Multi-cancer Early Detection

<fullUrl value="urn:uuid:2fdd9240-62ea-4180-95cb-0bb8351f8a60" />
<resource>
<MessageHeader>
<id value="2fdd9240-62ea-4180-95cb-0bb8351f8a60" />
<eventCoding>
<system value="http://snomed.info/sct" />
<code value="371528001" />
<display value="Pathology report" />
</eventCoding>
<destination>
<name value="Executive Agency - NHS ENGLAND - X26" />
<endpoint value="mesh-mailbox-nhs" />
<receiver>
<reference value="urn:uuid:c0ddd1c4-306e-4829-9d87-ea040d92cb27" />
</receiver>
</destination>
<sender>
<reference value="urn:uuid:1667dd0a-8aab-4999-80b7-dd6b930860f9" />
</sender>
<source>
<endpoint value="mesh-mailbox-ScreeningOrg" />
</source>
<focus>
<!--  Goes to the DiagnosticReport  -->
<reference value="urn:uuid:1ba48cf0-77a4-48b5-b4dd-bf0d1f2f973d" />
</focus>
<definition value="https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport" />
</MessageHeader>
</resource>

</entry>

<fullUrl value="urn:uuid:1667dd0a-8aab-4999-80b7-dd6b930860f9" />
<resource>
<Organization>
<id value="1667dd0a-8aab-4999-80b7-dd6b930860f9" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="ABC123" />
</identifier>
<name value="Screening Organisation Ltd" />
<address>
<text value="Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588" />
<resource>
<Organization>
<id value="9dccdf9d-d297-448f-b4f4-8f7721089588" />
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CLIA" />
<value value="ScreeningLab34D2231294CLIA" />
</identifier>
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CAP" />
<value value="ScreeningLab6793CAP" />
</identifier>
<name value="Screening Lab Name" />
<telecom>
<system value="phone" />
<value value="+18336942553" />
</telecom>
<telecom>
<system value="fax" />
<value value="+16509999000" />
</telecom>
<telecom>
<system value="email" />
<value value="customerservice@screeninglab.com" />
</telecom>
<address>
<text value="Screening Lab Name, The Lab, Anytown, AT66 7TY" />
</address>
<contact>
<name>
<text value="Ms Lab DIRECTOR" />
</name>
</contact>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:c0ddd1c4-306e-4829-9d87-ea040d92cb27" />
<resource>
<Organization>
<id value="c0ddd1c4-306e-4829-9d87-ea040d92cb27" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="X26" />
</identifier>
<name value="Executive Agency - NHS ENGLAND - X26" />
<address>
<line value="THE LEEDS GOVERNMENT HUB" />
<line value="7-8 WELLINGTON PLACE" />
<city value="LEEDS" />
<district value="WEST YORKSHIRE" />
<postalCode value="LS1 4AP" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:f389ca3a-e1a4-46f9-ad3a-3cfcc5fbacb7" />
<resource>
<Practitioner>
<id value="f389ca3a-e1a4-46f9-ad3a-3cfcc5fbacb7" />
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="3415870223" />
</identifier>
<name>
<text value="Dr. Daniel Davies" />
</name>
<address>
<text value="NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK" />
</address>
</Practitioner>
</resource>

</entry>

<fullUrl value="urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99" />
<resource>
<Patient>
<id value="17473ce3-f258-4112-b0b6-ac4982f07f99" />
<identifier>
<system value="https://ScreeningOrg/patient-id" />
<value value="NHS-AB12-CD34" />
</identifier>
</Patient>
</resource>

</entry>

<fullUrl value="urn:uuid:18b04eb1-01b6-4484-8dd8-da3bb636b1a5" />
<resource>
<ServiceRequest>
<id value="18b04eb1-01b6-4484-8dd8-da3bb636b1a5" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99" />
<display value="NHS-AB12-CD34" />
</subject>
<requester>
<reference value="urn:uuid:f389ca3a-e1a4-46f9-ad3a-3cfcc5fbacb7" />
<display value="Dr. Daniel Davies" />
</requester>
<performer>
<reference value="urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588" />
<display value="Screening Lab" />
</performer>
</ServiceRequest>
</resource>

</entry>

<fullUrl value="urn:uuid:1ba48cf0-77a4-48b5-b4dd-bf0d1f2f973d" />
<resource>
<DiagnosticReport>
<id value="1ba48cf0-77a4-48b5-b4dd-bf0d1f2f973d" />
<extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note">
<valueAnnotation>
<text value="Some Lab Comments" />
</valueAnnotation>
</extension>
<basedOn>
<reference value="urn:uuid:18b04eb1-01b6-4484-8dd8-da3bb636b1a5" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="721981007" />
<display value="Diagnostic studies report" />
</coding>
</code>
<subject>
<reference value="urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08" />
<display value="NHS9123123" />
</specimen>
<!--  result is the Observation grouper  -->
<result>
<reference value="urn:uuid:bcf61153-9f23-4b56-bfab-2650ee01878e" />
</result>
<conclusion value="The test results report PDF document is the official source of the test result and contains important information regarding the test and the patient's test results. Please read the official report for complete results." />
<!--  The PDF report goes here  -->
<presentedForm>
<contentType value="application/pdf" />
<data value="VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU=" />
</presentedForm>
</DiagnosticReport>
</resource>

</entry>

<fullUrl value="urn:uuid:bcf61153-9f23-4b56-bfab-2650ee01878e" />
<resource>
<Observation>
<id value="bcf61153-9f23-4b56-bfab-2650ee01878e" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08" />
<display value="NHS9123123" />
</specimen>
<!--  the overall detected / not detected  -->
<hasMember>
<reference value="urn:uuid:4a26bdd2-bb57-4f69-8f03-00ac6f1f8351" />
</hasMember>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:4a26bdd2-bb57-4f69-8f03-00ac6f1f8351" />
<resource>
<Observation>
<id value="4a26bdd2-bb57-4f69-8f03-00ac6f1f8351" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<basedOn>
<reference value="urn:uuid:18b04eb1-01b6-4484-8dd8-da3bb636b1a5" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854971000000106" />
<display value="Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing" />
</coding>
</code>
<subject>
<reference value="urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588" />
<display value="Screening Lab" />
</performer>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854991000000105" />
<display value="Multi-cancer early detection signal not detected" />
</coding>
</valueCodeableConcept>
<specimen>
<reference value="urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08" />
<display value="NHS9123123" />
</specimen>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08" />
<resource>
<Specimen>
<id value="f6dc2f5c-b1c9-41c3-b837-1e860abc3c08" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="available" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119297000" />
<display value="Blood specimen" />
</coding>
</type>
<subject>
<reference value="urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99" />
<display value="NHS-AB12-CD34" />
</subject>
<collection>
<collectedDateTime value="2020-09-23T11:00:00+00:00" />
</collection>
</Specimen>
</resource>

</entry>

</Bundle>

{

"resourceType": "Bundle",

"id": "MCED-CancerMarkersNotDetected-Example",

"meta": {

"lastUpdated": "2020-09-20T10:22:00+00:00"

"identifier": {

"system": "https://tools.ietf.org/html/rfc4122",

"value": "b84acc4c-81cb-4c6c-a08d-8631edc61f7f"

"type": "message",

"entry": [

{

"fullUrl": "urn:uuid:2fdd9240-62ea-4180-95cb-0bb8351f8a60",

"resource": {

"resourceType": "MessageHeader",

"id": "2fdd9240-62ea-4180-95cb-0bb8351f8a60",

"eventCoding": {

"system": "http://snomed.info/sct",
"code": "371528001",
"display": "Pathology report"

"destination": [

{

"name": "Executive Agency - NHS ENGLAND - X26",

"endpoint": "mesh-mailbox-nhs",

"receiver": {

"reference": "urn:uuid:c0ddd1c4-306e-4829-9d87-ea040d92cb27"

}

"sender": {

"reference": "urn:uuid:1667dd0a-8aab-4999-80b7-dd6b930860f9"

"source": {

"endpoint": "mesh-mailbox-ScreeningOrg"

"focus": [

{

"reference": "urn:uuid:1ba48cf0-77a4-48b5-b4dd-bf0d1f2f973d"

}

"definition": "https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport"

}

{

"fullUrl": "urn:uuid:1667dd0a-8aab-4999-80b7-dd6b930860f9",

"resource": {

"resourceType": "Organization",

"id": "1667dd0a-8aab-4999-80b7-dd6b930860f9",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "ABC123"

}

"name": "Screening Organisation Ltd",

"address": [

{

"text": "Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT"

}

]

}

{

"fullUrl": "urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588",

"resource": {

"resourceType": "Organization",

"id": "9dccdf9d-d297-448f-b4f4-8f7721089588",

"identifier": [

{

"system": "http://terminology.hl7.org/NamingSystem/CLIA",

"value": "ScreeningLab34D2231294CLIA"

{

"system": "http://terminology.hl7.org/NamingSystem/CAP",

"value": "ScreeningLab6793CAP"

}

"name": "Screening Lab Name",

"telecom": [

{

"system": "phone",

"value": "+18336942553"

{

"system": "fax",

"value": "+16509999000"

{

"system": "email",

"value": "customerservice@screeninglab.com"

}

"address": [

{

"text": "Screening Lab Name, The Lab, Anytown, AT66 7TY"

}

"contact": [

{

"name": {

"text": "Ms Lab DIRECTOR"

}

]

}

{

"fullUrl": "urn:uuid:c0ddd1c4-306e-4829-9d87-ea040d92cb27",

"resource": {

"resourceType": "Organization",

"id": "c0ddd1c4-306e-4829-9d87-ea040d92cb27",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "X26"

}

"name": "Executive Agency - NHS ENGLAND - X26",

"address": [

{

"line": [
"THE LEEDS GOVERNMENT HUB",
"7-8 WELLINGTON PLACE"
],
"city": "LEEDS",
"district": "WEST YORKSHIRE",
"postalCode": "LS1 4AP"

}

]

}

{

"fullUrl": "urn:uuid:f389ca3a-e1a4-46f9-ad3a-3cfcc5fbacb7",

"resource": {

"resourceType": "Practitioner",

"id": "f389ca3a-e1a4-46f9-ad3a-3cfcc5fbacb7",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/sds-user-id",

"value": "3415870223"

}

"name": [

{

"text": "Dr. Daniel Davies"

}

"address": [

{

"text": "NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK"

}

]

}

{

"fullUrl": "urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99",

"resource": {

"resourceType": "Patient",

"id": "17473ce3-f258-4112-b0b6-ac4982f07f99",

"identifier": [

{

"system": "https://ScreeningOrg/patient-id",

"value": "NHS-AB12-CD34"

}

]

}

{

"fullUrl": "urn:uuid:18b04eb1-01b6-4484-8dd8-da3bb636b1a5",

"resource": {

"resourceType": "ServiceRequest",

"id": "18b04eb1-01b6-4484-8dd8-da3bb636b1a5",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "active",

