電子病歷交換單張實作指引(EMR-IG)
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: 醫療影像及報告 DiagnosticReport example - JSON Representation

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{
  "resourceType" : "DiagnosticReport",
  "id" : "ImageDiagnosticReport",
  "meta" : {
    "profile" : [
      🔗 "https://twcore.mohw.gov.tw/ig/emr/StructureDefinition/DiagnosticReport-Image"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: DiagnosticReport ImageDiagnosticReport</b></p><a name=\"ImageDiagnosticReport\"> </a><a name=\"hcImageDiagnosticReport\"> </a><a name=\"ImageDiagnosticReport-en-US\"> </a><h2><span title=\"Codes:{https://twcore.mohw.gov.tw/ig/emr/CodeSystem/ICD-10-procedurecode BW24ZZZ}\">Computerized Tomography (CT Scan) of Chest and Abdomen</span> (<span title=\"Codes:{http://loinc.org LP29684-5}\">Radiology</span>) </h2><table class=\"grid\"><tr><td>Subject</td><td>胖吉 綠 (official) Male, DoB: 1987-01-01 ( National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code\u00a0(use:\u00a0official,\u00a0))</td></tr><tr><td>When For</td><td>2023-08-01 17:00:14-0500</td></tr><tr><td>Reported</td><td>2022-08-30 14:35:32+0000</td></tr><tr><td>Performer</td><td> <a href=\"Practitioner-TWCorePractitioner.html\">Practitioner 大吉 連 (official)</a></td></tr><tr><td>Identifier</td><td> <code>https://www.vghtpe.gov.tw/</code>/123456</td></tr></table><p><b>Report Details</b></p><table class=\"grid\"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td></tr><tr><td><a href=\"Observation-ObservationImagingResult.html\"><span title=\"Codes:{https://twcore.mohw.gov.tw/ig/emr/CodeSystem/ICD-10-procedurecode BW24ZZZ}\">Computerized Tomography (CT Scan) of Chest and Abdomen</span></a></td><td>LUNGS AND PLEURA: Clear lungs. Normal pulmonary vascularity. No pleural effusion. No pneumothorax.</td><td>Final</td></tr></table><p>No acute abnormality</p><p><b>Coded Conclusions:</b></p><ul><li><span title=\"Codes:{http://snomed.info/sct 3368006}\">Dull chest pain</span></li></ul></div>"
  },
  "identifier" : [
    {
      "system" : "https://www.vghtpe.gov.tw/",
      "value" : "123456"
    }
  ],
  "status" : "final",
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "LP29684-5",
          "display" : "Radiology"
        }
      ]
    }
  ],
  "code" : {
    "coding" : [
      {
        "system" : "https://twcore.mohw.gov.tw/ig/emr/CodeSystem/ICD-10-procedurecode",
        "code" : "BW24ZZZ",
        "display" : "Computerized Tomography (CT Scan) of Chest and Abdomen"
      }
    ]
  },
  "subject" : {
    🔗 "reference" : "Patient/TWCorePatient"
  },
  "encounter" : {
    🔗 "reference" : "Encounter/TWCoreEncounter"
  },
  "effectiveDateTime" : "2023-08-01T17:00:14-05:00",
  "issued" : "2022-08-30T14:35:32.631Z",
  "performer" : [
    {
      🔗 "reference" : "Practitioner/TWCorePractitioner"
    }
  ],
  "resultsInterpreter" : [
    {
      🔗 "reference" : "Practitioner/TWCorePractitioner"
    }
  ],
  "result" : [
    {
      🔗 "reference" : "Observation/ObservationImagingResult"
    }
  ],
  "imagingStudy" : [
    {
      🔗 "reference" : "ImagingStudy/ImagingStudyBase"
    }
  ],
  "conclusion" : "No acute abnormality",
  "conclusionCode" : [
    {
      "coding" : [
        {
          "system" : "http://snomed.info/sct",
          "code" : "3368006",
          "display" : "Dull chest pain"
        }
      ]
    }
  ]
}