Investigations
Investigations - Data Model
Note - It is imperative for Consumers to not display unified lab reports via PFS. (MORE INFO / ELABORATION IS NEEDED).
Patient Facing Services incorporates the GP Connect data model, this contains guidelines on how Providers need to populate each of the FHIR resources. It is advised to read the data model first, to understand how this is being populated by GP clinical systems.
The relevant profiles in the data model are as follows:
Observation - CareConnect-GPC-Observation-1
DiagnosticReport - CareConnect-GPC-DiagnosticReport-1
Specimen - CareConnect-GPC-Specimen-1
ProcedureRequest - CareConnect-GPC-ProcedureRequest-1
However, not all clinical information stored on GP systems may be safe to display for the end user (patients / citizens). This guide is intended to help Consumers understand what is clinically safe and useful to display via PFS from the GP Connect data model. Please see the PFS recommendations below.
PFS Recommendation
Safe to display to patient / citizen - With a safety rating of 'High', 'Medium' or 'Low'.
Useful to display to patient / citizen - With a recommendation of 'Recommended' or 'Not recommended'.
For example, the element 'Id’ has a safety rating of ‘High’, meaning it can be shown via Patient Facing Services (PFS). However, we believe it may not be useful to display 'Not Recommended' for the patient / citizen. It’s worth noting, there are elements that will have no meaning or have any merit in being displayed such as ‘Id’. For example, some elements are just entities that link data together.
For further information on the labelling please visit Data model labels used within this guidance.
DiagnosticReport
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| identifier | ||
| basedOn | ||
| status | ||
| category | ||
| code | ||
| subject | ||
| context | ||
| issued | ||
| performer | ||
| specimen | ||
| result | ||
| codedDiagnosis | ||
| conclusion |
Specimen
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| accessionIdentifier | ||
| status | ||
| type | ||
| subject | ||
| receivedTime | ||
| collection | ||
| collection.extension[fastingStatus] | ||
| collection.collector | ||
| collection.collected | ||
| collection.quantity | ||
| collection.bodysite | ||
| note |
Observation - test group header
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| identifier | ||
| status | ||
| code | ||
| subject | ||
| context | ||
| effective[x] | ||
| issued | ||
| performer | ||
| interpretation | ||
| comment | ||
| specimen | ||
| related |
Observation - test result
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| identifier | ||
| status | ||
| category | ||
| code | ||
| subject | ||
| context | ||
| effective[x] | ||
| issued | ||
| performer | ||
| value[x] | ||
| dataAbsentReason | ||
| interpretation | ||
| comment | ||
| bodysite | ||
| method | ||
| specimen | ||
| referenceRange | ||
| related |
Observation - filing Comments
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| identifier | ||
| status | ||
| code | ||
| subject | ||
| context | ||
| effective[x] | ||
| issued | ||
| performer | ||
| value[x] | ||
| comment | ||
| related |
ProcedureRequest
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| identifier | ||
| status | ||
| intent | ||
| code | ||
| subject | ||
| performer | ||
| requester | ||
| reasonCode | ||
| reasonReference | ||
| note |
Further Information
Note - Not every element will have further information. Further information is to simply give additional context and perspective to the element.
DiagnosticReport
basedOn
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen. Even with a clear use case, please check that it will be supported by having data present from GP clinical systems.
status
Use with caution for PFS
Further information
The 'status' element is most useful when it’s a preliminary result, therefore it is advised to be used in such circumstances.
category
Use with caution for PFS
Further information
The ‘category’ status indicates the area of the laboratory where the report comes from. This may not be very helpful to users but can be particularly useful when displayed in a group. For example, pathology, microbiology groups. However, this is not always clear, lab reports don't always clearly indicate the type of test lab it's come from.
code
Use with caution for PFS
Further information
This element is a CodeableConcept, it is advised to use the original term text as your primary clinical term. For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
This isn't a code of a particular test, the code here is just a fixed value.
context
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
issued
Use with caution for PFS
Further information
The ‘issued’ element states the date the result was published, not the date when it was taken. However, if there is no specimen date, issue date may be used. (Please note, the date that's most relevant will vary according to your presentation for the data.)
specimen
Further information
The DiagnosticReport can refer to more than one specimen. Where this is the case, you may chose to utilise the 'specimen' element to group and organise results. If doing so, ensure the association of individual results in test groups where applicable is maintained.
result
Further information
This is directly equivalent to the element ‘related’ from observation test group header. DiagnosticReport ‘result’ points to the headers, individual results or filing comments. Observation test group header ‘related’ points to results or filing comments.
codedDiagnosis
Use with caution for PFS
Further information
This element is a CodeableConcept, it is advised to use the original term text as your primary clinical term. For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
Specimen
type
Use with caution for PFS
Further information
This element is a CodeableConcept, it is advised to use the original term text as your primary clinical term. For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
receivedTime
Further information
This element may be useful for a clinician to interpret but not for a patient
collection.extension[fastingStatus]
Further information
The element can be especially useful when interpreting clinical results. For example, blood sugar level results are lower if the patient has been fasting. Gives the citizen / patient understanding and context.
collection.collected
Further information
This element is advised as the preferential date to be displayed via PFS. (The date and time when the specimen were drawn).
note
Further information
It is not advised to show the ‘note’ element in a summary view via of lab results but must be included with the detail of the specimen.
Observation - test group header
status
Use with caution for PFS
Further information
The 'status' element is most useful when it’s a preliminary result, therefore it is advised to be used in such circumstances.
code
Use with caution for PFS
Further information
This element is a CodeableConcept, it is advised to use the original term text as your primary clinical term. For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
context
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
effective[x]
Further information
The aim is to get the closest date to when the sample was taken.
Preferred element order date:
- 'collection.collected' (The date of the sample (preferred date))
- 'effective[x]' (when the batch or tests were conducted)
- 'issued' (result was issued by the laboratory)
- 'effective[x]' via Observation filing comments - filed date (GP review / annotations - the filing is the act of finalising the sample on the patient record)
This represents the date the batch of tests are recorded as completed. In simple use cases for presenting the whole lab report, this date may not be useful to present as other dates may be more informative to the patient / citizen (e.g. collection date). However, there may be other use cases that can be utilised for this data. In the absence of the preferred dates, you may choose to substitute the date.
LAB REPORT ILLUSTRATION CAN BE LINKED HERE - This isn't presented to be prescriptive as to how to display the data, but it is presented to create a narrative of a scenario. Other display options may be added in future to demonstrate other uses of dates.
issued
Use with caution for PFS
Further information
The date the lab send out the result, this is not to be confused with the collection.collected date (drawn date.
specimen
Further information
The 'specimen' element can be used to group results and obtain common data items such as collection date. This is provided the results remain primarily organised within any test groups they are associated to.
related
Further information
This element must be used to identify the test results and any filing comments relating to this batch header.
This is directly equivalent to the element ‘result’. DiagnosticReport ‘result’ points to the headers, individual results or filing comments. Observation ‘related’ for a header points to results or filing comments.
Observation - test result
status
Use with caution for PFS
Further information
The 'status' element is most useful when it’s a preliminary result, therefore it is advised to be used in such circumstances.
category
Use with caution for PFS
Further information
The ‘category’ status indicates the area of the laboratory where the report comes from. In the event that ‘category’ is different across the whole report, you may want to use it to group or to section out the report.
We advise only showing category at the highest level. If everything is all from the same category, then this can be shown at the report level.
code
Use with caution for PFS
Further information
This element is a CodeableConcept, it is advised to use the original term text as your primary clinical term. For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
context
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
effective[x]
Further information
The aim is to get the closest date to when the sample was taken.
Preferred element order date:
- 'collection.collected' (The date of the sample (preferred date))
- 'effective[x]' (when the batch or tests were conducted)
- 'issued' (result was issued by the laboratory)
- 'effective[x]' via Observation filing comments - filed date (GP review / annotations - the filing is the act of finalising the sample on the patient record)
This represents the date the batch of tests are recorded as completed. In simple use cases for presenting the whole lab report, this date may not be useful to present as other dates may be more informative to the patient / citizen (e.g. collection date). However, there may be other use cases that can be utilised for this data. In the absence of the preferred dates, you may choose to substitute the date.
LAB REPORT ILLUSTRATION CAN BE LINKED HERE - This isn't presented to be prescriptive as to how to display the data, but it is presented to create a narrative of a scenario. Other display options may be added in future to demonstrate other uses of dates.
issued
Use with caution for PFS
Further information
The date the lab send out the result, this is not to be confused with the collection.collected date (drawn date.
dataAbsentReason
Further information
The element can be used in scenarios such as lab results being lost – which may return a message stating "sample lost, please return". This can be especially useful to a patient / citizen to prompt them to book into the surgery for another sample to be taken.
specimen
Further information
The 'specimen' element can be used to group results and obtain common data items such as collection date. This is provided the results remain primarily organised within any test groups they are associated to.
related
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
Observation - filing Comments
status
Use with caution for PFS
Further information
There is no use case defined for the element 'status'. The expectation is it will only ever be set to unknown.
context
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
effective[x]
Further information
The aim is to get the closest date to when the sample was taken.
Preferred element order date:
- 'collection.collected' (The date of the sample (preferred date))
- 'effective[x]' (when the batch or tests were conducted)
- 'issued' (result was issued by the laboratory)
- 'effective[x]' via Observation filing comments - filed date (GP review / annotations - the filing is the act of finalising the sample on the patient record)
If presenting either the whole report or a part of the report filed to the record (when it becomes visible to the patient / citizen to view). Then the ‘effective[x]’ date from the filing comment is used, you cannot substitute it for anything else.
Or in the scenario of wanting a filing comment on to a lab report but wanted to date the report to the relevant date for the patient. Then the hierarchy displayed above may fit. However, this can all vary depending on other ruse cases.
LAB REPORT ILLUSTRATION CAN BE LINKED HERE - This isn't presented to be prescriptive as to how to display the data, but it is presented to create a narrative of a scenario. Other display options may be added in future to demonstrate other uses of dates.
issued
Use with caution for PFS
Further information
The date the lab send out the result, this is not to be confused with the collection.collected date (drawn date).
related
Use with caution for PFS
Further information
This references the test result or test group header that the filing comments resource relates to. However, this is not always going to be populated.
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
ProcedureRequest
status
Use with caution for PFS
Further information
The 'status' element is a fixed value and shouldn't be conveying any meaning in terms of its status. It should always be set as done.
intent
Not advised for PFS
Further information
There is potential for the language “order” to be misunderstood by patients or citizens. This may cause them to take an inappropriate action as a consequence.
code
Use with caution for PFS
Further information
This element is a CodeableConcept, it is advised to use the original term text as your primary clinical term. For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -