MR.R4.CORE\MR DiagnosticReport Pathology Result

MediRecords FHIR Implementation Guide

1.4.2 - release

Resource Profile: MR DiagnosticReport Pathology Result

Defining URL:

https://fhir.medirecords.com/StructureDefinition/mr-diagnosticpathologyresult

Version:

1.4.2

Name:

MRDiagnosticPathologyResult

Title:

MR DiagnosticReport Pathology Result

Status:

Active as of 2025-04-04 01:10:23+0000

Definition:

MediRecords Diagnostic Pathology Result profile to record pathology result for a patient

Source Resource:

XML / JSON / Turtle

The official URL for this profile is:

https://fhir.medirecords.com/StructureDefinition/mr-diagnosticpathologyresult

Formal Views of Profile Content

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

This structure is derived from Observation

Summary

Mandatory: 5 elements(6 nested mandatory elements)
Must-Support: 12 elements

Structures

This structure refers to these other structures:

MR Patient (https://fhir.medirecords.com/StructureDefinition/mr-patient-core)

Slices

This structure defines the following Slices:

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

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation			Observation
id	S	0..1	id	Logical id of this artifact
status	C	1..1	code	final inv-mr-status-observation-final: Fixed code value of 'final'
code	S	1..1	CodeableConcept	Test result name
coding		0..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system
text		1..1	string	Plain text representation of the concept
subject	S	1..1	Reference(MR Patient)	Patient the tests were requested for
Slices for effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	1..1	dateTime	Test date
Slices for value[x]		1..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueString			string
value[x]:valueString	S	0..1	string	Result string value
value[x]:valueQuantity	S	0..1	Quantity	Result quantity value
value	S	1..1	decimal	Numerical value (with implicit precision)
unit	S	1..1	string	Unit representation
interpretation	S	0..1	CodeableConcept	Result status
text	S	1..1	string	Plain text representation of the concept
referenceRange	S	0..*	BackboneElement	Provides guide for interpretation
text	S	1..1	string	Text based reference range in an observation
Documentation for this format

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present

id

SΣ

0..1

id

Logical id of this artifact

category

0..*

CodeableConcept

Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

code

SΣ

1..1

CodeableConcept

Test result name
Binding: LOINCCodes (example): Codes identifying names of simple observations.

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

coding

Σ

0..1

Coding

Code defined by a terminology system

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

system

Σ

1..1

uri

Identity of the terminology system
Required Pattern: http://loinc.org

version

Σ

0..1

string

Version of the system - if relevant

code

Σ

1..1

code

Symbol in syntax defined by the system

display

Σ

0..1

string

Representation defined by the system

userSelected

Σ

0..1

boolean

If this coding was chosen directly by the user

text

Σ

1..1

string

Plain text representation of the concept

subject

SΣ

1..1

Reference(MR Patient)

Patient the tests were requested for

focus

Σ

0..*

Reference(Resource)

What the observation is about, when it is not about the subject of record

encounter

Σ

0..1

Reference(Encounter)

Healthcare event during which this observation is made

Slices for effective[x]

Σ

1..1

dateTime

Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this

effective[x]:effectiveDateTime

SΣ

1..1

dateTime

Test date

issued

Σ

0..1

instant

Date/Time this version was made available

performer

Σ

0..*

Who is responsible for the observation

Slices for value[x]

ΣC

1..1

Actual result
Slice: Unordered, Closed by type:$this

valueQuantity

Quantity

valueString

string

value[x]:valueString

SΣC

0..1

string

Result string value

value[x]:valueQuantity

SΣC

0..1

Quantity

Result quantity value

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

SΣ

1..1

string

Unit representation

system

ΣC

0..1

uri

System that defines coded unit form

code

Σ

0..1

code

Coded form of the unit

dataAbsentReason

C

0..1

CodeableConcept

Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

S

0..1

CodeableConcept

Result status
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

coding

Σ

0..*

Coding

Code defined by a terminology system

text

SΣ

1..1

string

Plain text representation of the concept

note

0..*

Annotation

Comments about the observation

bodySite

0..1

CodeableConcept

Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

method

0..1

CodeableConcept

How it was done
Binding: ObservationMethods (example): Methods for simple observations.

specimen

0..1

Reference(Specimen)

Specimen used for this observation

device

0..1

Reference(Device | DeviceMetric)

(Measurement) Device

referenceRange

SC

0..*

BackboneElement

Provides guide for interpretation
obs-3: Must have at least a low or a high or text

