US Veterans Health Administration FHIR Map Set Implementation Guide
1.6.49 - 250701 United States of America flag

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Resource Profile: Lung Cancer Screening

Official URL: http://va.gov/fhir/StructureDefinition/LungCancerScreening Version: 1.6.49
Draft as of 2025-06-13 Computable Name: LungCancerScreening

This StructureDefinition contains the maps for VistA file TIU DOCUMENT (8925) to us-core-diagnosticreport-note.

See also the FHIR Shorthand.

Use Case Overview

Use Case: Lung Cancer Screening«us-core-diagnosticreport-note»LungCancerScreeningsubjectperformerencounterPatientPractitionerEncounterOutpatient

Usages:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DiagnosticReport C 0..* USCoreDiagnosticReportProfileNoteExchange(5.0.1) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Constraints: us-core-10
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣC 1..1 code registered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required)
.... category:us-core SΣ 0..* CodeableConcept Service category
Binding: US Core Diagnostic Report Category Codes (required)
... code SΣ 1..1 CodeableConcept US Core Report Code
Binding: US Core Non Laboratory Codes (extensible): LOINC codes
... subject SΣ 1..1 Reference(Patient) The subject of the report - usually, but not always, the patient
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Health care event when test ordered
... Slices for effective[x] SΣC 0..1 Diagnostically relevant time (typically the time of the procedure)
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effective[x]:effectiveDateTime SΣC 0..1 dateTime Diagnostically relevant time (typically the time of the procedure)
... issued SΣ 0..1 instant DateTime this version was made
... performer SΣ 0..* Reference(Practitioner) Responsible Diagnostic Service
... result S 0..* Reference(US Core Laboratory Result Observation Profile(5.0.1) | US Core Observation Clinical Test Result Profile | US Core Observation Imaging Result Profile) Observations
... media SΣ 0..* BackboneElement Key images associated with this report
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... link SΣ 1..1 Reference(Media) Reference to the image source
... presentedForm S 0..* Attachment Entire report as issued

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
DiagnosticReport.statusrequiredDiagnosticReportStatus
http://hl7.org/fhir/ValueSet/diagnostic-report-status
From the FHIR Standard
DiagnosticReport.categoryexampleDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
From the FHIR Standard
DiagnosticReport.category:us-corerequiredUSCoreDiagnosticReportCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-category
DiagnosticReport.codeextensibleUSCoreNonLaboratoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-report-and-note-codes

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDiagnosticReportIf 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-4errorDiagnosticReportIf 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-5errorDiagnosticReportIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDiagnosticReportA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-10errorDiagnosticReporteffective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
: (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()

This structure is derived from USCoreDiagnosticReportProfileNoteExchange

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DiagnosticReport 0..* USCoreDiagnosticReportProfileNoteExchange(5.0.1) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... status 1..1 code registered | partial | preliminary | final +
... Slices for category Content/Rules for all slices
.... category:us-core 0..* CodeableConcept Service category
... code 1..1 CodeableConcept US Core Report Code
... encounter 0..1 Reference(Encounter: Outpatient) Health care event when test ordered
... Slices for effective[x] 0..1 dateTime, Period Diagnostically relevant time (typically the time of the procedure)
Slice: Unordered, Open by type:$this
.... effective[x]:effectiveDateTime 0..1 dateTime Diagnostically relevant time (typically the time of the procedure)
... issued 0..1 instant DateTime this version was made
... performer 0..* Reference(Practitioner) Responsible Diagnostic Service
... result 0..* Reference(US Core Laboratory Result Observation Profile(5.0.1) | US Core Observation Clinical Test Result Profile | US Core Observation Imaging Result Profile) Observations
... media 0..* BackboneElement Key images associated with this report
.... link 1..1 Reference(Media) Reference to the image source
... presentedForm 0..* Attachment Entire report as issued

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DiagnosticReport C 0..* USCoreDiagnosticReportProfileNoteExchange(5.0.1) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Constraints: us-core-10
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for report
... basedOn 0..* Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) What was requested
... status ?!SΣC 1..1 code registered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required)
... Slices for category SΣ 1..* CodeableConcept Service category
Slice: Unordered, Open by pattern:$this
Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
.... category:us-core SΣ 0..* CodeableConcept Service category
Binding: US Core Diagnostic Report Category Codes (required)
... code SΣ 1..1 CodeableConcept US Core Report Code
Binding: US Core Non Laboratory Codes (extensible): LOINC codes
... subject SΣ 1..1 Reference(Patient) The subject of the report - usually, but not always, the patient
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Health care event when test ordered
... Slices for effective[x] SΣC 0..1 Diagnostically relevant time (typically the time of the procedure)
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime S
.... effectivePeriod Period
.... effective[x]:effectiveDateTime SΣC 0..1 dateTime S Diagnostically relevant time (typically the time of the procedure)
... issued SΣ 0..1 instant DateTime this version was made
... performer SΣ 0..* Reference(Practitioner) Responsible Diagnostic Service
... resultsInterpreter Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam) Primary result interpreter
... specimen 0..* Reference(Specimen) Specimens this report is based on
... result S 0..* Reference(US Core Laboratory Result Observation Profile(5.0.1) S | US Core Observation Clinical Test Result Profile S | US Core Observation Imaging Result Profile S) Observations
... imagingStudy 0..* Reference(ImagingStudy) Reference to full details of imaging associated with the diagnostic report
... media SΣ 0..* BackboneElement Key images associated with this report
.... 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
.... comment 0..1 string Comment about the image (e.g. explanation)
.... link SΣ 1..1 Reference(Media) Reference to the image source
... conclusion 0..1 string Clinical conclusion (interpretation) of test results
... conclusionCode 0..* CodeableConcept Codes for the clinical conclusion of test results
Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
... presentedForm S 0..* Attachment Entire report as issued

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
DiagnosticReport.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DiagnosticReport.statusrequiredDiagnosticReportStatus
http://hl7.org/fhir/ValueSet/diagnostic-report-status
From the FHIR Standard
DiagnosticReport.categoryexampleDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
From the FHIR Standard
DiagnosticReport.category:us-corerequiredUSCoreDiagnosticReportCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-category
DiagnosticReport.codeextensibleUSCoreNonLaboratoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-report-and-note-codes
DiagnosticReport.conclusionCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
From the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDiagnosticReportIf 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-4errorDiagnosticReportIf 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-5errorDiagnosticReportIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDiagnosticReportA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-10errorDiagnosticReporteffective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
: (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()

This structure is derived from USCoreDiagnosticReportProfileNoteExchange

Summary

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

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

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DiagnosticReport C 0..* USCoreDiagnosticReportProfileNoteExchange(5.0.1) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Constraints: us-core-10
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣC 1..1 code registered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required)
.... category:us-core SΣ 0..* CodeableConcept Service category
Binding: US Core Diagnostic Report Category Codes (required)
... code SΣ 1..1 CodeableConcept US Core Report Code
Binding: US Core Non Laboratory Codes (extensible): LOINC codes
... subject SΣ 1..1 Reference(Patient) The subject of the report - usually, but not always, the patient
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Health care event when test ordered
... Slices for effective[x] SΣC 0..1 Diagnostically relevant time (typically the time of the procedure)
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime
.... effective[x]:effectiveDateTime SΣC 0..1 dateTime Diagnostically relevant time (typically the time of the procedure)
... issued SΣ 0..1 instant DateTime this version was made
... performer SΣ 0..* Reference(Practitioner) Responsible Diagnostic Service
... result S 0..* Reference(US Core Laboratory Result Observation Profile(5.0.1) | US Core Observation Clinical Test Result Profile | US Core Observation Imaging Result Profile) Observations
... media SΣ 0..* BackboneElement Key images associated with this report
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... link SΣ 1..1 Reference(Media) Reference to the image source
... presentedForm S 0..* Attachment Entire report as issued

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
DiagnosticReport.statusrequiredDiagnosticReportStatus
http://hl7.org/fhir/ValueSet/diagnostic-report-status
From the FHIR Standard
DiagnosticReport.categoryexampleDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
From the FHIR Standard
DiagnosticReport.category:us-corerequiredUSCoreDiagnosticReportCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-category
DiagnosticReport.codeextensibleUSCoreNonLaboratoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-report-and-note-codes

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDiagnosticReportIf 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-4errorDiagnosticReportIf 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-5errorDiagnosticReportIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDiagnosticReportA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-10errorDiagnosticReporteffective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
: (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()

