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type: exampleresource: DiagnosticReportexample: diagnosticreport-example-lipid-panel

DiagnosticReport Example: diagnosticreport-example-lipid-panel

Narrative

Lipid Report for Wile. E. COYOTE (MRN: 23453) issued 3-Mar 2009 14:26

Test Units Value Reference Range Cholesterol mmol/L 6.3 <4.5 Triglyceride mmol/L 1.3 <2.0 HDL Cholesterol mmol/L 1.3 >1.5 LDL Chol. (calc) mmol/L 4.2 <3.0

Acme Laboratory, Inc signed: Dr Pete Pathologist

Example XML

<?xml version="1.0" encoding="UTF-8"?>
<DiagnosticReport xmlns="http://hl7.org/fhir">
  <id value="lipid-panel-example"/>
  <meta>
    <profile value="http://hl7.org/fhir/StructureDefinition/lipids-diagnostic-report"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <h3>Lipid Report for Wile. E. COYOTE (MRN: 23453) issued 3-Mar 2009 14:26</h3>
      <pre>
Test                  Units       Value       Reference Range
Cholesterol           mmol/L      6.3         &lt;4.5
Triglyceride          mmol/L      1.3         &lt;2.0
HDL Cholesterol       mmol/L      1.3         &gt;1.5
LDL Chol. (calc)      mmol/L      4.2         &lt;3.0
      </pre>
      <p>Acme Laboratory, Inc signed: Dr Pete Pathologist</p>
    </div>
  </text>

  <contained>
    <!-- Cholesterol observation with profile reference -->
    <Observation>
      <id value="cholesterol"/>
      <status value="final"/>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
          <code value="laboratory"/>
          <display value="Laboratory"/>
        </coding>
      </category>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="35200-5"/>
          <display value="Cholesterol [Mass or Moles/volume] in Serum or Plasma"/>
        </coding>
      </code>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <effectiveDateTime value="2011-03-04T08:30:00+11:00"/>
      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
      </performer>
      <valueQuantity>
        <value value="6.3"/>
        <unit value="mmol/L"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="mmol/L"/>
      </valueQuantity>
      <interpretation>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
          <code value="H"/>
          <display value="High"/>
        </coding>
      </interpretation>
      <note>
        <text value="Patient reported having eaten fatty foods the day before."/>
      </note>
      <referenceRange>
        <high>
          <value value="4.5"/>
           <unit value="mmol/l"/>
         <system value="http://unitsofmeasure.org"/>
          <code value="mmol/L"/>
        </high>
        <text value="High Risk at or above 4.5 mmol/L (Per Australian NHF Recommendations)"/>
      </referenceRange>
    </Observation>
    </contained>
    <contained>

    <!-- Triglyceride observation -->
    <Observation>
      <id value="triglyceride"/>
      <status value="final"/>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
          <code value="laboratory"/>
          <display value="Laboratory"/>
        </coding>
      </category>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="35217-9"/>
          <display value="Triglyceride [Mass or Moles/volume] in Serum or Plasma"/>
        </coding>
        <text value="Triglyceride"/>
      </code>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <effectiveDateTime value="2011-03-04T08:30:00+11:00"/>
      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
      </performer>
      <valueQuantity>
        <value value="1.3"/>
        <unit value="mmol/L"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="mmol/L"/>
      </valueQuantity>
      <interpretation>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
          <code value="N"/>
          <display value="Normal"/>
        </coding>
      </interpretation>
      <referenceRange>
        <high>
          <value value="2.0"/>
          <unit value="mmol/L"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="mmol/L"/>
        </high>
        <text value="Normal range: less than 2.0 mmol/L"/>
      </referenceRange>
    </Observation>
    </contained>

    <!-- HDL Cholesterol observation -->
    <contained>
    <Observation>
      <id value="hdlcholesterol"/>
      <status value="final"/>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
          <code value="laboratory"/>
          <display value="Laboratory"/>
        </coding>
      </category>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="2085-9"/>
          <display value="Cholesterol in HDL [Mass/volume] in Serum or Plasma"/>
        </coding>
        <text value="Cholesterol in HDL"/>
      </code>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <effectiveDateTime value="2011-03-04T08:30:00+11:00"/>
      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
      </performer>
      <valueQuantity>
        <value value="1.3"/>
        <unit value="mmol/L"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="mmol/L"/>
      </valueQuantity>
      <interpretation>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
          <code value="L"/>
          <display value="Low"/>
        </coding>
      </interpretation>
      <referenceRange>
        <low>
          <value value="1.5"/>
          <unit value="mmol/L"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="mmol/L"/>
        </low>
        <text value="Desirable: greater than 1.5 mmol/L"/>
      </referenceRange>
    </Observation>
    </contained>
    <contained>
    <!-- LDL Cholesterol observation -->
    <Observation>
      <id value="ldlcholesterol"/>
      <status value="final"/>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
          <code value="laboratory"/>
          <display value="Laboratory"/>
        </coding>
      </category>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="13457-7"/>
          <display value="Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation"/>
        </coding>
        <text value="LDL Chol. (Calc)"/>
      </code>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <effectiveDateTime value="2011-03-04T08:30:00+11:00"/>
      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
      </performer>
      <valueQuantity>
        <value value="4.6"/>
        <unit value="mmol/L"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="mmol/L"/>
      </valueQuantity>
      <interpretation>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
          <code value="H"/>
          <display value="High"/>
        </coding>
      </interpretation>
      <referenceRange>
        <high>
          <value value="3.0"/>
          <unit value="mmol/L"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="mmol/L"/>
        </high>
        <text value="Optimal: less than 3.0 mmol/L"/>
      </referenceRange>
    </Observation>
  </contained>
  <identifier>
    <system value="http://acme.com/lab/reports"/>
    <value value="5234342"/>
  </identifier>
  <status value="final"/>
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
      <code value="HM"/>
      <display value="Hematology"/>
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57698-3"/>
      <display value="Lipid panel with direct LDL - Serum or Plasma"/>
    </coding>
    <text value="Lipid Panel"/>
  </code>
  <subject>
    <reference value="Patient/pat2"/>
    <display value="Wile E. Coyote"/>
  </subject>
  <effectiveDateTime value="2011-03-04T08:30:00+11:00"/>
  <issued value="2013-01-27T11:45:33+11:00"/>
  <performer>
    <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
    <display value="Acme Laboratory, Inc"/>
  </performer>

  <!-- References to contained observations -->
  <result>
    <reference value="#cholesterol"/>
  </result>
  <result>
    <reference value="#triglyceride"/>
  </result>
  <result>
    <reference value="#hdlcholesterol"/>
  </result>
  <result>
    <reference value="#ldlcholesterol"/>
  </result>

  <!-- Contained resources -->

  <conclusion value="Patient has elevated total cholesterol and LDL levels with borderline low HDL. Recommend lifestyle modifications and consideration of lipid-lowering therapy."/>
</DiagnosticReport>