The result, including findings and the laboratory's interpretation, of an investigation performed on specimens collected from an individual or related to that individual.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Mandatory indicator of the localised language in which this Entry is written. Coded from openEHR Code Set languages .

Name of character set in which text values in this Entry are encoded. Coded from openEHR Code Set character sets.

Other participations at ENTRY level.

Identifier of externally held workflow engine data for this workflow execution, for this subject of care.

Id of human subject of this ENTRY, e.g.:

• organ donor
• foetus
• a family member
• another clinically relevant person.

Optional identification of provider of the information in this ENTRY, which might be:

• the patient
• a patient agent, e.g. parent, guardian
• the clinician
• a device or software

Generally only used when the recorder needs to make it explicit. Otherwise, Composition composer and other participants are assumed.

@ internal @

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

The items comprising the ITEM_TREE. Can include 0 or more CLUSTERs and/or 0 or more individual ELEMENTs.

Details of the laboratory which received the request and has overall responsibility to manage reporting of the test, even if other labs perform specific aspects.

A local identifier assigned by the receiving Laboratory Information System (LIS) to track the test process.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

Details about the test request.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Ordered list of items - CLUSTER or ELEMENT objects - under this CLUSTER.

Name of the original laboratory test requested.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

The local identifier assigned by the requesting clinical system.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

The local identifier assigned to the test order by the order filler, usually by the Laboratory Information System (LIS).

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

Details of the clinician or organisation requesting the laboratory test result.

Details of additional clinicians or organisations who require a copy of the test result.

This indicates whether the test was performed directly at Point-of-Care (POCT) as opposed to a formal result from a laboratory or other service delivery organisation.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

Description about the method used to perform the test.

Structured details about the method of analysis, device or interpretation used.

Additional information required to capture local content or to align with other reference models/formalisms.

Optional external identifier of guideline creating this Entry if relevant.

The data of this observation, in the form of a history of values which may be of any complexity.

Optional recording of the state of subject of this observation during the observation process, in the form of a separate history of values which may be of any complexity. State may also be recorded within the History of the data attribute.

The result, including findings and the laboratory's interpretation, of an investigation performed on specimens collected from an individual or related to that individual.

@ internal @

Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.

@ internal @

Name of the laboratory investigation performed on the specimen(s).

Details about the physical substance that has been analysed.

The status of the laboratory test result as a whole.

The date and/or time that ‘Overall test status’ was issued.

The diagnostic service or discipline that is responsible for the laboratory test result.

Description of clinical information available at the time of interpretation of results.

Results of the test performed on the specimen(s).

Narrative description of the key findings.

Single word, phrase or brief description that represents the clinical meaning and significance of the laboratory test result.

A structured or complex diagnosis for the laboratory test.

Digital image, video or diagram representing the test result.

Additional narrative about the test result not captured in other fields.

@ internal @

Issues or circumstances that impact on the accurate interpretation of the measurement or test result.

Details of issues or circumstances that impact on the accurate interpretation of the measurement or test result.

@ internal @

Details of the laboratory which received the request and has overall responsibility to manage reporting of the test, even if other labs perform specific aspects.

A local identifier assigned by the receiving Laboratory Information System (LIS) to track the test process.

Details about the test request.

Name of the original laboratory test requested.

The local identifier assigned by the requesting clinical system.

The local identifier assigned to the test order by the order filler, usually by the Laboratory Information System (LIS).

Details of the clinician or organisation requesting the laboratory test result.

Details of additional clinicians or organisations who require a copy of the test result.

This indicates whether the test was performed directly at Point-of-Care (POCT) as opposed to a formal result from a laboratory or other service delivery organisation.

Description about the method used to perform the test.

Structured details about the method of analysis, device or interpretation used.

Additional information required to capture local content or to align with other reference models/formalisms.

The result, including findings and the laboratory's interpretation, of an investigation performed on specimens collected from an individual or related to that individual.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Mandatory indicator of the localised language in which this Entry is written. Coded from openEHR Code Set languages .

Name of character set in which text values in this Entry are encoded. Coded from openEHR Code Set character sets.

Other participations at ENTRY level.

Identifier of externally held workflow engine data for this workflow execution, for this subject of care.

Id of human subject of this ENTRY, e.g.:

• organ donor
• foetus
• a family member
• another clinically relevant person.

Optional identification of provider of the information in this ENTRY, which might be:

• the patient
• a patient agent, e.g. parent, guardian
• the clinician
• a device or software

Generally only used when the recorder needs to make it explicit. Otherwise, Composition composer and other participants are assumed.

@ internal @

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

The items comprising the ITEM_TREE. Can include 0 or more CLUSTERs and/or 0 or more individual ELEMENTs.

Details of the laboratory which received the request and has overall responsibility to manage reporting of the test, even if other labs perform specific aspects.

A local identifier assigned by the receiving Laboratory Information System (LIS) to track the test process.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

Details about the test request.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Ordered list of items - CLUSTER or ELEMENT objects - under this CLUSTER.

Name of the original laboratory test requested.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

The local identifier assigned by the requesting clinical system.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

The local identifier assigned to the test order by the order filler, usually by the Laboratory Information System (LIS).

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

Details of the clinician or organisation requesting the laboratory test result.

Details of additional clinicians or organisations who require a copy of the test result.

This indicates whether the test was performed directly at Point-of-Care (POCT) as opposed to a formal result from a laboratory or other service delivery organisation.

Runtime name of this fragment, used to build runtime paths. This is the term provided via a clinical application or batch process to name this EHR construct: its retention in the EHR faithfully preserves the original label by which this entry was known to end users.

Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths. Always in the form of an at-code, e.g. at0005. This value enables a 'standardised' name for this node to be generated, by referring to the generating archetype local terminology.

At an archetype root point, the value of this attribute is always the stringified form of the _archetype_id_ found in the _archetype_details_ object.

Optional globally unique object identifier for root points of archetyped structures.

Links to other archetyped structures (data whose root object inherits from ARCHETYPED, such as ENTRY, SECTION and so on). Links may be to structures in other compositions.

Details of archetyping used on this node.

Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.

Flavour of null value, e.g. 253|unknown|, 271|no information|, 272|masked|, and 273|not applicable|.

Property representing leaf value object of ELEMENT. In real data, any concrete subtype of DATA_VALUE can be used.

Optional specific reason for null value; if set, _null_flavour_ must be set. Null reason may apply only to a minority of clinical data, commonly needed in reporting contexts.

Description about the method used to perform the test.

Structured details about the method of analysis, device or interpretation used.

Additional information required to capture local content or to align with other reference models/formalisms.

Optional external identifier of guideline creating this Entry if relevant.

The data of this observation, in the form of a history of values which may be of any complexity.

Optional recording of the state of subject of this observation during the observation process, in the form of a separate history of values which may be of any complexity. State may also be recorded within the History of the data attribute.