLE:
Diagnostic Report by Patient and Category and Date
Search for DiagnosticReports by combination patient and category and date. METHOD GETgr or lt or ge or le. Specification how to search by date in FHIR
HEADERS
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
RESPONSES
EXAMPLE:
Diagnostic Report by Patient and Status
Search for DiagnosticReports by combination patient and status. METHOD GET
RESPONSES
EXAMPLE:
Diagnostic Report by Patient and Code and Date
Search for DiagnosticReports by combination patient and code and date. METHOD GETgr or lt or ge or le. Specification how to search by date in FHIR
HEADERS
The Authorization token SHALL be obtained during the Authentication and Authorization process. Go to Authentication and Authorization for further details.
RESPONSES
EXAMPLE: