Short answer: Use DiagnosticReport for the result of a diagnostic test (a lab panel, an imaging study) with its individual results and the conclusion. Use DocumentReference to index any document, such as a scanned discharge letter or a PDF lab report, with its type, date, author and the patient it belongs to. Use Binary for the raw file content when it is stored on the server.
How they fit together
- A lab panel: one DiagnosticReport (code: the panel; result: references to each Observation; conclusion; presentedForm: the PDF if available).
- A scanned discharge letter: a DocumentReference (type, date, author, subject) whose content.attachment points to the PDF, stored as a Binary or at a URL.
- An imaging study: a DiagnosticReport for the radiologist's report, and an ImagingStudy for the DICOM series. See DICOM vs FHIR.
A rule of thumb: if the data is structured and coded, use DiagnosticReport and Observations; if it is a document to be read by a person, use DocumentReference.
Why both often exist
Labs often send structured results and a PDF. Keeping both lets software chart the values while a person can still see the original layout and signature.
In Anpheros
In Anpheros, scanned letters and reports are DocumentReferences whose attachment points to the stored file, and the lab values extracted from them become Observations, so you keep both the original and the data. The Platform also supports DiagnosticReport; it does not expose Binary as a resource. See Documents in the app and, for developers, storing medical records in FHIR.
Related pages
Sources
Frequently asked questions
Where do I store a PDF in FHIR?
Index it with a DocumentReference; the file itself goes in content.attachment, as a URL or a Binary resource.
When should I use DiagnosticReport?
For the result of a diagnostic test with its Observations and conclusion.
Can a DiagnosticReport include the PDF?
Yes, in presentedForm, alongside the structured results.
Is Binary a clinical resource?
No. It only holds raw content; the meaning comes from the DocumentReference or DiagnosticReport that points to it.
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