Clinical Tests

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.

The following are example usage scenarios for the this profile:

  • 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)

Each Diagnostic Report has next elements:

  • 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)

Each Diagnostic Report must support:

  • the encounter the report occurred within
  • 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)

Profile specific implementation guidance:

  • See Clinical Notes Guidance

  • The DiagnosticReport.category binding 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.

This resource conforms to USCDI V2 profile for Diagnostic Report - refers to US Core DiagnosticReport Profile for Report and Note Exchange. DiagnosticReport response will be provided in JSON (refers to Capability Statement) format as per FHIR standard R4 version.

Must support elements, mandatory and optional search parameters

DiagnosticReport must support these elements:

  • status
  • Slices for category
    • category:us-core
  • code
  • subject
  • encounter
  • effectiveDateTime
  • issued
  • performer
  • result
  • media
    • linkÍ
  • presentedForm

The syntax used to describe the interactions is described here.

The following search parameters and search parameter combinations SHALL be supported:

SHALL support searching for all DiagnosticReports for a patient using the 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

[base url]/DiagnosticReport?patient={Type/}[id]

PARAMS
[base url] - FHIR base url
{Type/} - optional reference type
[id] - Id for the Patient

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Go to Authentication and Authorization for further details.

HeaderTypeRequired/OptionalValue
Authorizationstringrequired'Bearer'

RESPONSES

CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404no Route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Diagnostic Report by Patient and Category

Search for DiagnosticReports by combination patient and category.

METHOD GET

[base url]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]

PARAMS

[base url] - FHIR base url
{Type/} - optional reference type
[id] - Id for the Patient
{system|} - The system for the category, e.g. http://loinc.org
{code} - code for observation in the system, e.g. LP29684-5

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Go to Authentication and Authorization for further details.

HeaderTypeRequired/OptionalValue
Authorizationstringrequired'Bearer'

RESPONSES

CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404no Route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://loinc.org|LP29684-5' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Diagnostic Report by Patient and Code

Search for DiagnosticReports by combination patient and code.

METHOD GET

[base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]

PARAMS
[base url] - FHIR base url
{Type/} - optional reference type
[id] - Id for the Patient
{system|} - The system for the category, e.g. http://loinc.org
{code} - code for observation in the system, e.g. 24323-8

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.

HeaderTypeRequired/OptionalValue
Authorizationstringrequired'Bearer'

RESPONSES

CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404no Route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|24323-8' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Diagnostic Report by Patient and Category and Date

Search for DiagnosticReports by combination patient and category and date.

METHOD GET

[base url]/DiagnosticReport?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

PARAMS
[base url] - FHIR base url
{Type/} - optional reference type
[id] - Id for the Patient
{system|} - The system for the category, e.g. http://loinc.org
{code} - Code for observation in the system, e.g. 24323-8
[date] - Filter's date
{gt|lt|ge|le} - Search modifier gr or lt or ge or le. Specification how to search by date in FHIR

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.

HeaderTypeRequired/OptionalValue
Authorizationstringrequired'Bearer'

RESPONSES

CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404no Route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&category=http://loinc.org|LP29684-5&date=ge2010-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Diagnostic Report by Patient and Status

Search for DiagnosticReports by combination patient and status.

METHOD GET

[base url]/DiagnosticReport?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}

PARAMS
[base url] - FHIR base url
{Type/} - optional reference type
[id] - Id for the Patient
{system|} - The system for the category, e.g. http://loinc.org
{code} - code for observation in the system, e.g. 24323-8

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.

HeaderTypeRequired/OptionalValue
Authorizationstringrequired'Bearer'

RESPONSES

CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404no Route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&status=completed' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'

Diagnostic Report by Patient and Code and Date

Search for DiagnosticReports by combination patient and code and date.

METHOD GET

[base url]/DiagnosticReport?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

PARAMS
[base url] - FHIR base url
{Type/} - optional reference type
[id] - Id for the Patient
{system|} - The system for the category, e.g. http://loinc.org
{code} - code for observation in the system, e.g. 24323-8
[date] - Filter's date
{gt|lt|ge|le} - Search modifier gr or lt or ge or le. Specification how to search by date in FHIR

HEADERS

The Authorization token SHALL be obtained during Authentication and Authorization process. Authentication and Authorization for further details.

HeaderTypeRequired/OptionalValue
Authorizationstringrequired'Bearer'

RESPONSES

CodeDescriptionComment
200OKThe request was processed successfully
400Bad requestInvalid request parameters or FHIR operation outcome resource returned
401UnauthorizedThis code indicates that the client request has not been completed because it lacks valid authentication credentials for the requested resource
404no Route matched with those valuesThe request was able to communicate with a given server, but the server could not find what was requested
500Internal Server ErrorThe server has encountered a situation it doesn't know how to handle

EXAMPLE:

curl --location --request GET 'https://sandbox.fhir.elationemr.com/fhir/DiagnosticReport?patient=Patient/c5137fa5-3216-b12a-cbbc-a0c6bef361g7&code=http://loinc.org|24323-8&date=ge2019-01-14T00:00:00Z' \
--header 'Authorization: Bearer fe1cd986-1ac7-4c26-b8b3-d632a48408fd'