"intent": "order",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99",

"display": "NHS-AB12-CD34"

"requester": {

"reference": "urn:uuid:f389ca3a-e1a4-46f9-ad3a-3cfcc5fbacb7",

"display": "Dr. Daniel Davies"

"performer": [

{

"reference": "urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588",

"display": "Screening Lab"

}

]

}

{

"fullUrl": "urn:uuid:1ba48cf0-77a4-48b5-b4dd-bf0d1f2f973d",

"resource": {

"resourceType": "DiagnosticReport",

"id": "1ba48cf0-77a4-48b5-b4dd-bf0d1f2f973d",

"extension": [

{

"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note",

"text": "Some Lab Comments"

}

"basedOn": [

{

"reference": "urn:uuid:18b04eb1-01b6-4484-8dd8-da3bb636b1a5"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"

}

]

"subject": {

"reference": "urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588",

"display": "Screening Lab"

}

"specimen": [

{

"reference": "urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08",

"display": "NHS9123123"

}

"result": [

{

"reference": "urn:uuid:bcf61153-9f23-4b56-bfab-2650ee01878e"

}

"conclusion": "The test results report PDF document is the official source of the test result and contains important information regarding the test and the patient's test results. Please read the official report for complete results.",

{

"contentType": "application/pdf",

"data": "VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU="

}

]

}

{

"fullUrl": "urn:uuid:bcf61153-9f23-4b56-bfab-2650ee01878e",

"resource": {

"resourceType": "Observation",

"id": "bcf61153-9f23-4b56-bfab-2650ee01878e",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588",

"display": "Screening Lab"

}

"specimen": {

"reference": "urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08",

"display": "NHS9123123"

"hasMember": [

{

"reference": "urn:uuid:4a26bdd2-bb57-4f69-8f03-00ac6f1f8351"

}

]

}

{

"fullUrl": "urn:uuid:4a26bdd2-bb57-4f69-8f03-00ac6f1f8351",

"resource": {

"resourceType": "Observation",

"id": "4a26bdd2-bb57-4f69-8f03-00ac6f1f8351",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"basedOn": [

{

"reference": "urn:uuid:18b04eb1-01b6-4484-8dd8-da3bb636b1a5"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854971000000106",
"display": "Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing"

}

]

"subject": {

"reference": "urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:9dccdf9d-d297-448f-b4f4-8f7721089588",

"display": "Screening Lab"

}

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854991000000105",
"display": "Multi-cancer early detection signal not detected"

}

]

"specimen": {

"reference": "urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08",

"display": "NHS9123123"

}

{

"fullUrl": "urn:uuid:f6dc2f5c-b1c9-41c3-b837-1e860abc3c08",

"resource": {

"resourceType": "Specimen",

"id": "f6dc2f5c-b1c9-41c3-b837-1e860abc3c08",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "available",

"type": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"

}

]

"subject": {

"reference": "urn:uuid:17473ce3-f258-4112-b0b6-ac4982f07f99",

"display": "NHS-AB12-CD34"

"collection": {

"collectedDateTime": "2020-09-23T11:00:00+00:00"

}

]

}

Example - Cancer Markers Detected

<meta>

</meta>

</identifier>

<fullUrl value="urn:uuid:a4409d7c-b613-477c-b623-87e60406c2f0" />
<resource>
<MessageHeader>
<id value="a4409d7c-b613-477c-b623-87e60406c2f0" />
<eventCoding>
<system value="http://snomed.info/sct" />
<code value="371528001" />
<display value="Pathology report" />
</eventCoding>
<destination>
<name value="Executive Agency - NHS ENGLAND - X26" />
<endpoint value="mesh-mailbox-nhs" />
<receiver>
<reference value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
</receiver>
</destination>
<sender>
<reference value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
</sender>
<source>
<endpoint value="mesh-mailbox-ScreeningOrg" />
</source>
<focus>
<!-- Goes to the DiagnosticReport -->
<reference value="urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
</focus>
<definition value="https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport" />
</MessageHeader>
</resource>

</entry>

<fullUrl value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
<resource>
<Organization>
<id value="d6407de7-0e86-45eb-93cb-035094aaa49e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="ABC123" />
</identifier>
<name value="Screening Organisation Ltd" />
<address>
<text value="Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<resource>
<Organization>
<id value="e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CLIA" />
<value value="ScreeningLab34D2231294CLIA" />
</identifier>
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CAP" />
<value value="ScreeningLab6793CAP" />
</identifier>
<name value="Screening Lab Name" />
<telecom>
<system value="phone" />
<value value="+18336942553" />
</telecom>
<telecom>
<system value="fax" />
<value value="+16509999000" />
</telecom>
<telecom>
<system value="email" />
<value value="customerservice@screeninglab.com" />
</telecom>
<address>
<text value="Screening Lab Name, The Lab, Anytown, AT66 7TY" />
</address>
<contact>
<name>
<text value="Ms Lab DIRECTOR" />
</name>
</contact>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<resource>
<Organization>
<id value="bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="X26" />
</identifier>
<name value="Executive Agency - NHS ENGLAND - X26" />
<address>
<line value="THE LEEDS GOVERNMENT HUB" />
<line value="7-8 WELLINGTON PLACE" />
<city value="LEEDS" />
<district value="WEST YORKSHIRE" />
<postalCode value="LS1 4AP" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<resource>
<Practitioner>
<id value="f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="3415870223" />
</identifier>
<name>
<text value="Dr. Daniel Davies" />
</name>
<address>
<text value="NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK" />
</address>
</Practitioner>
</resource>

