US Veterans Health Administration FHIR Map Set Implementation Guide
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Resource Profile: ObservationImagingResultRadNuc - Mappings

Draft as of 2025-06-13

Mappings for the ObservationImagingResultRadNuc resource profile.

Scroll down for the Raw FHIR, CDW & SDA mappings (if any).

Note that the CDW, SDA and VPR XML mappings are derived from a look-up based on the VistA source.

Mapping Sources

Use Case: Observation Imaging Result: Rad/Nuc (Source)Use Case: Observation Imaging Result: Rad/Nuc (Source)RAD/NUC MED REPORTS (74).001IEN2PATIENT NAME3EXAM DATE/TIME5REPORT STATUS7VERIFIED DATE9VERIFYING PHYSICIAN300IMPRESSION TEXTREGISTERED EXAMS (70.02)50EXAMINATIONS

Cross Mappings

FHIR Path VistA CDW SDA VPR
Observation.identifier.value 74-.001      
Observation.partOf 70.02-50      
Observation.status 74-5 SStaff.RadiologyNuclearMedicineReport.ReportStatus Documents.DocumentCompletionStatus  
Observation.subject 74-2 SStaff.RadiologyNuclearMedicineReport.PatientIEN Documents.DocumentName  
Observation.effectiveDateTime 74-3 SStaff.RadiologyNuclearMedicineReport.ExamDateTime    
Observation.issued 74-7 SStaff.RadiologyNuclearMedicineReport.VerifiedDateTime Documents.AuthorizationTime
Documents.ToTime
 
Observation.performer 74-9 SStaff.RadiologyNuclearMedicineReport.VerifyingPhysicianStaffIEN Documents.Extension[DocumentExtension].CareProviders  
Observation.valueString 74-300      

Raw Mappings

key status direction source mapApproach mapCase FHIR Path subPath mapValue mapParameter mapComment FHIR URL | Ver
1619 in process V2F RAD/NUC MED REPORTS - IEN (74-.001) source value Observation.identifier .value .system = http://va.gov/identifiers/$Sta3n/74 http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1620 in process V2F REGISTERED EXAMS - EXAMINATIONS (70.02-50) reference Observation.partOf /ProcedureSurgeryProcedure See use case Procedure: Radiology for US Core FHIR Procedure mapped elements http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1623 in process V2F RAD/NUC MED REPORTS - REPORT STATUS (74-5) terminologyMaps Observation.status VF_ImageStatusRadNuc http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1633 in process V2F RAD/NUC MED REPORTS - PATIENT NAME (74-2) reference Observation.subject /Patient http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1636 in process V2F RAD/NUC MED REPORTS - EXAM DATE/TIME (74-3) source value Observation.effectiveDateTime http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1639 in process V2F RAD/NUC MED REPORTS - VERIFIED DATE (74-7) source value Observation.issued http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1642 in process V2F RAD/NUC MED REPORTS - VERIFYING PHYSICIAN (74-9) source value Observation.performer Practitioner http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1647 in process V2F RAD/NUC MED REPORTS - IMPRESSION TEXT (74-300) source value Observation.valueString http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
2196 in process V2F target not supported Observation.code auto added because of must-support http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging
1624 in process V2F fixed value Observation.category[imaging] http://terminology.hl7.org/CodeSystem/observation-category#imaging http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1
1796 for review V2F target not supported Observation.dataAbsentReason Always has data http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging | 5.0.1

Mappings for Veterans Health Information Systems Technology and Architecture (VistA) ()

ObservationImagingResultRadNuc
Observation
   identifier
      system1619-1: fixed value = http://va.gov/identifiers/$Sta3n/74

generated from mapParameter line 1

      value1619: source value based on RAD/NUC MED REPORTS - IEN (74-.001)
   partOf1620: reference based on REGISTERED EXAMS - EXAMINATIONS (70.02-50)

See use case Procedure: Radiology for US Core FHIR Procedure mapped elements

   status1623: terminologyMaps using VF_ImageStatusRadNuc on RAD/NUC MED REPORTS - REPORT STATUS (74-5)
   category (imaging)1624: fixed value = http://terminology.hl7.org/CodeSystem/observation-category#imaging
   code2196: target not supported

auto added because of must-support

   subject1633: reference based on RAD/NUC MED REPORTS - PATIENT NAME (74-2)
   effective[x] (effectiveDateTime)1636: source value based on RAD/NUC MED REPORTS - EXAM DATE/TIME (74-3)
   issued1639: source value based on RAD/NUC MED REPORTS - VERIFIED DATE (74-7)
   performer1642: source value based on RAD/NUC MED REPORTS - VERIFYING PHYSICIAN (74-9)
   value[x] (valueString)1647: source value based on RAD/NUC MED REPORTS - IMPRESSION TEXT (74-300)
   dataAbsentReason1796: target not supported

Always has data

Mappings for Clinical Data Warehouse (CDW) ()

ObservationImagingResultRadNuc
Observation
   statusSStaff.RadiologyNuclearMedicineReport.ReportStatus
   subjectSStaff.RadiologyNuclearMedicineReport.PatientIEN
   effective[x] (effectiveDateTime)SStaff.RadiologyNuclearMedicineReport.ExamDateTime
   issuedSStaff.RadiologyNuclearMedicineReport.VerifiedDateTime
   performerSStaff.RadiologyNuclearMedicineReport.VerifyingPhysicianStaffIEN

Mappings for Summary Document Architecure (SDA) ()

