Hi ChatGPT, my name is Jimmy - I’m going to give you a series of FHIR messages, and ask you questions as we go through. The first one I’ll share is just about me.
{
"resourceType": "Patient",
"id": "PAT12345",
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR"
}
]
},
"system": "urn:oid:1.2.36.146.595.217.0.1",
"value": "12345",
"period": {
"start": "2001-05-06"
},
"assigner": {
"display": "Acme Healthcare"
}
}
],
"active": true,
"name": [
{
"use": "official",
"family": "Smith",
"given": [
"James"
]
},
{
"use": "usual",
"given": [
"Jimmy"
]
}
],
"telecom": [
{
"system": "phone",
"value": "(03) 5555 6473",
"use": "work",
"rank": 1
},
{
"system": "phone",
"value": "(03) 3410 5613",
"use": "mobile",
"rank": 2
}
],
"gender": "male",
"birthDate": "1980-01-01",
"deceasedBoolean": false,
"address": [
{
"use": "home",
"type": "both",
"text": "123 Main St, Anytown PA 10201",
"line": [
"123 Main St"
],
"city": "Anytown",
"state": "PA",
"postalCode": "10201",
"period": {
"start": "1980-01-01"
}
}
],
"managingOrganization": {
"reference": "HOSP1"
}
}
I’ve been feeling really tired lately and I don’t know why. My knee has been sore and looks a bit swollen. I’ve also noticed I’ve been bruising more easily. Any thoughts on what this could be?
{
"resourceType": "Bundle",
"type": "collection",
"entry": [
{
"resource": {
"resourceType": "Observation",
"id": "cbc-wbc",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "6690-2",
"display": "Leukocytes [#/volume] in Blood by Automated count"
}
]
},
"subject": {
"reference": "PAT12345"
},
"valueQuantity": {
"value": 2.8,
"unit": "10^9/L",
"system": "http://unitsofmeasure.org",
"code": "10*9/L"
},
"referenceRange": [
{
"low": { "value": 4.0, "unit": "10^9/L" },
"high": { "value": 11.0, "unit": "10^9/L" }
}
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "cbc-hb",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "718-7",
"display": "Hemoglobin [Mass/volume] in Blood"
}
]
},
"subject": {
"reference": "PAT12345"
},
"valueQuantity": {
"value": 9.8,
"unit": "g/dL",
"system": "http://unitsofmeasure.org",
"code": "g/dL"
},
"referenceRange": [
{
"low": { "value": 12.0, "unit": "g/dL" },
"high": { "value": 16.0, "unit": "g/dL" }
}
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "cbc-plt",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "777-3",
"display": "Platelets [#/volume] in Blood by Automated count"
}
]
},
"subject": {
"reference": "PAT12345"
},
"valueQuantity": {
"value": 95,
"unit": "10^9/L",
"system": "http://unitsofmeasure.org",
"code": "10*9/L"
},
"referenceRange": [
{
"low": { "value": 150, "unit": "10^9/L" },
"high": { "value": 400, "unit": "10^9/L" }
}
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "chem-crp",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "1988-5",
"display": "C reactive protein [Mass/volume] in Serum or Plasma"
}
]
},
"subject": {
"reference": "PAT12345"
},
"valueQuantity": {
"value": 22,
"unit": "mg/L",
"system": "http://unitsofmeasure.org",
"code": "mg/L"
},
"referenceRange": [
{
"low": { "value": 0, "unit": "mg/L" },
"high": { "value": 5, "unit": "mg/L" }
}
]
}
}
]
}
What are some things that might cause such a set of results?
Thanks ChatGPT! My doctor ordered me a laboratory test, let me paste the results.
