LaboratoryResult
Laboratory test result containing measured values, units, clinical interpretation, and reference ranges. Supports quantitative, qualitative, and coded results with critical value flagging and validation workflows.
Overview
LaboratoryResult captures the outcome of a single laboratory test. It includes the measured value (numeric, text, or coded), units, clinical interpretation (normal/abnormal/critical), and applicable reference ranges. The entity tracks the result lifecycle from preliminary through final, with validation by qualified professionals. Critical values trigger immediate notification workflows.
Key Concepts
Result Status
The status field tracks result lifecycle:
| Status | Description | Clinical Use |
|---|---|---|
registered | Specimen received | Not yet tested |
preliminary | Pending verification | Use with caution |
final | Validated | Actionable |
amended | Modified after final | Check updates |
corrected | Error corrected | Use corrected value |
cancelled | Cancelled | No result |
Value Types
Results can be expressed multiple ways:
| Field | Type | Use Case |
|---|---|---|
valueQuantity + valueUnit | Number | Glucose: 95 mg/dL |
valueString | Text | Culture: "Staph aureus identified" |
valueCode | Coded | HIV: Positive (SNOMED) |
Clinical Interpretation
The interpretation field provides clinical context:
| Interpretation | Meaning | Alert Level |
|---|---|---|
normal | Within reference range | None |
abnormal | Outside range (unspecified) | Review |
high | Above upper limit | Review |
low | Below lower limit | Review |
critical-high | Dangerously elevated | Immediate |
critical-low | Dangerously decreased | Immediate |
positive | Finding present | Varies |
negative | Finding absent | None |
indeterminate | Cannot determine | Repeat |
Reference Ranges
The referenceRange array provides interpretation context:
- Normal ranges for comparison
- Critical thresholds for alerting
- May vary by age, sex, pregnancy
- Linked to patient demographics
Critical Values
Life-threatening results requiring immediate action:
isCritical- Boolean flagcriticalNotifiedDateTime- When provider notified- Mandatory notification protocols
- Documented read-back
- Time-sensitive
Specimen Link
The specimen field references Specimen:
- What was tested
- Collection details
- Quality assessment
- Chain of custody
Testing Method
The method field documents the procedure:
- Analytical technique used
- May affect interpretation
- Supports quality review
- Required for some results
Validation
Quality assurance:
validatedBy- Reviewing professionalvalidatedDateTime- When validated- Required before final status
- Ensures accuracy
Timing
Important timestamps:
effectiveDateTime- When specimen collectedissued- When result released- Affects clinical interpretation
- Supports turnaround metrics
Use Cases
Quantitative Result
For numeric measurements:
- Run analysis on specimen
- Record
valueQuantityandvalueUnit - Compare to reference range
- Set
interpretationbased on comparison - Flag if critical
- Validate and release
Qualitative Result
For categorical findings:
- Perform test (e.g., culture)
- Record
valueStringwith description - Set
valueCodeif applicable - Interpret as positive/negative
- Add detailed notes
- Validate and release
Critical Value
When result is critical:
- Set
isCritical: true - Set interpretation (critical-high/low)
- Immediately notify provider
- Document
criticalNotifiedDateTime - Perform read-back verification
- Release as preliminary or final
Result Amendment
When correction needed:
- Change status to
amendedorcorrected - Update value if changed
- Document reason in notes
- Re-validate
- Notify ordering provider
- Preserve audit trail
Trend Analysis
For longitudinal review:
- Query results by patient and test
- Display values over time
- Show reference ranges
- Highlight abnormal trends
- Support clinical decisions
Related Entities
| Entity | Relationship | Description |
|---|---|---|
| Patient | References | Whose result this is |
| Encounter | References | Visit context |
| LaboratoryOrder | References | Original order |
| LabTest | References | Test definition |
| Specimen | References | Specimen tested |
| Facility | References | Performing lab |
| Practitioner | References | Validator |
| ReferenceRange | Contains many | Normal/critical ranges |
| Coding | Contains | Method and value codes |
| ClinicalIdentifier | Contains | Result identifiers |
| LaboratoryPanel | Referenced by | Panel containing this result |
Calculated Fields
| Field | Type | Description |
|---|---|---|
isAbnormal | boolean | True when interpretation is not normal |
isFinal | boolean | True when status is final |
Enums
status
| Value | Description |
|---|---|
registered | Specimen received, testing not yet started |
preliminary | Results available but pending final verification |