ObservationImagingResultRadNuc
Observation
   statusDocuments.DocumentCompletionStatus
   subjectDocuments.DocumentName
   issuedDocuments.AuthorizationTime Documents.ToTime
   performerDocuments.Extension[DocumentExtension].CareProviders

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

ObservationImagingResultRadNuc
ObservationEvent
   identifierEvent.identifier
   basedOnEvent.basedOn
   partOfEvent.partOf
   statusEvent.status
   codeEvent.code
   subjectEvent.subject
   encounterEvent.context
   effective[x]Event.occurrence[x]
   effective[x] (effectiveDateTime)Event.occurrence[x]
   performerEvent.performer.actor

Mappings for SNOMED CT Concept Domain Binding (http://snomed.info/conceptdomain)

ObservationImagingResultRadNuc
Observation< 363787002 |Observable entity|
   status< 445584004 |Report by finality status|
   code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
   value[x]< 441742003 |Evaluation finding|
   value[x] (valueString)< 441742003 |Evaluation finding|
   interpretation< 260245000 |Findings values|
   bodySite< 123037004 |Body structure|
   specimen< 123038009 |Specimen|
   device< 49062001 |Device|
   referenceRange
      type< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
      appliesTo< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
   component
      code< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
      value[x]363714003 |Interprets| < 441742003 |Evaluation finding|
      interpretation< 260245000 |Findings values|

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

ObservationImagingResultRadNuc
ObservationOBX
   identifierOBX.21 For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
      useN/A
      typeCX.5
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   basedOnORC
   partOfVaries by domain
   statusOBX-11
   codeOBX-3
   subjectPID-3
   focusOBX-3
   encounterPV1
   effective[x]OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   effective[x] (effectiveDateTime)OBX-14, and/or OBX-19 after v2.4 (depends on who observation made)
   issuedOBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)
   performerOBX.15 / (Practitioner) OBX-16, PRT-5:PRT-4='RO' / (Device) OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization) OBX-23, PRT-8:PRT-4='PO'
   value[x]OBX.2, OBX.5, OBX.6
   value[x] (valueString)OBX.2, OBX.5, OBX.6
   dataAbsentReasonN/A
   interpretationOBX-8
   noteNTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)
   bodySiteOBX-20
   methodOBX-17
   specimenSPM segment
   deviceOBX-17 / PRT -10
   referenceRangeOBX.7
      lowOBX-7
      highOBX-7
      typeOBX-10
      appliesToOBX-10
      textOBX-7
   hasMemberRelationships established by OBX-4 usage
   derivedFromRelationships established by OBX-4 usage
   componentcontainment by OBX-4?
      codeOBX-3
      value[x]OBX.2, OBX.5, OBX.6
      dataAbsentReasonN/A
      interpretationOBX-8
      referenceRangeOBX.7

Mappings for RIM Mapping (http://hl7.org/v3)

ObservationImagingResultRadNuc
ObservationEntity. Role, or Act, Observation[classCode=OBS, moodCode=EVN]
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifierid
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   basedOn.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
   partOf.outboundRelationship[typeCode=FLFS].target
   statusstatus Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
   category.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   category (imaging).outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
   codecode
   subjectparticipation[typeCode=RTGT]
   focusparticipation[typeCode=SBJ]
   encounterinboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
   effective[x]effectiveTime
   effective[x] (effectiveDateTime)effectiveTime
   issuedparticipation[typeCode=AUT].time
   performerparticipation[typeCode=PRF]
   value[x]value
   value[x] (valueString)value
   dataAbsentReasonvalue.nullFlavor
   interpretationinterpretationCode
   notesubjectOf.observationEvent[code="annotation"].value
   bodySitetargetSiteCode
   methodmethodCode
   specimenparticipation[typeCode=SPC].specimen
   deviceparticipation[typeCode=DEV]
   referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
      idn/a
      extensionn/a
      modifierExtensionN/A
      lowvalue:IVL_PQ.low
      highvalue:IVL_PQ.high
      typeinterpretationCode
      appliesTointerpretationCode
      ageoutboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
      textvalue:ST
   hasMemberoutBoundRelationship
   derivedFrom.targetObservation
   componentoutBoundRelationship[typeCode=COMP]
      idn/a
      extensionn/a
      modifierExtensionN/A
      codecode
      value[x]value
      dataAbsentReasonvalue.nullFlavor
      interpretationinterpretationCode
      referenceRangeoutboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

ObservationImagingResultRadNuc
Observation
   identifierFiveWs.identifier
   statusFiveWs.status
   categoryFiveWs.class
   category (imaging)FiveWs.class
   codeFiveWs.what[x]
   subjectFiveWs.subject[x], FiveWs.subject
   focusFiveWs.subject[x], FiveWs.subject
   encounterFiveWs.context
   effective[x]FiveWs.done[x]
   effective[x] (effectiveDateTime)FiveWs.done[x]
   issuedFiveWs.recorded
   performerFiveWs.actor
   component
      codeFiveWs.what[x]

Mappings for SNOMED CT Attribute Binding (http://snomed.org/attributebinding)

ObservationImagingResultRadNuc
Observation
   code116680003 |Is a|
   value[x]363714003 |Interprets|
   value[x] (valueString)363714003 |Interprets|
   interpretation363713009 |Has interpretation|
   bodySite718497002 |Inherent location|
   specimen704319004 |Inherent in|
   device424226004 |Using device|
   component
      value[x]363714003 |Interprets|
      interpretation363713009 |Has interpretation|