</entry>

<fullUrl value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<resource>
<Patient>
<id value="8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<identifier>
<system value="https://ScreeningOrg/patient-id" />
<value value="NHS-AB12-CD34" />
</identifier>
</Patient>
</resource>

</entry>

<fullUrl value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
<resource>
<ServiceRequest>
<id value="d9df1431-22ac-462a-946a-f195f6c639af" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<requester>
<reference value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<display value="Dr. Daniel Davies" />
</requester>
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
</ServiceRequest>
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</entry>

<fullUrl value="urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
<resource>
<DiagnosticReport>
<id value="3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
<extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note">
<valueAnnotation>
<text value="Some Lab Comments" />
</valueAnnotation>
</extension>
<basedOn>
<reference value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="721981007" />
<display value="Diagnostic studies report" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
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<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
<!-- result is the Observation grouper -->
<result>
<reference value="urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
</result>
<conclusion value="The test results report PDF document is the official source of the test result and contains important information regarding the test and the patient's test results. Please read the official report for complete results." />
<!-- The PDF report goes here -->
<presentedForm>
<contentType value="application/pdf" />
<data value="VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU=" />
</presentedForm>
</DiagnosticReport>
</resource>

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<fullUrl value="urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
<resource>
<Observation>
<id value="9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
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<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
<!-- the overall detected / not detected -->
<hasMember>
<reference value="urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4" />
</hasMember>
<!-- primary site -->
<hasMember>
<reference value="urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db" />
</hasMember>
<!-- secondary site -->
<hasMember>
<reference value="urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f" />
</hasMember>
</Observation>
</resource>

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<fullUrl value="urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4" />
<resource>
<Observation>
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<identifier>
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<value value="NHS9123123" />
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<basedOn>
<reference value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854971000000106" />
<display value="Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing" />
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</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
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<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
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<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854981000000108" />
<display value="Multi-cancer early detection signal detected" />
</coding>
</valueCodeableConcept>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
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<fullUrl value="urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db" />
<resource>
<Observation>
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<identifier>
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<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873921000000106" />
<display value="Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier" />
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</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
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<issued value="2019-01-29T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
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<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="89837001" />
<display value="Urinary bladder structure" />
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<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
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<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="57789003" />
<display value="Structure of urothelium" />
</coding>
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<fullUrl value="urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f" />
<resource>
<Observation>
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<identifier>
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<value value="NHS9123123" />
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<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873931000000108" />
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<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
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<performer>
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<component>
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<coding>
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<code value="123037004" />
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<coding>
<system value="http://snomed.info/sct" />
<code value="64033007" />
<display value="Kidney structure" />
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<fullUrl value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<resource>
<Specimen>
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<identifier>
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<value value="NHS9123123" />
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<status value="available" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119297000" />
<display value="Blood specimen" />
</coding>
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<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
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<collection>
<collectedDateTime value="2020-09-23T11:00:00+00:00" />
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{

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{

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{

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{

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{

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"code": "1854971000000106",
"display": "Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854981000000108",
"display": "Multi-cancer early detection signal detected"

}

]

"specimen": {

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

}

{

"fullUrl": "urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db",

"resource": {

"resourceType": "Observation",

"id": "dacb177a-9501-4dcc-8b22-b941791ae0db",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873921000000106",
"display": "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "89837001",
"display": "Urinary bladder structure"

}

]

}

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "57789003",
"display": "Structure of urothelium"

}

]

}

]

}

{

"fullUrl": "urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f",

"resource": {

"resourceType": "Observation",

"id": "3f9730c8-5527-4f58-9865-55aef4dfa11f",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873931000000108",
"display": "Multi-cancer early detection second highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "64033007",
"display": "Kidney structure"

}

]

}

]

}

{

"fullUrl": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"resource": {

"resourceType": "Specimen",

"id": "756a8361-79ce-4561-afcb-a91fe19df123",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "available",

"type": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"collection": {

"collectedDateTime": "2020-09-23T11:00:00+00:00"

}

]

}

Example - Cancer Markers Detected Single Probable Site

<meta>

</meta>

</identifier>

<fullUrl value="urn:uuid:0a43b490-de91-4665-ab8b-0e868ea7f043" />
<resource>
<MessageHeader>
<id value="0a43b490-de91-4665-ab8b-0e868ea7f043" />
<eventCoding>
<system value="http://snomed.info/sct" />
<code value="371528001" />
<display value="Pathology report" />
</eventCoding>
<destination>
<name value="Executive Agency - NHS ENGLAND - X26" />
<endpoint value="mesh-mailbox-nhs" />
<receiver>
<reference value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
</receiver>
</destination>
<sender>
<reference value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
</sender>
<source>
<endpoint value="mesh-mailbox-ScreeningOrg" />
</source>
<focus>
<!-- Goes to the DiagnosticReport -->
<reference value="urn:uuid:871032f5-a59e-4e11-954a-867519e0e640" />
</focus>
<definition value="https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport" />
</MessageHeader>
</resource>

