{
"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" } ]
}