Difference between revisions of "DiagnosticReport FHIR Resource Proposal"

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The findings and interpretation of diagnostic tests performed on patients and/or specimens. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretation, and formatted representation of diagnostic reports.
 
The findings and interpretation of diagnostic tests performed on patients and/or specimens. The report includes clinical context such as requesting and provider information, and some mix of atomic results, images, textual and coded interpretation, and formatted representation of diagnostic reports.
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Note the use of the Observation resource to represent the actual result. There are many circumstances where the use of the Observation resource alone is sufficient to record clinical information, such as clinical observations made directly by a clinician of patient.
  
 
==RIM scope==
 
==RIM scope==

Revision as of 20:14, 23 June 2013



DiagnosticReport

Owning committee name

Orders & Observations WG

Interested Work Groups

  • Anatomic Pathology
  • Clinical Genomics
  • Imaging Integration
  • Public Health and Emergency Response

FHIR Resource Development Project Insight ID

952

Scope of coverage

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

Note the use of the Observation resource to represent the actual result. There are many circumstances where the use of the Observation resource alone is sufficient to record clinical information, such as clinical observations made directly by a clinician of patient.

RIM scope

ActClass = OBS and children MoodCode = EVN

<note - need to refine to differentiate from observations>

Resource appropriateness

Diagnostic reporting is central to the business of healthcare. The basic process of healthcare is the diagnosis and treatment of patients. The diagnostic report is the primary means of communicating diagnostic results to providers, in domains such as laboratory, radiology, pathology, etc.

Expected implementations

Can be expected to be implemented by diagnostic laboratories and consumed by EHR/PHR/EMR systems. Note the relationship to the Observation resource to record the observation result/s, and to the DiagnosticOrder resource to manage the workflow aspects.


Content sources

  • HL7 v3 Laboratory Standard - Normative
  • HL7 v2.x
  • HL7 Radiology Report standards (for instance the DR Structured Report in C-CDA)


Resource Relationships

  • Order
  • OrderResponse
  • DiagnosticOrder
  • Observation
  • Specimen
  • Substance
  • Supply
  • ImagingStudy

Timelines

  • Vote by WG (Ready for ballot): July 2013
  • Ballot: September 2013

gForge Users

  • Patrick Loyd
  • Lorraine Constable