final | Result verified, validated, and ready for clinical use |
amended | Result modified after being finalized |
corrected | Result corrected due to error in original value |
cancelled | Testing cancelled, no result generated |
entered-in-error | Result created in error |
unknown | Result status cannot be determined |
interpretation
| Value | Description |
|---|---|
normal | Result within normal reference range |
abnormal | Result outside normal limits (direction unspecified) |
high | Result above upper reference limit |
low | Result below lower reference limit |
critical-high | Result dangerously elevated, requires immediate notification |
critical-low | Result dangerously decreased, requires immediate notification |
positive | Finding is present (for qualitative tests) |
negative | Finding is absent (for qualitative tests) |
indeterminate | Result cannot be definitively interpreted |
Properties
| Property | Type | Mode | Description | Required |
|---|---|---|---|---|
| identifier | ClinicalIdentifier[] | stored | Collection of unique business identifiers assigned to this laboratory result by various systems, laboratories, or organizations for tracking and reference purposes Example: | Optional |
| patient | Patient | stored | Reference to the patient for whom this laboratory test was performed and to whom the results apply | Required |
| encounter | Encounter | stored | Reference to the healthcare encounter or visit during which this laboratory test was ordered or specimen was collected | Optional |
| order | LaboratoryOrder | stored | Reference to the laboratory order that requested this test and which this result fulfills | Optional |
| status | string | stored | Current workflow status of the laboratory result, indicating the stage of completion and reliability of the result data Values: Example: | Required |
| code | LabTest | stored | Reference to the standardized laboratory test definition indicating which test was performed, typically using LOINC or other coding systems | Required |
| effectiveDateTime | DateTime | stored | Date and time when the specimen was collected from the patient, representing the clinically relevant time for the measurement | Optional |
| issued | DateTime | stored | Date and time when the laboratory result was published, released, or made available to clinicians | Optional |
| performer | Facility | stored | Reference to the laboratory facility or organization that performed the test and generated the result | Optional |
| valueQuantity | number | stored | Numeric value of the laboratory measurement for quantitative results | Optional |
| valueUnit | string | stored | Unit of measurement for the numeric result value (e.g., mg/dL, mEq/L, g/dL) | Optional |
| valueString | string | stored | Textual representation of the result for qualitative or descriptive findings | Optional |
| valueCode | Coding | stored | Coded representation of the result value for categorical findings such as positive/negative, reactive/non-reactive, or other standardized result codes Example: | Optional |
| interpretation | string | stored | Clinical interpretation or assessment of the result value in relation to reference ranges and clinical significance Values: Example: | Optional |
| referenceRange | ReferenceRange[] | stored | Collection of reference ranges providing normal, therapeutic, or critical value boundaries applicable to this result for comparison and interpretation Example: | Optional |
| method | Coding | stored | Laboratory methodology or technique used to perform the test, providing procedural context for result interpretation Example: | Optional |
| specimen | Specimen | stored | Reference to the biological specimen that was analyzed to produce this laboratory result | Optional |
| note | string | stored | Additional comments, annotations, or interpretive notes from the pathologist or laboratory technician regarding the result | Optional |
| isCritical | boolean | stored | Flag indicating whether this result contains a critical value that requires immediate notification to the ordering provider or clinical team | Optional |
| criticalNotifiedDateTime | DateTime | stored | Date and time when the critical value was communicated to the responsible healthcare provider, fulfilling regulatory notification requirements | Optional |
| validatedBy | Practitioner | stored | Reference to the pathologist, laboratory director, or qualified professional who validated and approved the result for clinical use | Optional |
| validatedDateTime | DateTime | stored | Date and time when the result was validated and approved by the responsible laboratory professional | Optional |
| isAbnormal | boolean | calculated | Calculated indicator of whether the result interpretation is abnormal, derived from the interpretation field being any value other than 'normal' | Optional |