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

low

C

0..1

SimpleQuantity

Low Range, if relevant

high

C

0..1

SimpleQuantity

High Range, if relevant

type

0..1

CodeableConcept

Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

appliesTo

0..*

CodeableConcept

Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.

age

0..1

Range

Applicable age range, if relevant

text

S

1..1

string

Text based reference range in an observation

hasMember

Σ

0..*

Reference(Observation | QuestionnaireResponse | MolecularSequence)

Related resource that belongs to the Observation group

derivedFrom

Σ

0..*

Related measurements the observation is made from

component

Σ

0..*

BackboneElement

Component results

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

code

Σ

1..1

CodeableConcept

Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

value[x]

Σ

0..1

Actual component result

valueQuantity

valueCodeableConcept

valueString

valueBoolean

valueInteger

valueRange

valueRatio

valueSampledData

valueTime

valueDateTime

valuePeriod

0..1

Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

0..*

CodeableConcept

High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.

referenceRange

0..*

See referenceRange (Observation)

Provides guide for interpretation of component result

Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	Measurements and simple assertions
id	Σ	0..1	id	Logical id of this artifact
code	Σ	1..1	CodeableConcept	Test result name Binding: LOINCCodes (example): Codes identifying names of simple observations.
subject	Σ	1..1	Reference(MR Patient)	Patient the tests were requested for
Slices for effective[x]				Content/Rules for all slices
effective[x]:effectiveDateTime	Σ	1..1	dateTime	Test date
Slices for value[x]				Content/Rules for all slices
value[x]:valueString	ΣC	0..1	string	Result string value
value[x]:valueQuantity	ΣC	0..1	Quantity	Result quantity value
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	1..1	string	Unit representation
interpretation		0..1	CodeableConcept	Result status Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
text	Σ	1..1	string	Plain text representation of the concept
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
text		1..1	string	Text based reference range in an observation
Documentation for this format

This structure is derived from Observation

Summary

Mandatory: 5 elements(6 nested mandatory elements)
Must-Support: 12 elements

Structures

This structure refers to these other structures:

MR Patient (https://fhir.medirecords.com/StructureDefinition/mr-patient-core)

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation			Observation
id	S	0..1	id	Logical id of this artifact
status	C	1..1	code	final inv-mr-status-observation-final: Fixed code value of 'final'
code	S	1..1	CodeableConcept	Test result name
coding		0..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Required Pattern: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system
text		1..1	string	Plain text representation of the concept
subject	S	1..1	Reference(MR Patient)	Patient the tests were requested for
Slices for effective[x]		1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	1..1	dateTime	Test date
Slices for value[x]		1..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueString			string
value[x]:valueString	S	0..1	string	Result string value
value[x]:valueQuantity	S	0..1	Quantity	Result quantity value
value	S	1..1	decimal	Numerical value (with implicit precision)
unit	S	1..1	string	Unit representation
interpretation	S	0..1	CodeableConcept	Result status
text	S	1..1	string	Plain text representation of the concept
referenceRange	S	0..*	BackboneElement	Provides guide for interpretation
text	S	1..1	string	Text based reference range in an observation
Documentation for this format

Snapshot View

Description & Constraints

Observation

C

0..*

Observation

Measurements and simple assertions
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present

id

SΣ

0..1

id

Logical id of this artifact

category

0..*

CodeableConcept

Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

code

SΣ

1..1

CodeableConcept

Test result name
Binding: LOINCCodes (example): Codes identifying names of simple observations.

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

coding

Σ

0..1

Coding

Code defined by a terminology system

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

system

Σ

1..1

uri

Identity of the terminology system
Required Pattern: http://loinc.org

version

Σ

0..1

string

Version of the system - if relevant

code

Σ

1..1

code

Symbol in syntax defined by the system

display

Σ

0..1

string

Representation defined by the system

userSelected

Σ

0..1

boolean

If this coding was chosen directly by the user

text

Σ

1..1

string

Plain text representation of the concept

subject

SΣ

1..1

Reference(MR Patient)

Patient the tests were requested for

focus

Σ

0..*

Reference(Resource)

What the observation is about, when it is not about the subject of record

encounter

Σ

0..1

Reference(Encounter)

Healthcare event during which this observation is made

Slices for effective[x]

Σ

1..1

dateTime

Clinically relevant time/time-period for observation
Slice: Unordered, Closed by type:$this

effective[x]:effectiveDateTime

SΣ

1..1

dateTime

Test date

issued

Σ

0..1

instant

Date/Time this version was made available

performer

Σ

0..*

Who is responsible for the observation

Slices for value[x]