Differential View

This structure is derived from USCoreDiagnosticReportProfileNoteExchange

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DiagnosticReport 0..* USCoreDiagnosticReportProfileNoteExchange(5.0.1) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
... status 1..1 code registered | partial | preliminary | final +
... Slices for category Content/Rules for all slices
.... category:us-core 0..* CodeableConcept Service category
... code 1..1 CodeableConcept US Core Report Code
... encounter 0..1 Reference(Encounter: Outpatient) Health care event when test ordered
... Slices for effective[x] 0..1 dateTime, Period Diagnostically relevant time (typically the time of the procedure)
Slice: Unordered, Open by type:$this
.... effective[x]:effectiveDateTime 0..1 dateTime Diagnostically relevant time (typically the time of the procedure)
... issued 0..1 instant DateTime this version was made
... performer 0..* Reference(Practitioner) Responsible Diagnostic Service
... result 0..* Reference(US Core Laboratory Result Observation Profile(5.0.1) | US Core Observation Clinical Test Result Profile | US Core Observation Imaging Result Profile) Observations
... media 0..* BackboneElement Key images associated with this report
.... link 1..1 Reference(Media) Reference to the image source
... presentedForm 0..* Attachment Entire report as issued

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DiagnosticReport C 0..* USCoreDiagnosticReportProfileNoteExchange(5.0.1) A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
Constraints: us-core-10
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for report
... basedOn 0..* Reference(CarePlan | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) What was requested
... status ?!SΣC 1..1 code registered | partial | preliminary | final +
Binding: DiagnosticReportStatus (required)
... Slices for category SΣ 1..* CodeableConcept Service category
Slice: Unordered, Open by pattern:$this
Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
.... category:us-core SΣ 0..* CodeableConcept Service category
Binding: US Core Diagnostic Report Category Codes (required)
... code SΣ 1..1 CodeableConcept US Core Report Code
Binding: US Core Non Laboratory Codes (extensible): LOINC codes
... subject SΣ 1..1 Reference(Patient) The subject of the report - usually, but not always, the patient
... encounter SΣ 0..1 Reference(Encounter: Outpatient) Health care event when test ordered
... Slices for effective[x] SΣC 0..1 Diagnostically relevant time (typically the time of the procedure)
Slice: Unordered, Open by type:$this
.... effectiveDateTime dateTime S
.... effectivePeriod Period
.... effective[x]:effectiveDateTime SΣC 0..1 dateTime S Diagnostically relevant time (typically the time of the procedure)
... issued SΣ 0..1 instant DateTime this version was made
... performer SΣ 0..* Reference(Practitioner) Responsible Diagnostic Service
... resultsInterpreter Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam) Primary result interpreter
... specimen 0..* Reference(Specimen) Specimens this report is based on
... result S 0..* Reference(US Core Laboratory Result Observation Profile(5.0.1) S | US Core Observation Clinical Test Result Profile S | US Core Observation Imaging Result Profile S) Observations
... imagingStudy 0..* Reference(ImagingStudy) Reference to full details of imaging associated with the diagnostic report
... media SΣ 0..* BackboneElement Key images associated with this report
.... 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
.... comment 0..1 string Comment about the image (e.g. explanation)
.... link SΣ 1..1 Reference(Media) Reference to the image source
... conclusion 0..1 string Clinical conclusion (interpretation) of test results
... conclusionCode 0..* CodeableConcept Codes for the clinical conclusion of test results
Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
... presentedForm S 0..* Attachment Entire report as issued

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
DiagnosticReport.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DiagnosticReport.statusrequiredDiagnosticReportStatus
http://hl7.org/fhir/ValueSet/diagnostic-report-status
From the FHIR Standard
DiagnosticReport.categoryexampleDiagnosticServiceSectionCodes
http://hl7.org/fhir/ValueSet/diagnostic-service-sections
From the FHIR Standard
DiagnosticReport.category:us-corerequiredUSCoreDiagnosticReportCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-category
DiagnosticReport.codeextensibleUSCoreNonLaboratoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-report-and-note-codes
DiagnosticReport.conclusionCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
From the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDiagnosticReportIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDiagnosticReportIf 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-4errorDiagnosticReportIf 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-5errorDiagnosticReportIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDiagnosticReportA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
us-core-10errorDiagnosticReporteffective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended'
: (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()

This structure is derived from USCoreDiagnosticReportProfileNoteExchange

Summary

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

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

 

Other representations of profile: CSV, Excel, Schematron