# US Quality Core DiagnosticReport Profile for Report and Note Exchange - 2026 US Quality Core Implementation Guide v0.5.0

## Resource Profile: US Quality Core DiagnosticReport Profile for Report and Note Exchange 

 
Profile of DiagnosticReport for Note exchange for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. 

### USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the [Must Support](must-support.md) section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

**USCDI+ Quality Elements:**

* status: (USCDI+ Quality) (USCDI) registered | partial | preliminary | final +
* category:us-core: (USCDI+ Quality) (USCDI) Service category
* code: (USCDI+ Quality) (USCDI) US Quality Core Report Code
* effective[x]: (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of the procedure)
* result: (USCDI+ Quality) (USCDI) Observations

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The [Formal Views](#profile) section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

**Usages:**

* Refer to this Profile: [US Quality Core ImagingStudy](StructureDefinition-us-quality-core-imagingstudy.md) and [US Quality Core Procedure](StructureDefinition-us-quality-core-procedure.md)
* Examples for this Profile: [DiagnosticReport/note-example](DiagnosticReport-note-example.md)
* CapabilityStatements using this Profile: [US Quality Core Client CapabilityStatement](CapabilityStatement-us-quality-core-client.md) and [US Quality Core Server CapabilityStatement](CapabilityStatement-us-quality-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/fhir.onc.us-quality-core|current/StructureDefinition/StructureDefinition-us-quality-core-diagnosticreport-note.json)

### Formal Views of Profile Content

 [Description Differentials, Snapshots, and other representations](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](../StructureDefinition-us-quality-core-diagnosticreport-note.csv), [Excel](../StructureDefinition-us-quality-core-diagnosticreport-note.xlsx), [Schematron](../StructureDefinition-us-quality-core-diagnosticreport-note.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-quality-core-diagnosticreport-note",
  "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-diagnosticreport-note",
  "version" : "0.5.0",
  "name" : "USQualityCoreDiagnosticReportNote",
  "title" : "US Quality Core DiagnosticReport Profile for Report and Note Exchange",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-06-05",
  "publisher" : "Office of the National Coordinator for Health Information Technology (ONC)",
  "contact" : [{
    "name" : "Office of the National Coordinator for Health Information Technology (ONC)",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.healthit.gov/feedback"
    }]
  }],
  "description" : "Profile of DiagnosticReport for Note exchange for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }],
    "text" : "USA"
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "DiagnosticReport",
  "baseDefinition" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note|6.1.0",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "DiagnosticReport",
      "path" : "DiagnosticReport"
    },
    {
      "id" : "DiagnosticReport.status",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.status",
      "short" : "(USCDI+ Quality) (USCDI) registered | partial | preliminary | final +"
    },
    {
      "id" : "DiagnosticReport.category",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.category",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "$this"
        }],
        "rules" : "open"
      },
      "short" : "(USCDI) Service Category",
      "min" : 1
    },
    {
      "id" : "DiagnosticReport.category:us-core",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.category",
      "sliceName" : "us-core",
      "short" : "(USCDI+ Quality) (USCDI) Service category"
    },
    {
      "id" : "DiagnosticReport.code",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.code",
      "short" : "(USCDI+ Quality) (USCDI) US Quality Core Report Code",
      "definition" : "The test, panel, report, or note that was ordered.",
      "comment" : "The typical patterns for codes are:  1)  a LOINC code either as a translation from a \"local\" code or as a primary code, or 2)  a local code only if no suitable LOINC exists,  or 3)  both the local and the LOINC translation.   Systems SHALL be capable of sending the local code if one exists.",
      "alias" : ["Type"],
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "DiagnosticReport.code",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : true,
      "binding" : {
        "strength" : "extensible",
        "description" : "LOINC codes",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-diagnosticreport-report-and-note-codes"
      }
    },
    {
      "id" : "DiagnosticReport.subject",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.subject",
      "short" : "(USCDI) The subject of the report - usually, but not always, the patient",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient"]
      }]
    },
    {
      "id" : "DiagnosticReport.encounter",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.encounter",
      "short" : "(USCDI) Health care event when test ordered",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter"]
      }]
    },
    {
      "id" : "DiagnosticReport.effective[x]",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.effective[x]",
      "short" : "(USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of the procedure)",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "DiagnosticReport.effective[x]",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "dateTime"
      },
      {
        "code" : "Period"
      }],
      "isModifier" : false,
      "isSummary" : true
    },
    {
      "id" : "DiagnosticReport.issued",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.issued",
      "short" : "(USCDI) DateTime this version was made"
    },
    {
      "id" : "DiagnosticReport.performer",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.performer",
      "short" : "(USCDI) Responsible Diagnostic Service",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitioner",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization"]
      }]
    },
    {
      "id" : "DiagnosticReport.result",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.result",
      "short" : "(USCDI+ Quality) (USCDI) Observations",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-observation-lab",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"]
      }]
    },
    {
      "id" : "DiagnosticReport.imagingStudy",
      "path" : "DiagnosticReport.imagingStudy",
      "short" : "Reference to full details of imaging associated with the diagnostic report",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-imagingstudy"]
      }]
    },
    {
      "id" : "DiagnosticReport.media",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "DiagnosticReport.media",
      "short" : "(USCDI) Key images associated with this report"
    }]
  }
}

```
