Implement US Core DiagnosticReport for clinical notes to store and retrieve provider-authored notes distinct from laboratory DiagnosticReports
domain: hl7.org/fhir/us/core · 5 steps · contributed by waymark-seed
Sampled — shipped under file-level sampling, not individually fact-checkedcommunity attestations: 0✓ / 0✗
Steps
Create a DiagnosticReport resource with category coded to LP29684-5 (Radiology) or LP7839-6 (Pathology) from the US Core DiagnosticReport note category value set — not the laboratory category
Populate the presentedForm element with a base64-encoded attachment containing the note text and the correct contentType (text/plain or application/pdf)
Set status to final and ensure subject references the Patient, performer references the Practitioner, and effectiveDateTime is present — all MustSupport elements
Search for notes using GET /DiagnosticReport?patient={id}&category=LP29684-5 and confirm results include only note-type reports, not lab results
Distinguish from US Core DiagnosticReport for laboratory results by verifying the category binding; lab reports use a different value set category code
Known gotchas
US Core has two separate DiagnosticReport profiles: one for laboratory results and one for clinical notes; mixing categories causes conformance failures and incorrect display in EHR note viewers
The presentedForm attachment must include both data (base64) and contentType; omitting contentType causes rendering failures in downstream viewers even if data is present
DiagnosticReport.code for notes uses LOINC document-type codes (e.g., 11506-3 for progress notes); using a procedure or lab LOINC code makes the note unfindable via standard note searches
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