</entry>

<fullUrl value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
<resource>
<Organization>
<id value="d6407de7-0e86-45eb-93cb-035094aaa49e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="ABC123" />
</identifier>
<name value="Screening Organisation Ltd" />
<address>
<text value="Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<resource>
<Organization>
<id value="e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CLIA" />
<value value="ScreeningLab34D2231294CLIA" />
</identifier>
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CAP" />
<value value="ScreeningLab6793CAP" />
</identifier>
<name value="Screening Lab Name" />
<telecom>
<system value="phone" />
<value value="+18336942553" />
</telecom>
<telecom>
<system value="fax" />
<value value="+16509999000" />
</telecom>
<telecom>
<system value="email" />
<value value="customerservice@screeninglab.com" />
</telecom>
<address>
<text value="Screening Lab Name, The Lab, Anytown, AT66 7TY" />
</address>
<contact>
<name>
<text value="Ms Lab DIRECTOR" />
</name>
</contact>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<resource>
<Organization>
<id value="bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="X26" />
</identifier>
<name value="Executive Agency - NHS ENGLAND - X26" />
<address>
<line value="THE LEEDS GOVERNMENT HUB" />
<line value="7-8 WELLINGTON PLACE" />
<city value="LEEDS" />
<district value="WEST YORKSHIRE" />
<postalCode value="LS1 4AP" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:e638a8c1-d2ce-4866-8874-b58ad4476928" />
<resource>
<Practitioner>
<id value="e638a8c1-d2ce-4866-8874-b58ad4476928" />
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="3415870223" />
</identifier>
<name>
<text value="Dr. Daniel Davies" />
</name>
<address>
<text value="NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK" />
</address>
</Practitioner>
</resource>

</entry>

<fullUrl value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<resource>
<Patient>
<id value="9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<identifier>
<system value="https://ScreeningOrg/patient-id" />
<value value="NHS-AB12-CD34" />
</identifier>
</Patient>
</resource>

</entry>

<fullUrl value="urn:uuid:ebb4078d-4365-47d8-b2cc-538e2b0a749a" />
<resource>
<ServiceRequest>
<id value="ebb4078d-4365-47d8-b2cc-538e2b0a749a" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<display value="NHS-AB12-CD34" />
</subject>
<requester>
<reference value="urn:uuid:e638a8c1-d2ce-4866-8874-b58ad4476928" />
<display value="Dr. Daniel Davies" />
</requester>
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
</ServiceRequest>
</resource>

</entry>

<fullUrl value="urn:uuid:871032f5-a59e-4e11-954a-867519e0e640" />
<resource>
<DiagnosticReport>
<id value="871032f5-a59e-4e11-954a-867519e0e640" />
<extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note">
<valueAnnotation>
<text value="Some Lab Comments" />
</valueAnnotation>
</extension>
<basedOn>
<reference value="urn:uuid:ebb4078d-4365-47d8-b2cc-538e2b0a749a" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="721981007" />
<display value="Diagnostic studies report" />
</coding>
</code>
<subject>
<reference value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af" />
<display value="NHS9123123" />
</specimen>
<!-- result is the Observation grouper -->
<result>
<reference value="urn:uuid:a7d5aec0-e404-4fd7-90d5-0c3b5df77ea1" />
</result>
<conclusion value="The test results report PDF document is the official source of the test result and contains important information regarding the test and the patient's test results. Please read the official report for complete results." />
<!-- The PDF report goes here -->
<presentedForm>
<contentType value="application/pdf" />
<data value="VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU=" />
</presentedForm>
</DiagnosticReport>
</resource>

</entry>

<fullUrl value="urn:uuid:a7d5aec0-e404-4fd7-90d5-0c3b5df77ea1" />
<resource>
<Observation>
<id value="a7d5aec0-e404-4fd7-90d5-0c3b5df77ea1" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
</meta>
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af" />
<display value="NHS9123123" />
</specimen>
<!-- the overall detected / not detected -->
<hasMember>
<reference value="urn:uuid:82faf6a6-e463-41ca-a957-5a8e4cbef879" />
</hasMember>
<!-- primary site -->
<hasMember>
<reference value="urn:uuid:52860bac-8a23-4386-9198-aaceffa4dbb5" />
</hasMember>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:82faf6a6-e463-41ca-a957-5a8e4cbef879" />
<resource>
<Observation>
<id value="82faf6a6-e463-41ca-a957-5a8e4cbef879" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
</meta>
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<basedOn>
<reference value="urn:uuid:ebb4078d-4365-47d8-b2cc-538e2b0a749a" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854971000000106" />
<display value="Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing" />
</coding>
</code>
<subject>
<reference value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854981000000108" />
<display value="Multi-cancer early detection signal detected" />
</coding>
</valueCodeableConcept>
<specimen>
<reference value="urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af" />
<display value="NHS9123123" />
</specimen>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:52860bac-8a23-4386-9198-aaceffa4dbb5" />
<resource>
<Observation>
<id value="52860bac-8a23-4386-9198-aaceffa4dbb5" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" />
</meta>
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873921000000106" />
<display value="Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier" />
</coding>
</code>
<subject>
<reference value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2019-01-29T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="89837001" />
<display value="Urinary bladder structure" />
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af" />
<resource>
<Specimen>
<id value="189fd847-0b83-40f4-98d4-89421e4a89af" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="available" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119297000" />
<display value="Blood specimen" />
</coding>
</type>
<subject>
<reference value="urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299" />
<display value="NHS-AB12-CD34" />
</subject>
<collection>
<collectedDateTime value="2020-09-23T11:00:00+00:00" />
</collection>
</Specimen>
</resource>

</entry>

</Bundle>

{

"resourceType": "Bundle",

"id": "MCED-CancerMarkersDetectedSingleProbableSite-Example",

"meta": {

"lastUpdated": "2020-09-20T10:22:00+00:00"

