MII PR Mikrobio Diagnostic Report - MII Implementation Guide Microbiology v2027.0.0-ballot2

MII Implementation Guide Microbiology - Local Development build (v2027.0.0-ballot2) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MII PR Mikrobio Diagnostic Report

Official URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-pr-mikrobio-diagnostic-report				Version: 2027.0.0-ballot2
Active as of 2026-09-14				Computable Name: MII_PR_Mikrobio_Diagnostic_Report

Mikrobiologischer Befundbericht zur Zusammenfassung und Kontextualisierung zugehöriger mikrobiologischer Untersuchungsergebnisse.

Microbiological diagnostic report for summarising and contextualising related microbiological investigation results.

Category and report type

DiagnosticReport.category carries two slices with different jobs:

Slice	Cardinality	Content
`mibi-category`	1..1	Marks the report as microbiological: `v2-0074#MB \\|Microbiology\\|`, mandatory, plus optionally `18725-2 \\|Microbiology studies\\|`
`mibi-sub-category`	0..*	Clinical report type from `mii-vs-mikrobio-befundtyp-loinc`, e.g. `92894-5 \\|Microbiology - bacterial studies\\|`

The report type is optional. A report that cannot be assigned to any of the study types, or that is to be classified only generally, is represented via mibi-category alone - a general report-type code is not needed for that and does not exist in this LOINC family either.

If a report covers several study types, for instance detection of bacteria and fungi, several sub-types are given:

"category": [
  { "coding": [
      { "system": "http://terminology.hl7.org/CodeSystem/v2-0074", "code": "MB", "display": "Microbiology" },
      { "system": "http://loinc.org", "code": "18725-2", "display": "Mikrobiologie" } ] },
  { "coding": [ { "system": "http://loinc.org", "code": "92894-5",
                  "display": "Microbiology - bacterial studies" } ] },
  { "coding": [ { "system": "http://loinc.org", "code": "96398-3",
                  "display": "Microbiology - mycology studies" } ] }
]

The summarising conclusion

DiagnosticReport.conclusion carries the laboratory's summarising assessment as free text. It is Must Support, inherited from the laboratory base profile, and in serology it is the load-bearing part of the report rather than an addition.

The reason is that a serological diagnosis is often not any one of its measurements. In acute EBV infection, IgM against the viral capsid antigen appears first, VCA IgG follows, and EBNA IgG arises only after six to twelve weeks. Each of the three results is an Observation of its own; the statement "acute infection" or "past infection" follows from reading them together and is none of them. The HL7 EU Lab Semantic Workgroup puts it as "a serological report is often more than the sum of its parts" and asks that the conclusion be exchangeable, "free text to begin with".

conclusionCode is deliberately not constrained here. The HL7 EU Lab Semantic Workgroup proposes free text for the time being, and this module has no value set for coded overall assessments.

What the report bundles, and what the Observations carry

DiagnosticReport.result references the investigations the report covers, every step of a diagnostic chain among them, from the culture to a derived resistance category. The list is flat and carries no order: it says which investigations belong to this report, not how they relate to one another.

Those relationships are recorded on the Observations themselves — triggeredBy for a triggered follow-up investigation, derivedFrom for a derived result, hasMember for a panel held together by an organizer. A consumer therefore reads the report for the scope of a finding and the Observations for its structure. Profile Selection and Delimitation sets out the division of labour between the three.

Examples

Example (minimal):

mii-exa-mikrobio-diagnostic-report

Usages:

Examples for this Profile: DiagnosticReport/mii-exa-mikrobio-diagnostic-report
CapabilityStatements using this Profile: MII CPS Mikrobio Metadata

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots, and their representations.

