{

"resourceType": "DiagnosticReport",
"id": "micro",
"text": {
  "status": "generated",
  "div": "<div><p><b>Generated Narrative with Details</b></p><p><b>id</b>: micro</p><p><b>contained</b>: , , , , , , , , , , , , , , , , , , , , , , , , , </p><p><b>identifier</b>: 290741144</p><p><b>status</b>: final</p><p><b>category</b>: Microbiology <span>(Details : {http://hl7.org/fhir/v2/0074 code 'MB' = 'Microbiology)</span></p><p><b>code</b>: Culture, MRSA <span>(Details : {LOINC code '632-0' = 'Bacteria identified in Wound by Aerobe culture)</span></p><p><b>subject</b>: <a>Patient/example</a></p><p><b>effective</b>: 07/08/2009 7:00:00 PM</p><p><b>issued</b>: 10/08/2009 8:25:44 AM</p><p><b>performer</b>: Todd Ashby</p><p><b>request</b>: id: req; Patient/example; 255337816</p><p><b>result</b>: id: org1; status: final; Staphylococcus aureus Panel <span>(Details : {http://acme.org/lab/codes/organisms code 'Staaur' = '??)</span>; Patient/example</p></div>"
},
"contained": [
  {
    "resourceType": "Observation",
    "id": "obx1-4",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "ORGANISM"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueCodeableConcept": {
      "coding": [
        {
          "fhir_comments": [
            "     CE     "
          ],
          "system": "http://acme.org/lab/codes/organisms",
          "code": "Staaur"
        }
      ],
      "text": "Staphylococcus aureus"
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx1-5",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "CULTPOSNEG"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueCodeableConcept": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/flags",
          "code": "POS"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-1",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60504",
          "display": "Ampicillin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "R"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-2",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60512",
          "display": "Cefazolin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 2,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-4",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60516",
          "display": "Cefoxitin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 4,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-6",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60527",
          "display": "Clindamycin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5,
      "comparator": ">="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-8",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "61203",
          "display": "Daptomycin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 1,
      "comparator": ">="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-10",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60532",
          "display": "Doxycycline"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-12",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60533",
          "display": "Erythromycin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 8,
      "comparator": ">="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "R"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-14",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60536",
          "display": "Gentamicin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 2,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-16",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "61007",
          "display": "Levofloxacin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-18",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60699",
          "display": "Linezolid"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 4
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-20",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "61204",
          "display": "Moxifloxacin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-22",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60551",
          "display": "Oxacillin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-24",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60552",
          "display": "Penicillin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 2,
      "comparator": ">="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "R"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-26",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60697",
          "display": "Quinupristin/Dalfopristin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-28",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60555",
          "display": "Rifampin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-30",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60558",
          "display": "Tetracycline"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.5,
      "comparator": "<="
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-32",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60561",
          "display": "Trimethoprim/Sulfamethoxazole"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 0.0526,
      "comparator": "<=",
      "_comparator": {
        "fhir_comments": [
          "     not sure what to do with <=1/19     "
        ]
      }
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obx2-34",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60563",
          "display": "Vancomycin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueQuantity": {
      "value": 1
    },
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "nte-1",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "2099930",
          "display": "D-Test"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "valueString": "D-Test:  Negative - This isolate does not demonstrate inducible clindamycin resistance in vitro."
  },
  {
    "resourceType": "Observation",
    "id": "obx3-1",
    "status": "final",
    "code": {
      "coding": [
        {
          "system": "http://acme.org/lab/codes/tests",
          "code": "60036",
          "display": "Oxacillin"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "interpretation": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/v2/0078",
          "code": "S"
        }
      ]
    }
  },
  {
    "resourceType": "Observation",
    "id": "obr-2",
    "status": "final",
    "code": {
      "fhir_comments": [
        "     OBR 2     "
      ],
      "coding": [
        {
          "system": "http://acme.org/lab/codes/panels",
          "code": "60790",
          "display": "Susceptibility - Automated broth dilution (Billed)"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "performer": [
      {
        "fhir_comments": [
          "     of course, in practive, this would be a real reference     "
        ],
        "display": "Todd Ashby"
      }
    ],
    "related": [
      {
        "fhir_comments": [
          "     now, references to the OBXs. for reader convenience, we take keep the OBX identification, though this is not required in practice. Note that many of the oBX segments are pairs that get collapsed     "
        ],
        "type": "has-member",
        "target": {
          "reference": "#obx2-1"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-2"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-4"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-6"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-8"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-10"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-12"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-14"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-16"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-18"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-20"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-22"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-24"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-26"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-28"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-30"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-32"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx2-34"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#nte-1"
        }
      }
    ]
  },
  {
    "resourceType": "Observation",
    "id": "obr-3",
    "status": "final",
    "code": {
      "fhir_comments": [
        "     OBR 3     "
      ],
      "coding": [
        {
          "system": "http://acme.org/lab/codes/panels",
          "code": "60418",
          "display": "Susceptibility - Disk diffusion (Billed)"
        }
      ]
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "related": [
      {
        "type": "has-member",
        "target": {
          "reference": "#obx3-1"
        }
      }
    ]
  },
  {
    "resourceType": "Observation",
    "id": "org1",
    "status": "final",
    "code": {
      "fhir_comments": [
        "     OBR 1     "
      ],
      "coding": [
        {
          "system": "http://acme.org/lab/codes/organisms",
          "code": "Staaur"
        }
      ],
      "text": "Staphylococcus aureus Panel"
    },
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "related": [
      {
        "type": "has-member",
        "target": {
          "reference": "#obx1-4"
        }
      },
      {
        "type": "has-member",
        "target": {
          "reference": "#obx1-5"
        }
      },
      {
        "fhir_comments": [
          "     group - automated broth dilution. This is unusual - usually, there's just one level of group, and this group would be skipped     "
        ],
        "type": "has-member",
        "target": {
          "reference": "#obr-2"
        }
      },
      {
        "fhir_comments": [
          "     group - Disk diffusion     "
        ],
        "type": "has-member",
        "target": {
          "reference": "#obr-3"
        }
      }
    ]
  },
  {
    "resourceType": "DiagnosticOrder",
    "id": "req",
    "subject": {
      "fhir_comments": [
        "     patient chosen at random     "
      ],
      "reference": "Patient/example"
    },
    "identifier": [
      {
        "value": "255337816"
      }
    ]
  }
],
"identifier": [
  {
    "system": "http://hnam.org/identifiers/orders",
    "value": "290741144",
    "_value": {
      "fhir_comments": [
        "     seems like a likely choice     "
      ]
    }
  }
],
"status": "final",
"category": {
  "coding": [
    {
      "system": "http://hl7.org/fhir/v2/0074",
      "code": "MB"
    }
  ]
},
"code": {
  "fhir_comments": [
    "     start of the main resource     "
  ],
  "coding": [
    {
      "system": "http://loinc.org",
      "code": "632-0"
    }
  ],
  "text": "Culture, MRSA"
},
"subject": {
  "fhir_comments": [
    "     patient chosen at random     "
  ],
  "reference": "Patient/example"
},
"effectiveDateTime": "2009-08-07T19:00:00+10:00",
"issued": "2009-08-10T08:25:44+10:00",
"performer": {
  "fhir_comments": [
    "     of course, in practive, this would be a real reference     "
  ],
  "display": "Todd Ashby"
},
"request": [
  {
    "reference": "#req"
  }
],
"result": [
  {
    "reference": "#org1"
  }
]

}