"identifier": {

"system": "https://tools.ietf.org/html/rfc4122",

"value": "8693565b-5e18-423e-8922-52bdaff17104"

"type": "message",

"entry": [

{

"fullUrl": "urn:uuid:0a43b490-de91-4665-ab8b-0e868ea7f043",

"resource": {

"resourceType": "MessageHeader",

"id": "0a43b490-de91-4665-ab8b-0e868ea7f043",

"eventCoding": {

"system": "http://snomed.info/sct",
"code": "371528001",
"display": "Pathology report"

"destination": [

{

"name": "Executive Agency - NHS ENGLAND - X26",

"endpoint": "mesh-mailbox-nhs",

"receiver": {

"reference": "urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e"

}

"sender": {

"reference": "urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e"

"source": {

"endpoint": "mesh-mailbox-ScreeningOrg"

"focus": [

{

"reference": "urn:uuid:871032f5-a59e-4e11-954a-867519e0e640"

}

"definition": "https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport"

}

{

"fullUrl": "urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e",

"resource": {

"resourceType": "Organization",

"id": "d6407de7-0e86-45eb-93cb-035094aaa49e",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "ABC123"

}

"name": "Screening Organisation Ltd",

"address": [

{

"text": "Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT"

}

]

}

{

"fullUrl": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"resource": {

"resourceType": "Organization",

"id": "e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"identifier": [

{

"system": "http://terminology.hl7.org/NamingSystem/CLIA",

"value": "ScreeningLab34D2231294CLIA"

{

"system": "http://terminology.hl7.org/NamingSystem/CAP",

"value": "ScreeningLab6793CAP"

}

"name": "Screening Lab Name",

"telecom": [

{

"system": "phone",

"value": "+18336942553"

{

"system": "fax",

"value": "+16509999000"

{

"system": "email",

"value": "customerservice@screeninglab.com"

}

"address": [

{

"text": "Screening Lab Name, The Lab, Anytown, AT66 7TY"

}

"contact": [

{

"name": {

"text": "Ms Lab DIRECTOR"

}

]

}

{

"fullUrl": "urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e",

"resource": {

"resourceType": "Organization",

"id": "bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "X26"

}

"name": "Executive Agency - NHS ENGLAND - X26",

"address": [

{

"line": [
"THE LEEDS GOVERNMENT HUB",
"7-8 WELLINGTON PLACE"
],
"city": "LEEDS",
"district": "WEST YORKSHIRE",
"postalCode": "LS1 4AP"

}

]

}

{

"fullUrl": "urn:uuid:e638a8c1-d2ce-4866-8874-b58ad4476928",

"resource": {

"resourceType": "Practitioner",

"id": "e638a8c1-d2ce-4866-8874-b58ad4476928",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/sds-user-id",

"value": "3415870223"

}

"name": [

{

"text": "Dr. Daniel Davies"

}

"address": [

{

"text": "NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK"

}

]

}

{

"fullUrl": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"resource": {

"resourceType": "Patient",

"id": "9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"identifier": [

{

"system": "https://ScreeningOrg/patient-id",

"value": "NHS-AB12-CD34"

}

]

}

{

"fullUrl": "urn:uuid:ebb4078d-4365-47d8-b2cc-538e2b0a749a",

"resource": {

"resourceType": "ServiceRequest",

"id": "ebb4078d-4365-47d8-b2cc-538e2b0a749a",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "active",

"intent": "order",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"display": "NHS-AB12-CD34"

"requester": {

"reference": "urn:uuid:e638a8c1-d2ce-4866-8874-b58ad4476928",

"display": "Dr. Daniel Davies"

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

]

}

{

"fullUrl": "urn:uuid:871032f5-a59e-4e11-954a-867519e0e640",

"resource": {

"resourceType": "DiagnosticReport",

"id": "871032f5-a59e-4e11-954a-867519e0e640",

"extension": [

{

"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note",

"text": "Some Lab Comments"

}

"basedOn": [

{

"reference": "urn:uuid:ebb4078d-4365-47d8-b2cc-538e2b0a749a"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"

}

]

"subject": {

"reference": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"specimen": [

{

"reference": "urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af",

"display": "NHS9123123"

}

"result": [

{

"reference": "urn:uuid:a7d5aec0-e404-4fd7-90d5-0c3b5df77ea1"

}

{

"contentType": "application/pdf",

"data": "VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU="

}

]

}

{

"fullUrl": "urn:uuid:a7d5aec0-e404-4fd7-90d5-0c3b5df77ea1",

"resource": {

"resourceType": "Observation",

"id": "a7d5aec0-e404-4fd7-90d5-0c3b5df77ea1",

"meta": {

"profile": [

"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation"

]

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"specimen": {

"reference": "urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af",

"display": "NHS9123123"

"hasMember": [

{

"reference": "urn:uuid:82faf6a6-e463-41ca-a957-5a8e4cbef879"

{

"reference": "urn:uuid:52860bac-8a23-4386-9198-aaceffa4dbb5"

}

]

}

{

"fullUrl": "urn:uuid:82faf6a6-e463-41ca-a957-5a8e4cbef879",

"resource": {

"resourceType": "Observation",

"id": "82faf6a6-e463-41ca-a957-5a8e4cbef879",

"meta": {

"profile": [

"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation"

]

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"basedOn": [

{

"reference": "urn:uuid:ebb4078d-4365-47d8-b2cc-538e2b0a749a"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854971000000106",
"display": "Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing"

}

]

