Stream: implementers
Topic: Diagnostic report for lab results
Pranitha Sruthi (May 05 2017 at 11:53):
Hi all, we are using the resource diagnostic report to record the lab results. Which terms in the structure definition of the resource exactly define the lab panel names and their respective components?
Grahame Grieve (May 06 2017 at 05:04):
DiagnosticReport.code and Observation.code
Pranitha Sruthi (May 08 2017 at 05:47):
Ok thank you so much
Natalya Pogrebetsky (May 15 2017 at 17:27):
Hello everyone,
Any idea how we can group in one order (diagnostic report) multiple test requests with associated multiple test results (observation)? For example Complete Blood Count test request which may contain 10 test results?
Eric Haas (May 15 2017 at 17:44):
each component for the CBC is an Observation referenced through .result . See http://build.fhir.org/diagnosticreport-example-lipids.html
Natalya Pogrebetsky (May 15 2017 at 18:30):
Eric, thank you for your response. How you dial with the scenario where you have test requests "panel"? Our lab reports can contain multiple test requests with associated multiple test results. For example: Electrolytes with 5 results associated and CBC with 10 results associated and it all should appear in 1 report. I have difficulty to group observations and link it to test request and then group test requests and link them back to the order.
Eric Haas (May 15 2017 at 20:09):
I refer to this as a panel of panels. When I last spoke to the EHR vendors they were leaning towards reporting each panel as a separate DiagnosticReport. The orders can be linked by a single requisition number ( see the ProcedureRequest resource ).
Bob Milius (Sep 20 2017 at 19:17):
I have a related question. I've been planning on using DiagnosticReport to report HLA typing, and point to separate observations for each gene that is typed. One report may contain a panel of HLA-A, HLA-B, HLA-C, and another report may contain a subset of these and several others. The question is how to handle the codes required in DiagnosticReport and the individual Observations. For example I can use a different LOINC code for each Observation for each gene (e.g., 57290-9 HLA-A [Type] by High resolution) but what would I put in for the code for the DiagnosticReport? It doesn't look like I can enter multiple codes, but I can't find a generic one for "HLA typing." Or is it okay just to enter a display value without a code? How do I enter a post-coordinated panel of codes in DiagnosticReport?
Eric Haas (Sep 20 2017 at 19:48):
DR.code is a CodeableConcept datatype and it supports text only.
Other Options:
- temporary local codes and submit for new loinc panel codes
- local codes only which could include post coordination too
how to post coordinate a particular code system is not defined in FHIR. The Coding elements are the same whether pre or post coordinated codes are used.
Bob Milius (Sep 20 2017 at 19:56):
I think our examples will begin with using text only, and we will put in a loinc code request for a general diagnostic code for HLA typing panel with undefined content.
Mattias Flodin (Mar 12 2018 at 11:41):
I think I've run into the exact same problem. I have a set of observations from a lab that I want to map into a DiagnosticReport. I can map the individual observation types, but what do I do about DiagnosticReport.code? There may be a theme to the observations but it is not explicitly specified in the source data. All I know is that the measurements have been requested in a work order and that they come from a chemical laboratory. Is there a generic "Chemical laboratory results" LOINC code now?
Eric Haas (Mar 12 2018 at 19:01):
Since the type is CodeableConcept, you can use a plain text representation of the concept. (or submit for new LOINC if there is not one if after your search you can not find an appropriate LOINC)
Mattias Flodin (Mar 13 2018 at 07:41):
Alright, thank you Eric.
Last updated: Apr 12 2022 at 19:14 UTC