ΣC

1..1

Actual result
Slice: Unordered, Closed by type:$this

valueQuantity

Quantity

valueString

string

value[x]:valueString

SΣC

0..1

string

Result string value

value[x]:valueQuantity

SΣC

0..1

Quantity

Result quantity value

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

SΣ

1..1

string

Unit representation

system

ΣC

0..1

uri

System that defines coded unit form

code

Σ

0..1

code

Coded form of the unit

dataAbsentReason

C

0..1

CodeableConcept

Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

S

0..1

CodeableConcept

Result status
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

coding

Σ

0..*

Coding

Code defined by a terminology system

text

SΣ

1..1

string

Plain text representation of the concept

note

0..*

Annotation

Comments about the observation

bodySite

0..1

CodeableConcept

Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

method

0..1

CodeableConcept

How it was done
Binding: ObservationMethods (example): Methods for simple observations.

specimen

0..1

Reference(Specimen)

Specimen used for this observation

device

0..1

Reference(Device | DeviceMetric)

(Measurement) Device

referenceRange

SC

0..*

BackboneElement

Provides guide for interpretation
obs-3: Must have at least a low or a high or text

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

low

C

0..1

SimpleQuantity

Low Range, if relevant

high

C

0..1

SimpleQuantity

High Range, if relevant

type

0..1

CodeableConcept

Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

appliesTo

0..*

CodeableConcept

Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.

age

0..1

Range

Applicable age range, if relevant

text

S

1..1

string

Text based reference range in an observation

hasMember

Σ

0..*

Reference(Observation | QuestionnaireResponse | MolecularSequence)

Related resource that belongs to the Observation group

derivedFrom

Σ

0..*

Related measurements the observation is made from

component

Σ

0..*

BackboneElement

Component results

id

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

code

Σ

1..1

CodeableConcept

Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

value[x]

Σ

0..1

Actual component result

valueQuantity

valueCodeableConcept

valueString

valueBoolean

valueInteger

valueRange

valueRatio

valueSampledData

valueTime

valueDateTime

valuePeriod

0..1

Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

interpretation

0..*

CodeableConcept

High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.

referenceRange

0..*

See referenceRange (Observation)

Provides guide for interpretation of component result

Documentation for this format

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

Path Conformance ValueSet URI

Observation.language

preferred

CommonLanguages

http://hl7.org/fhir/ValueSet/languages

from the FHIR Standard

Additional Bindings

Purpose

AllLanguages

Max Binding

Observation.status

required

ObservationStatus

http://hl7.org/fhir/ValueSet/observation-status|4.0.1

from the FHIR Standard

Observation.category

preferred

ObservationCategoryCodes

http://hl7.org/fhir/ValueSet/observation-category

from the FHIR Standard

Observation.code

example

LOINCCodes (a valid code from LOINC)

http://hl7.org/fhir/ValueSet/observation-codes

from the FHIR Standard

Observation.value[x]:valueQuantity.comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

from the FHIR Standard

Observation.dataAbsentReason

extensible

DataAbsentReason

http://hl7.org/fhir/ValueSet/data-absent-reason

from the FHIR Standard

Observation.interpretation

extensible

ObservationInterpretationCodes

http://hl7.org/fhir/ValueSet/observation-interpretation

from the FHIR Standard

Observation.bodySite

example

SNOMEDCTBodyStructures

http://hl7.org/fhir/ValueSet/body-site

from the FHIR Standard

Observation.method

example

ObservationMethods

http://hl7.org/fhir/ValueSet/observation-methods

from the FHIR Standard

Observation.referenceRange.type

preferred

ObservationReferenceRangeMeaningCodes

http://hl7.org/fhir/ValueSet/referencerange-meaning

from the FHIR Standard

Observation.referenceRange.appliesTo

example

ObservationReferenceRangeAppliesToCodes

http://hl7.org/fhir/ValueSet/referencerange-appliesto

from the FHIR Standard

Observation.component.code

example

LOINCCodes (a valid code from LOINC)

http://hl7.org/fhir/ValueSet/observation-codes

from the FHIR Standard

Observation.component.dataAbsentReason

extensible

DataAbsentReason

http://hl7.org/fhir/ValueSet/data-absent-reason

from the FHIR Standard

Observation.component.interpretation

extensible

ObservationInterpretationCodes

http://hl7.org/fhir/ValueSet/observation-interpretation

from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-mr-status-observation-final	error	Observation.status	Fixed code value of 'final' : $this.exists() implies $this = 'final'
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()