"subject": {

"reference": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854981000000108",
"display": "Multi-cancer early detection signal detected"

}

]

"specimen": {

"reference": "urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af",

"display": "NHS9123123"

}

{

"fullUrl": "urn:uuid:52860bac-8a23-4386-9198-aaceffa4dbb5",

"resource": {

"resourceType": "Observation",

"id": "52860bac-8a23-4386-9198-aaceffa4dbb5",

"meta": {

"profile": [

"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation"

]

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873921000000106",
"display": "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "89837001",
"display": "Urinary bladder structure"

}

]

}

]

}

{

"fullUrl": "urn:uuid:189fd847-0b83-40f4-98d4-89421e4a89af",

"resource": {

"resourceType": "Specimen",

"id": "189fd847-0b83-40f4-98d4-89421e4a89af",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "available",

"type": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"

}

]

"subject": {

"reference": "urn:uuid:9e64b25a-c5db-4ac8-9bd5-8e93ca3df299",

"display": "NHS-AB12-CD34"

"collection": {

"collectedDateTime": "2020-09-23T11:00:00+00:00"

}

]

}

Example - Amended Test

<meta>

</meta>

</identifier>

<fullUrl value="urn:uuid:a4409d7c-b613-477c-b623-87e60406c2f0" />
<resource>
<MessageHeader>
<id value="a4409d7c-b613-477c-b623-87e60406c2f0" />
<eventCoding>
<system value="http://snomed.info/sct" />
<code value="371528001" />
<display value="Pathology report" />
</eventCoding>
<destination>
<name value="Executive Agency - NHS ENGLAND - X26" />
<endpoint value="mesh-mailbox-nhs" />
<receiver>
<reference value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
</receiver>
</destination>
<sender>
<reference value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
</sender>
<source>
<endpoint value="mesh-mailbox-ScreeningOrg" />
</source>
<focus>
<!-- Goes to the DiagnosticReport -->
<reference value="urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
</focus>
<definition value="https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport" />
</MessageHeader>
</resource>

</entry>

<fullUrl value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
<resource>
<Organization>
<id value="d6407de7-0e86-45eb-93cb-035094aaa49e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="ABC123" />
</identifier>
<name value="Screening Organisation Ltd" />
<address>
<text value="Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<resource>
<Organization>
<id value="e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CLIA" />
<value value="ScreeningLab34D2231294CLIA" />
</identifier>
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CAP" />
<value value="ScreeningLab6793CAP" />
</identifier>
<name value="Screening Lab Name" />
<telecom>
<system value="phone" />
<value value="+18336942553" />
</telecom>
<telecom>
<system value="fax" />
<value value="+16509999000" />
</telecom>
<telecom>
<system value="email" />
<value value="customerservice@screeninglab.com" />
</telecom>
<address>
<text value="Screening Lab Name, The Lab, Anytown, AT66 7TY" />
</address>
<contact>
<name>
<text value="Ms Lab DIRECTOR" />
</name>
</contact>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<resource>
<Organization>
<id value="bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="X26" />
</identifier>
<name value="Executive Agency - NHS ENGLAND - X26" />
<address>
<line value="THE LEEDS GOVERNMENT HUB" />
<line value="7-8 WELLINGTON PLACE" />
<city value="LEEDS" />
<district value="WEST YORKSHIRE" />
<postalCode value="LS1 4AP" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<resource>
<Practitioner>
<id value="f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="3415870223" />
</identifier>
<name>
<text value="Dr. Daniel Davies" />
</name>
<address>
<text value="NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK" />
</address>
</Practitioner>
</resource>

</entry>

<fullUrl value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<resource>
<Patient>
<id value="8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<identifier>
<system value="https://ScreeningOrg/patient-id" />
<value value="NHS-AB12-CD34" />
</identifier>
</Patient>
</resource>

</entry>

<fullUrl value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
<resource>
<ServiceRequest>
<id value="d9df1431-22ac-462a-946a-f195f6c639af" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<requester>
<reference value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<display value="Dr. Daniel Davies" />
</requester>
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
</ServiceRequest>
</resource>

</entry>

<fullUrl value="urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
<resource>
<DiagnosticReport>
<id value="3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
<extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note">
<valueAnnotation>
<text value="Some Lab Comments" />
</valueAnnotation>
</extension>
<basedOn>
<reference value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
</basedOn>
<status value="amended" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="721981007" />
<display value="Diagnostic studies report" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
<!-- result is the Observation grouper -->
<result>
<reference value="urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
</result>
<conclusion value="The test results report PDF document is the official source of the test result and contains important information regarding the test and the patient's test results. Please read the official report for complete results." />
<!-- The PDF report goes here -->
<presentedForm>
<contentType value="application/pdf" />
<data value="VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU=" />
</presentedForm>
</DiagnosticReport>
</resource>