{
"resourceType": "Bundle",
"type": "collection",
"entry": [
{
"resource": {
"resourceType": "DiagnosticReport",
"id": "bm-biopsy-001",
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0074",
"code": "PAT",
"display": "Pathology"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "34543-9",
"display": "Bone marrow aspirate+biopsy report"
}
],
"text": "Bone marrow aspirate and biopsy"
},
"subject": {
"reference": "PAT12345"
},
"effectiveDateTime": "2025-09-14T10:00:00-04:00",
"issued": "2025-09-14T15:00:00-04:00",
"performer": [
{
"reference": "Organization/PathologyLab",
"display": "Acme Pathology Services"
}
],
"conclusion": "Normocellular marrow with trilineage hematopoiesis. No evidence of dysplasia, infiltration, or increased blasts. Findings consistent with normal bone marrow.",
"conclusionCode": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "129684003",
"display": "Normal bone marrow"
}
]
}
],
"result": [
{
"reference": "Observation/bm-cellularity"
},
{
"reference": "Observation/bm-blasts"
}
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "bm-cellularity",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "58444-2",
"display": "Bone marrow cellularity"
}
],
"text": "Marrow cellularity"
},
"subject": {
"reference": "PAT12345"
},
"valueString": "40% cellularity (appropriate for age)"
}
},
{
"resource": {
"resourceType": "Observation",
"id": "bm-blasts",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "58445-9",
"display": "Bone marrow blasts/100 cells"
}
],
"text": "Blast count"
},
"subject": {
"reference": "PAT12345"
},
"valueQuantity": {
"value": 1,
"unit": "%",
"system": "http://unitsofmeasure.org",
"code": "%"
},
"referenceRange": [
{
"low": { "value": 0, "unit": "%" },
"high": { "value": 5, "unit": "%" }
}
]
}
}
]
}
What are some things that might cause such a set of results?
{
"resourceType": "Bundle",
"type": "collection",
"entry": [
{
"resource": {
"resourceType": "Observation",
"id": "ana-screen",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "42254-3",
"display": "Antinuclear Ab [Presence] in Serum by Immunofluorescence"
}
]
},
"subject": { "reference": "PAT12345" },
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "10828004",
"display": "Positive"
}
]
}
}
},
{
"resource": {
"resourceType": "Observation",
"id": "ana-titer",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "5048-4",
"display": "Antinuclear Ab [Titer] in Serum by Immunofluorescence"
}
]
},
"subject": { "reference": "PAT12345" },
"valueQuantity": {
"value": 640,
"unit": "1:640",
"system": "http://unitsofmeasure.org",
"code": "{titer}"
}
}
},
{
"resource": {
"resourceType": "Observation",
"id": "ana-pattern",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "13068-2",
"display": "Nuclear Ab pattern [Interpretation] in Serum by Immunofluorescence"
}
]
},
"subject": { "reference": "PAT12345" },
"valueString": "Homogeneous and Speckled"
}
},
{
"resource": {
"resourceType": "Observation",
"id": "anti-dsDNA",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "7465-1",
"display": "DNA double strand Ab [Units/volume] in Serum"
}
]
},
"subject": { "reference": "PAT12345" },
"valueQuantity": {
"value": 120,
"unit": "IU/mL",
"system": "http://unitsofmeasure.org",
"code": "IU/mL"
},
"referenceRange": [
{ "high": { "value": 30, "unit": "IU/mL" } }
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "anti-sm",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "33939-6",
"display": "Smith extractable nuclear Ab [Units/volume] in Serum"
}
]
},
"subject": { "reference": "PAT12345" },
"valueQuantity": {
"value": 75,
"unit": "U/mL",
"system": "http://unitsofmeasure.org",
"code": "U/mL"
},
"referenceRange": [
{ "high": { "value": 20, "unit": "U/mL" } }
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "complement-c3",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "4485-9",
"display": "Complement C3 [Mass/volume] in Serum or Plasma"
}
]
},
"subject": { "reference": "PAT12345" },
"valueQuantity": {
"value": 60,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"referenceRange": [
{ "low": { "value": 90, "unit": "mg/dL" }, "high": { "value": 180, "unit": "mg/dL" } }
]
}
},
{
"resource": {
"resourceType": "Observation",
"id": "complement-c4",
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "4498-2",
"display": "Complement C4 [Mass/volume] in Serum or Plasma"
}
]
},
"subject": { "reference": "PAT12345" },
"valueQuantity": {
"value": 8,
"unit": "mg/dL",
"system": "http://unitsofmeasure.org",
"code": "mg/dL"
},
"referenceRange": [
{ "low": { "value": 15, "unit": "mg/dL" }, "high": { "value": 45, "unit": "mg/dL" } }
]
}
}
]
}
What's the most likely disease I have?