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	MII_PR_Labor_Laborbefund	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
source	SΣ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier	SΣ	1..*	Identifier	Identifikator Slice: Unordered, Open by pattern:type
identifier:befund	SΣ	1..1	Identifier	Filler-Identifikator
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
text		0..1	string	Plain text representation of the concept
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
Slices for coding				Content/Rules for all slices
coding:fillerV2	SΣ	1..1	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
assigner	SΣC	1..1	Reference(Organization)	Organization that issued id (may be just text) Constraints: ref-1
basedOn	SC	1..1	Reference(CarePlan \| ImmunizationRecommendation \| MedicationRequest \| NutritionOrder \| ServiceRequest)	basiert auf Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
status	?!SΣ	1..1	code	Status Binding: DiagnosticReportStatus (required): The status of the diagnostic report.
Slices for category	SΣ	2..*	CodeableConcept	Kategorie Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections.
category:v2-lab	SΣ	1..1	CodeableConcept	Labor-Kategorie Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: LAB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:mibi-category	SΣ	1..1	CodeableConcept	Mikrobiologie-Kategorie Binding: DiagnosticServiceSectionCodes (example): Codes for diagnostic service sections. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:mibi-sub-category	SΣ	0..*	CodeableConcept	Mikrobiologie-Kategorie LOINC Binding: MII VS Mikrobio Befundtyp [LOINC] (required)
code	SΣ	1..1	CodeableConcept	Code Binding: LOINCDiagnosticReportCodes (preferred): Codes that describe Diagnostic Reports.
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices				Content/Rules for all slices
system	SΣ	1..1	uri	Identity of the terminology system
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
coding:loinc-labReport	SΣ	1..1	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
subject	SΣC	1..1	Reference(Patient \| Group \| Device \| Location)	Subjekt Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
encounter	SΣC	0..1	Reference(Encounter)	Fall oder Kontakt Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
effective[x]	SΣ	1..1	dateTime	Klinisches Bezugsdatum
Slices for extension				Content/Rules for all slices
extension:QuelleKlinischesBezugsdatum	S	0..1	Coding	Quelle des klinischen Bezugsdatums URL: https://www.medizininformatik-initiative.de/fhir/core/modul-labor/StructureDefinition/QuelleKlinischesBezugsdatum Binding: MII VS Labor Quelle klinisches Bezugsdatum (required)
issued	SΣ	1..1	instant	Dokumentationsdatum
performer	SΣC	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Ausführende*r Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
resultsInterpreter	SΣC	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Primary result interpreter Constraints: ref-1
specimen	SC	0..*	Reference(Specimen)	Probenmaterial Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
result	SC	1..*	Reference(MII PR Mikrobio Allgemeine Kultur \| MII PR Mikrobio Allgemeine Bestimmung (Identifizierung) \| MII PR Mikrobio Spezifische Bestimmung \| MII PR Mikrobio Keimzahl \| MII PR Mikrobio Empfindlichkeit \| MII PR Mikrobio Allgemeine Mikroskopie \| MII PR Mikrobio Spezifische Mikroskopie \| MII PR Mikrobio Antigen Antikoerper Quantitativ \| MII PR Mikrobio Aviditaet \| MII PR Mikrobio CT Wert \| MII PR Mikrobio Titer \| MII PR Mikrobio Nugent Score \| MII PR Mikrobio Bartlett Score \| MII PR Mikrobio Molekulare Pathogenlast \| MII PR Mikrobio Resistenzmechanismen Determinanten \| MII PR Mikrobio Virulenzfaktor \| MII PR Mikrobio Resistenzkategorie Status \| MII PR Mikrobio MRGN Klasse \| MII PR Mikrobio Voraussichtliche Empfindlichkeit)	Ergebnis Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
conclusion	S	0..1	string	Zusammenfassende Beurteilung des Labors im Freitext. Fuer serologische Befunde die tragende Stelle, weil sich die Diagnose dort erst aus der Zusammenschau mehrerer Einzelergebnisse ergibt.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.identifier:befund.use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
DiagnosticReport.identifier:befund.type	Base	extensible	IdentifierType	📦4.0.1	FHIR Std.
DiagnosticReport.status	Base	required	DiagnosticReportStatus	📍4.0.1	FHIR Std.
DiagnosticReport.category	Base	example	Diagnostic Service Section Codes	📦4.0.1	FHIR Std.
DiagnosticReport.category:v2-lab	Base	example	Diagnostic Service Section Codes	📦4.0.1	FHIR Std.
DiagnosticReport.category:mibi-category	Base	example	Diagnostic Service Section Codes	📦4.0.1	FHIR Std.
DiagnosticReport.category:mibi-sub-category	Base	required	MII VS Mikrobio Befundtyp [LOINC]	📦2027.0.0-ballot2	This IG
DiagnosticReport.code	Base	preferred	LOINC Diagnostic Report Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DiagnosticReport	If the resource is contained in another resource, it SHALL NOT contain nested Resources	`contained.contained.empty()`
dom-3	error	DiagnosticReport	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	`contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5	error	DiagnosticReport	If a resource is contained in another resource, it SHALL NOT have a security label	`contained.meta.security.empty()`
dom-6	best practice	DiagnosticReport	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children	`hasValue() or (children().count() > id.count())`
ext-1	error	ALL extensions	Must have either extensions or value[x], not both	`extension.exists() != value.exists()`
ref-1	error	DiagnosticReport.identifier:befund.assigner, DiagnosticReport.basedOn, DiagnosticReport.subject, DiagnosticReport.encounter, DiagnosticReport.performer, DiagnosticReport.resultsInterpreter, DiagnosticReport.specimen, DiagnosticReport.result	SHALL have a contained resource if a local reference is provided	`reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))`

