Existing Wording: "In the context of FHIR we are currently utilizing the FHIR DiagnosticReport anchor resource as since it provides a resource definition that can be referenced in a broad variety of other clinical communications as the reason for other treatment and diagnostic choices. This resource does not however provide the structural capabilities to aggregate together collections of observation, conditions and recommendations into the sections and subsections that are currently expected in a breast radiology report. For this ballot we have chosen to use the Composition resource which was designed for this purpose. Since DiagnosticReport did not inherently provide a method to reference Composition in this way, we were left with the somewhat awkward option of constraining out the Result attribute and then adding back in a nearly identical attribute ResultComposition which allows for referencing Composition."

Proposed Wording: We would like to see an alternative, or ways to make the DiagnosticReport resource useful for the current use case described in this ballot. This would not only benefit the breast radiology reporting, but diagnostic reporting in general. Hence, to answer question 2, we would suggest to make DiagnosticReport a top-level parent; however would mean enhancements need to be made to the DiagnosticReport resource (question 3).

Comment:

See our comments (Breast Radiology Reporting Ballot2.doc

Summary:

Diagnostic Reports should be the anchor or the parent, not the reference.