Read

From initial design work, it is expected the main use case will be labs and requesting systems polling the central service for test orders and reports, including associated clinical information, as well as polling the system for the current state of Tasks and Task update history, through associated AuditEvents and Provenance resources.

Retrieval of sets of resources using GraphDefinitions are also planned. The complete set of resources/operations supported are listed within the Instance page. All resources are expected to be compliant with UK Core FHIR R4.

Supported Functionality

  • The search parameters to be supported by the Genomic Order Management system are defined within the Instance page. Custom search parameters defined within SearchParameters will also be supported, such as a search parameter for supporting retrieval of supporting-info on ServiceRequests.

  • Multiple _include/_revinclude parameters will be supported within a single URL search string. The :iterate modifier will also be supported to enable traversal of multiple levels of references in searches e.g. GET [base]/MedicationDispense?_include=Medication:prescription&_include:iterate=MedicationRequest:requester&criteria....

  • The _history and _lastUpdated parameters will be supported as part of history and audit provenance needs. The _history parameter will only be supported on instance level reads, i.e. history will not be retrievable at the resource type or base levels.

  • Token type searching for coded values based on system and/or code e.g. http://snomed.info/sct%7C3738000 will be supported, to enable unambiguous searching of codes.

  • Date and number based prefixes, such as eq, gr, lt will be supported, to enable retrieval of resources based on date/time and quantity ranges.

  • Chaining, e.g. ServiceRequest?subject:Patient.name will be supported to aid building of complex search criteria.

  • Search result modifiers such as _count, _total and _sort will be supported to allow clients to tailor search results.

  • The :not operator will be supported to allow organizations visibility of tests outside their region, e.g. for home GLHs which want to see tests from within their patch routed to labs outside their region. An example of the query to support this would be:

GET [base]/ServiceRequest?requester:PractitionerRole.organization={ODS_codes_in_my_patch}&performer:not={my_GLH_code}
  • The :identifier modifier will be supported on SearchParameters of type reference, where identifiers are used within the referencing resource, in preference over inclusion of full resources, e.g. references using practitioner or organization identifiers, as the resources containing the relevant information logically sit within other NHS England services, e.g. SPINE SDS or ODS respectively.

Unsupported Functionality

  • Inclusion of external references (resources not hosted on the server) through the _include parameter will not be supported as there will be no guarantee they resolve or that they will return valid FHIR. While this may mean clients will need to perform multiple calls to construct a complete set of data, this ensures consistency of the responses from the broker. Within this Implementation Guide we expect a test requester to submit all relevant information for a test order to the broker so there should be very few instances where an external reference is used.

  • No use cases requiring use of _query or $operation type searches have been elaborated so these are not planned to be supported as of the time of publication. Equally, usage of tags to encode data, and use of the _tag parameter will not be supported until use cases detailing their need are elaborated.

  • Search modifiers such as :contains, :missing, :not-in, etc. will not be supported as there are currently no use cases for supporting text-based/fuzzy searching.

Common Patterns