FHIR Genomics Implementation Guide

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.

Extension-UKCore-NHSNumberUnavailableReason

Usage

This extends the Patient resource to support the exchange of information about the reason why a patient does not have an NHS Number.

Context of Use

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Tree View

ExtensionUKCoreNHSNumberUnavailableReason (Extension)	I		Extension	Element id Extension Short description The reason why a patient does not have an NHS Number Definition The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Extension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Extension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	Element id Extension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description The reason why a patient does not have an NHS Number Definition The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient. Binding UKCoreNHSNumberUnavailableReason (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCodeableConcept			CodeableConcept	Data type CodeableConcept

Detailed Descriptions

Extension
Definition	The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.
Cardinality	0...1
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Extension.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Extension.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Extension.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Cardinality	1...1
Type	uri
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value	https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason
Mappings	rim: N/A
Extension.value[x]
Definition	The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.
Cardinality	1...1
Type	CodeableConcept
Binding	UKCoreNHSNumberUnavailableReason (extensible)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A

Table View

Extension		..1
Extension.url		..
Extension.value[x]	CodeableConcept	1..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="Extension-UKCore-NHSNumberUnavailableReason" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason" />
    <version value="1.0.0" />
    <name value="ExtensionUKCoreNHSNumberUnavailableReason" />
    <title value="Extension UK Core NHS Number Unavailable Reason" />
    <status value="active" />
    <date value="2023-04-28" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This extends the Patient resource to support the exchange of information about the reason why a patient does not have an NHS Number." />
    <purpose value="This extension is a Genomics use case to record why an NHS Number for the patient has not been provided within a test request. This differs from NHS Number trace status as this indicates reason." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <kind value="complex-type" />
    <abstract value="false" />
    <context>
        <type value="element" />
        <expression value="Patient" />
    </context>
    <type value="Extension" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
    <derivation value="constraint" />
    <differential>
        <element id="Extension">
            <path value="Extension" />
            <short value="The reason why a patient does not have an NHS Number" />
            <definition value="The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient." />
            <max value="1" />
        </element>
        <element id="Extension.url">
            <path value="Extension.url" />
            <fixedUri value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason" />
        </element>
        <element id="Extension.value[x]">
            <path value="Extension.value[x]" />
            <short value="The reason why a patient does not have an NHS Number" />
            <definition value="The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient." />
            <min value="1" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-NHSNumberUnavailableReason" />
            </binding>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "Extension-UKCore-NHSNumberUnavailableReason",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason",
    "version": "1.0.0",
    "name": "ExtensionUKCoreNHSNumberUnavailableReason",
    "title": "Extension UK Core NHS Number Unavailable Reason",
    "status": "active",
    "date": "2023-04-28",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This extends the Patient resource to support the exchange of information about the reason why a patient does not have an NHS Number.",
    "purpose": "This extension is a Genomics use case to record why an NHS Number for the patient has not been provided within a test request. This differs from NHS Number trace status as this indicates reason.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        }
    ],
    "kind": "complex-type",
    "abstract": false,
    "context":  [
        {
            "type": "element",
            "expression": "Patient"
        }
    ],
    "type": "Extension",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Extension",
                "path": "Extension",
                "short": "The reason why a patient does not have an NHS Number",
                "definition": "The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.",
                "max": "1"
            },
            {
                "id": "Extension.url",
                "path": "Extension.url",
                "fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason"
            },
            {
                "id": "Extension.value[x]",
                "path": "Extension.value[x]",
                "short": "The reason why a patient does not have an NHS Number",
                "definition": "The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.",
                "min": 1,
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-NHSNumberUnavailableReason"
                }
            }
        ]
    }
}

Examples

NHS Number Unavailable Reason- An example of the extension which states the reason a patient's NHS number is unavailable.

Example-UKCore-Extension-NHSNumberUnavailableReason

Propose a change to Extension-UKCore-NHSNumberUnavailableReason

Extension Specific Guidance

There is a binding within this extension to a ValueSet-Genomic-NHSNumber-Unavailable-Reason.