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
DiagnosticReport		0..*	MII_PR_Labor_Laborbefund	A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
basedOn		1..1	Reference(CarePlan \| ImmunizationRecommendation \| MedicationRequest \| NutritionOrder \| ServiceRequest)	basiert auf
category		2..*	CodeableConcept	Kategorie
Slices for category				Content/Rules for all slices
category:mibi-category	S	1..1	CodeableConcept	Mikrobiologie-Kategorie Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
category:mibi-sub-category	S	0..*	CodeableConcept	Mikrobiologie-Kategorie LOINC Binding: MII VS Mikrobio Befundtyp [LOINC] (required)
resultsInterpreter	S	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam)	Primary result interpreter
result		1..*	Reference(MII PR Mikrobio Allgemeine Kultur \| MII PR Mikrobio Allgemeine Bestimmung (Identifizierung) \| MII PR Mikrobio Spezifische Bestimmung \| MII PR Mikrobio Keimzahl \| MII PR Mikrobio Empfindlichkeit \| MII PR Mikrobio Allgemeine Mikroskopie \| MII PR Mikrobio Spezifische Mikroskopie \| MII PR Mikrobio Antigen Antikoerper Quantitativ \| MII PR Mikrobio Aviditaet \| MII PR Mikrobio CT Wert \| MII PR Mikrobio Titer \| MII PR Mikrobio Nugent Score \| MII PR Mikrobio Bartlett Score \| MII PR Mikrobio Molekulare Pathogenlast \| MII PR Mikrobio Resistenzmechanismen Determinanten \| MII PR Mikrobio Virulenzfaktor \| MII PR Mikrobio Resistenzkategorie Status \| MII PR Mikrobio MRGN Klasse \| MII PR Mikrobio Voraussichtliche Empfindlichkeit)	Ergebnis
conclusion		0..1	string	Zusammenfassende Beurteilung des Labors im Freitext. Fuer serologische Befunde die tragende Stelle, weil sich die Diagnose dort erst aus der Zusammenschau mehrerer Einzelergebnisse ergibt.
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DiagnosticReport.category:mibi-sub-category	Base	required	MII VS Mikrobio Befundtyp [LOINC]	📦2027.0.0-ballot2	This IG