Notice
- Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
- This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.
Test Request
Purpose
Elements are included for the billing approach, TAT/SLA tracking and prioritisation. To confirm validity of urgency and apply lower level prioritisation. To know which test has been requested, which further tests are required within this request and how many patients are being tested within this request.
Notes
Mapped to ServiceRequest, extensions are still in review. CI and CITT codes for genomic tests are pending addition to SNOMED-CT
Mapping
| ID | Source Data item | Target FHIR Element | HL7v2.5.1 Mapping | Description |
|---|---|---|---|---|
| TR-2 | Test request - Payment status | ServiceRequest.extension:coverage | IN1-15 | How the test request is funded. The current ValueSet for this field is pending addition to UK Core |
| TR-4 | Test request - Requesting reason rare disease | ServiceRequest.category | Likely ORC-29 (TBC) | The reason for a rare disease genomic test. |
| TR-38 | Test request - Requesting reason cancer | ServiceRequest.category. The current ValueSet for this field is pending addition to the Genomics IG | Likely ORC-29 (TBC) | The reason for a cancer genomic test. |
| TR-5 | Test request - High level test identifier | ServiceRequest.code.coding.code | OBR-4.1 | Legacy high level ids which identify the requested test. Options provided by old Test Directory. |
| TR-6 | Test request - High level test identifier description | ServiceRequest.code.coding.display | OBR-4.2 | Legacy high level name of the id requested |
| TR-7 | Test request - Low level test identifier | ServiceRequest.code.coding.code | OBR-4.1 | The low level CITT code which identifies the requested test. Options provided by Test Directory. |
| TR-8 | Test request - Low level test identifier description | ServiceRequest.code.coding.display | OBR-4.2 | The low level CITT name of the considered test. |
| TR-9 | Test request - Low level multipurpose test identifier | ServiceRequest.orderDetail.coding.code | OBR-4.1 | The low level code which identifies the test to be actioned when the CITT code is multipurpose. |
| TR-10 | Test request - Low level multipurpose test identifier description | ServiceRequest.orderDetail.coding.display | OBR-4.2 | The low level name of the test to be actioned when the CITT code is multipurpose. |
| TR-21 | Test request - Genomic package id | ServiceRequest.reasonCode.coding.code | OBR-31.1 | Id of the package requested. |
| TR-22 | Test request - Genomic package name | ServiceRequest.reasonCode.coding.display | OBR-31.2 | Name of the package requested. |
| TR-23 | Test request - Genomic package version | ServiceRequest.reasonCode.coding.extension:code-version | N/A Potentially part of OBR-31.3 | Version of the package requested. |
| TR-24 | Test request - Genomic test id | ServiceRequest.code.coding.code | OBR-4.1 | Id of the test requested. |
| TR-25 | Test request - Genomic test name | ServiceRequest.code.coding.display | OBR-4.2 | Name of the test requested. |
| TR-26 | Test request - Genomic test version | ServiceRequest.code.coding.extension:code-version | N/A Potentially part of OBR-4.3 | Version of the test requested. |
| TR-27 | Test request - Additional panels | Additional ServiceRequest.orderDetail elements | Additional OBR segments | Additional panels to test. |
| TR-28 | Test request - Target type | ServiceRequest.orderDetail.coding.system | OBR-4.3 | Type of target to test. |
| TR-29 | Test request - Target detail | ServiceRequest.orderDetail.coding.code | OBR-4.1 | Detail of target to test. |
| TR-11 | Test request - Count of patients to be tested | New extension for type of test on ServiceRequest. e.g. Duo/Trio, Can be inferred after submission by number of requests with same requisition ID | N/A - for HL7v2, each patient test request SHOULD be sent using a new OML^O21 message | Count of patients to be tested. |
| TR-12 | Test request - Urgency reason | ServiceRequest.extension:priorityReason | N/A could possibly use TQ1-10 | If urgent, the test request urgency reason. |
| TR-13 | Test request - Reason for reanalysis | Additional ServiceRequest.category elements | Likely ORC-29 (TBC) | The reason for a genomic test. |
| TR-14 | Test request - Detail of reason for reanalysis | ServiceRequest.supportingInfo elements (if structured, ServiceRequest.note if unstructured TBC) | NTE segments linked to OBR segment for reanalysis reason | The detail associated to the reason reanalysis has been requested. |
| TR-15 | Test request - Type of reanalysis | ServiceRequest.orderDetail | Additional NTE segments attached to OBR | The type of reanalysis which has been requested. |
| TR-17 | Test request - Is urgent | ServiceRequest.priority | TQ1-9 | Confirmation if the test request is urgent. |
| TR-35 | Test request - Purpose of linking | ServiceRequest.basedOn.display (TBC) | Potentially under the NTE segment for the order prior | The reason a given test request has been linked to another test request. |
| TR-36 | Test request - Central email address for reporting | Additional PractitionerRole.telecom:system=email (referenced from ServiceRequest.requester) marked with extension:contactpoint-comment indicating reporting, may need to be additionally indicated in subscription depending on notification method used TBC | Additional CTD segment (CTD-5.4) | Central email address for contingency in the event of not being able to obtain a report via the requester. |
| TR-20 | Test request - Genomic report delivery method | PractitionerRole.telecom.rank=1 (referenced from ServiceRequest.requester) TBC | CTD-6 | Report preferred delivery method. |
| TR-30 | Test request - Add private genomic request and report to NHS record | TBC No current mapping for this field in FHIR, could be added as an additional ServiceRequest.note | Potentially NTE segment related to OBR | Confirmation if the content of a private genomic test request should be added to an NHS record. |
| TR-31 | Test request - Test request form version | TBC No current mapping for this field in FHIR, though could be added as a reference to a Questionnaire via ServiceRequest.supportingInfo | Potentially NTE segment related to OBR | Version of the test order form completed and submitted. |
| TR-32 | Test request - File / Link to file | ServiceRequest.supportingInfo referencing DocumentReference containing/pointing to file | TBC N/A though could be captured in OBX-5 for order prior as encapsulated data | Upload of a file or a link to a file for adding documents such as previous genomic reports to a test order. |
| TR-33 | Test request - File detail | DocumentReference.type/description | Part of Order prior OBX-5 encapsulated data | Detail to provide context to an uploaded file or document link. |
| TR-34 | Test request - Clinical utility | TBC Potentially could be added as additional ServiceRequest.reasonCode elements, though a ValueSet matching the MDS needs to be developed | TBC OBR-31 | Clinical benefit to patient of obtaining a requested genomic report. |
| TR-39 | Test request - Linked test request reference | ServiceRequest.basedOn | ORC-8 | The reference to any associated test requests |