| isFinal | boolean | calculated | Calculated indicator of whether the result status is final, signifying that the result is complete, validated, and ready for clinical decision-making | Optional |
Examples
Example 1
{
"@type": "LaboratoryResult",
"identifier": [
{
"system": "http://hospital.example.org/lab-results",
"value": "LAB-2024-00123456"
}
],
"patient": "Patient/patient-123",
"encounter": "Encounter/encounter-456",
"order": "LaboratoryOrder/order-789",
"status": "final",
"code": "LabTest/glucose-serum",
"effectiveDateTime": "2024-11-30T08:30:00Z",
"issued": "2024-11-30T10:15:00Z",
"performer": "Facility/lab-central",
"valueQuantity": 95,
"valueUnit": "mg/dL",
"interpretation": "normal",
"referenceRange": [
{
"low": {
"value": 70,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"high": {
"value": 100,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"type": "normal",
"text": "Normal fasting glucose range for adults",
"appliesTo": [
"adult"
]
}
],
"method": {
"code": "enzymatic",
"display": "Enzymatic colorimetric assay",
"system": "http://terminology.hl7.org/CodeSystem/observation-method"
},
"specimen": "Specimen/specimen-001",
"isCritical": false,
"validatedBy": "Practitioner/pathologist-dr-jones",
"validatedDateTime": "2024-11-30T10:10:00Z",
"_comment": "isAbnormal: false, isFinal: true"
}Example 2
{
"@type": "LaboratoryResult",
"identifier": [
{
"system": "http://hospital.example.org/lab-results",
"value": "LAB-2024-00123457"
}
],
"patient": "Patient/patient-124",
"encounter": "Encounter/encounter-457",
"order": "LaboratoryOrder/order-790",
"status": "final",
"code": "LabTest/potassium-serum",
"effectiveDateTime": "2024-11-30T09:00:00Z",
"issued": "2024-11-30T11:00:00Z",
"performer": "Facility/lab-central",
"valueQuantity": 5.8,
"valueUnit": "mEq/L",
"interpretation": "high",
"referenceRange": [
{
"low": {
"value": 3.5,
"unit": "mEq/L",
"system": "http://unitsofmeasure.org",
"code": "meq/L"
},
"high": {
"value": 5,
"unit": "mEq/L",
"system": "http://unitsofmeasure.org",
"code": "meq/L"
},
"type": "normal",
"text": "Normal potassium range for adults",
"appliesTo": [
"adult"
]
}
],
"specimen": "Specimen/specimen-002",
"note": "Elevated potassium level. Recommend repeat testing and review of medications. Rule out hemolysis.",
"isCritical": false,
"validatedBy": "Practitioner/pathologist-dr-jones",
"validatedDateTime": "2024-11-30T10:55:00Z",
"_comment": "isAbnormal: true, isFinal: true"
}Example 3
{
"@type": "LaboratoryResult",
"identifier": [
{
"system": "http://hospital.example.org/lab-results",
"value": "LAB-2024-00123458"
}
],
"patient": "Patient/patient-125",
"encounter": "Encounter/encounter-458",
"order": "LaboratoryOrder/order-791",
"status": "final",
"code": "LabTest/hemoglobin-blood",
"effectiveDateTime": "2024-11-30T07:45:00Z",
"issued": "2024-11-30T09:30:00Z",
"performer": "Facility/lab-central",
"valueQuantity": 6.5,
"valueUnit": "g/dL",
"interpretation": "critical-low",
"referenceRange": [
{
"low": {
"value": 12,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
},
"high": {
"value": 15.5,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
},
"type": "normal",
"text": "Normal hemoglobin range for adult females",
"appliesTo": [
"adult",
"female"
]
},
{
"low": {
"value": 7,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
},
"type": "critical",
"text": "Critical low hemoglobin threshold",
"appliesTo": [
"adult"
]
}
],
"specimen": "Specimen/specimen-003",
"note": "CRITICAL LOW HEMOGLOBIN. Severe anemia requiring immediate clinical intervention. Consider transfusion.",
"isCritical": true,
"criticalNotifiedDateTime": "2024-11-30T09:35:00Z",
"validatedBy": "Practitioner/pathologist-dr-smith",
"validatedDateTime": "2024-11-30T09:25:00Z",
"_comment": "isAbnormal: true, isFinal: true"
}Example 4
{
"@type": "LaboratoryResult",
"identifier": [
{
"system": "http://hospital.example.org/lab-results",
"value": "LAB-2024-00123459"
}
],
"patient": "Patient/patient-126",
"encounter": "Encounter/encounter-459",
"order": "LaboratoryOrder/order-792",
"status": "final",
"code": "LabTest/culture-blood",
"effectiveDateTime": "2024-11-28T14:00:00Z",
"issued": "2024-11-30T12:00:00Z",
"performer": "Facility/lab-microbiology",
"valueCode": {
"code": "10828004",
"display": "Positive",
"system": "http://snomed.info/sct"
},
"valueString": "Staphylococcus aureus identified. Antibiotic sensitivity testing in progress.",
"interpretation": "positive",
"specimen": "Specimen/specimen-004",
"note": "Positive blood culture after 24 hours incubation. Gram-positive cocci in clusters. Final identification: Staphylococcus aureus. Sensitivity results to follow.",
"isCritical": true,
"criticalNotifiedDateTime": "2024-11-29T08:15:00Z",
"validatedBy": "Practitioner/microbiologist-dr-chen",
"validatedDateTime": "2024-11-30T11:55:00Z",
"_comment": "isAbnormal: true, isFinal: true"
}