MII IG Kerndatensatz-Modul Bildgebung
2027.0.0-ballot.1 - Germany

MII IG Kerndatensatz-Modul Bildgebung - Downloaded Version 2027.0.0-ballot.1 See the Directory of published versions

: MII Example Bildgebung Radiologische Beobachtung

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<Observation xmlns="http://hl7.org/fhir">
  <id value="mii-exa-bildgebung-radiologische-beobachtung"/>
  <meta>
    <profile
             value="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-pr-bildgebung-radiologische-beobachtung"/>
  </meta>
  <language value="de"/>
  <text>
    <status value="extensions"/>
    <div xml:lang="de" lang="de"><hr/><p><b>German</b></p><hr/><p class="res-header-id"><b>Generated Narrative: Observation mii-exa-bildgebung-radiologische-beobachtung</b></p><a name="de-mii-exa-bildgebung-radiologische-beobachtung"> </a><a name="de-hcmii-exa-bildgebung-radiologische-beobachtung"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-mii-pr-bildgebung-radiologische-beobachtung.html">MII PR Bildgebung Radiologische Beobachtung</a></p></div><p><b>MII EX Bildgebung Bildnummer</b>: example-series-uid</p><p><b>MII EX Bildgebung SOPInstanz</b>: example-sop-instance-uid</p><p><b>partOf</b>: <a href="Procedure-mii-exa-bildgebung-radiologische-befundungsprozedur.html">Procedure Consultation and report by radiologist (procedure)</a></p><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category imaging}">Imaging</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 32422-8}">Physical findings of Breast</span></p><p><b>subject</b>: <a href="Patient-mii-exa-bildgebung-radiologischer-patient.html">Erika Beispielpatientin  Female, DoB: 1970-01-01</a></p><p><b>issued</b>: 2024-07-19 12:03:30+0200</p><p><b>value</b>: microcalcifications in the upper outer quadrant in the left breast</p><p><b>bodySite</b>: <span title="Codes:{http://snomed.info/sct 76752008}">Breast structure (body structure)</span></p><p><b>hasMember</b>: <a href="https://simplifier.net/resolve?scope=de.basisprofil.r4@1.6.0&amp;canonical=http://fhir.org/packages/de.basisprofil.r4/Observation/ObsExample">Observation/ObsExample</a></p><p><b>derivedFrom</b>: <a href="ImagingStudy-mii-exa-bildgebung-bildgebungsstudie-ct.html">ImagingStudy: extension = Verdacht auf Karzinom; status = available; modality = Computed Tomography (DICOM#CT); numberOfSeries = 2; numberOfInstances = 390; description = whole body aquisition</a></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://loinc.org 10157-6}">History of family member diseases note</span></td><td>true</td></tr></table></div>
  </text>
  <extension
             url="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-series-uid">
    <valueId value="example-series-uid"/>
  </extension>
  <extension
             url="https://www.medizininformatik-initiative.de/fhir/ext/modul-bildgebung/StructureDefinition/mii-ex-bildgebung-sop-instanz-uid">
    <valueId value="example-sop-instance-uid"/>
  </extension>
  <partOf>🔗 
    <reference
               value="Procedure/mii-exa-bildgebung-radiologische-befundungsprozedur"/>
  </partOf>
  <status value="final"/>
  <category>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="imaging"/>
      <display value="Imaging"/>
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://loinc.org"/>
      <code value="32422-8"/>
      <display value="Physical findings of Breast"/>
    </coding>
  </code>
  <subject>🔗 
    <reference value="Patient/mii-exa-bildgebung-radiologischer-patient"/>
  </subject>
  <issued value="2024-07-19T12:03:30+02:00"/>
  <valueString
               value="microcalcifications in the upper outer quadrant in the left breast"/>
  <bodySite>
    <extension url="http://hl7.org/fhir/StructureDefinition/bodySite">
      <valueReference>🔗 
        <reference value="BodyStructure/mii-exa-bildgebung-koerperstruktur"/>
      </valueReference>
    </extension>
    <coding>
      <system value="http://snomed.info/sct"/>
      <version
               value="http://snomed.info/sct/900000000000207008/version/20260701"/>
      <code value="76752008"/>
      <display value="Breast structure (body structure)"/>
    </coding>
  </bodySite>
  <hasMember>
    <reference value="Observation/ObsExample"/>
  </hasMember>
  <derivedFrom>🔗 
    <reference value="ImagingStudy/mii-exa-bildgebung-bildgebungsstudie-ct"/>
  </derivedFrom>
  <component>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10157-6"/>
        <display value="History of family member diseases note"/>
      </coding>
    </code>
    <valueBoolean value="true"/>
  </component>
</Observation>