</entry>

<fullUrl value="urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
<resource>
<Observation>
<id value="9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
<!-- the overall detected / not detected -->
<hasMember>
<reference value="urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4" />
</hasMember>
<!-- primary site -->
<hasMember>
<reference value="urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db" />
</hasMember>
<!-- secondary site -->
<hasMember>
<reference value="urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f" />
</hasMember>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4" />
<resource>
<Observation>
<id value="efae5859-28df-4e7d-be91-6df56d8215e4" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<basedOn>
<reference value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854971000000106" />
<display value="Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854981000000108" />
<display value="Multi-cancer early detection signal detected" />
</coding>
</valueCodeableConcept>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db" />
<resource>
<Observation>
<id value="dacb177a-9501-4dcc-8b22-b941791ae0db" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873921000000106" />
<display value="Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2019-01-29T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="89837001" />
<display value="Urinary bladder structure" />
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="57789003" />
<display value="Structure of urothelium" />
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f" />
<resource>
<Observation>
<id value="3f9730c8-5527-4f58-9865-55aef4dfa11f" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873931000000108" />
<display value="Multi-cancer early detection second highest scored cancer signal origin by machine learning-based classifier" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2019-01-29T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="64033007" />
<display value="Kidney structure" />
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<resource>
<Specimen>
<id value="756a8361-79ce-4561-afcb-a91fe19df123" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="available" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119297000" />
<display value="Blood specimen" />
</coding>
</type>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<collection>
<collectedDateTime value="2020-09-23T11:00:00+00:00" />
</collection>
</Specimen>
</resource>

</entry>

</Bundle>

{

"resourceType": "Bundle",

"id": "MCED-AmendedTest-Example",

"meta": {

"lastUpdated": "2020-09-20T10:22:00+00:00"

"identifier": {

"system": "https://tools.ietf.org/html/rfc4122",

"value": "f36927ef-7703-45ed-b0e5-6ec6723cf0f6"

"type": "message",

"entry": [

{

"fullUrl": "urn:uuid:a4409d7c-b613-477c-b623-87e60406c2f0",

"resource": {

"resourceType": "MessageHeader",

"id": "a4409d7c-b613-477c-b623-87e60406c2f0",

"eventCoding": {

"system": "http://snomed.info/sct",
"code": "371528001",
"display": "Pathology report"

"destination": [

{

"name": "Executive Agency - NHS ENGLAND - X26",

"endpoint": "mesh-mailbox-nhs",

"receiver": {

"reference": "urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e"

}

"sender": {

"reference": "urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e"

"source": {

"endpoint": "mesh-mailbox-ScreeningOrg"

"focus": [

{

"reference": "urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1"

}

"definition": "https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport"

}

{

"fullUrl": "urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e",

"resource": {

"resourceType": "Organization",

"id": "d6407de7-0e86-45eb-93cb-035094aaa49e",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "ABC123"

}

"name": "Screening Organisation Ltd",

"address": [

{

"text": "Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT"

}

]

}

{

"fullUrl": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"resource": {

"resourceType": "Organization",

"id": "e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"identifier": [

{

"system": "http://terminology.hl7.org/NamingSystem/CLIA",

"value": "ScreeningLab34D2231294CLIA"

{

"system": "http://terminology.hl7.org/NamingSystem/CAP",

"value": "ScreeningLab6793CAP"

}

"name": "Screening Lab Name",

"telecom": [

{

"system": "phone",

"value": "+18336942553"

{

"system": "fax",

"value": "+16509999000"

{

"system": "email",

"value": "customerservice@screeninglab.com"

}

"address": [

{

"text": "Screening Lab Name, The Lab, Anytown, AT66 7TY"

}

"contact": [

{

"name": {

"text": "Ms Lab DIRECTOR"

}

]

}

{

"fullUrl": "urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e",

"resource": {

"resourceType": "Organization",

"id": "bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "X26"

}

"name": "Executive Agency - NHS ENGLAND - X26",

"address": [

{

"line": [
"THE LEEDS GOVERNMENT HUB",
"7-8 WELLINGTON PLACE"
],
"city": "LEEDS",
"district": "WEST YORKSHIRE",
"postalCode": "LS1 4AP"

}

]

}

{

"fullUrl": "urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01",

"resource": {

"resourceType": "Practitioner",

"id": "f25e9d63-6a4e-4de6-b9dc-c912fda62b01",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/sds-user-id",

"value": "3415870223"

}

"name": [

{

"text": "Dr. Daniel Davies"

}

"address": [

{

"text": "NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK"

}

]

}

{

"fullUrl": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"resource": {

"resourceType": "Patient",

"id": "8d6c2cd5-0eec-496a-88d0-3785a135df09",

"identifier": [

{

"system": "https://ScreeningOrg/patient-id",

"value": "NHS-AB12-CD34"

}

]

}

{

"fullUrl": "urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af",

"resource": {

"resourceType": "ServiceRequest",

"id": "d9df1431-22ac-462a-946a-f195f6c639af",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "active",

"intent": "order",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"requester": {

"reference": "urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01",

"display": "Dr. Daniel Davies"

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

]

}

{

"fullUrl": "urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1",

"resource": {

"resourceType": "DiagnosticReport",

"id": "3d2f37fd-ca19-4199-9f72-4871cfe12df1",

"extension": [

{

"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note",

"text": "Some Lab Comments"

}

"basedOn": [

{

"reference": "urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af"

}

"status": "amended",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"specimen": [

{

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

}

"result": [

{

"reference": "urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6"

}

{

"contentType": "application/pdf",

"data": "VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU="

}

]

}

{

"fullUrl": "urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6",

"resource": {

"resourceType": "Observation",

"id": "9f7babcd-19cb-4063-b96b-61a20b2e07e6",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"specimen": {

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

"hasMember": [

{

"reference": "urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4"

{

"reference": "urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db"

{

"reference": "urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f"

}

]

}

{

"fullUrl": "urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4",

"resource": {

"resourceType": "Observation",

"id": "efae5859-28df-4e7d-be91-6df56d8215e4",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"basedOn": [

{

"reference": "urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854971000000106",
"display": "Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854981000000108",
"display": "Multi-cancer early detection signal detected"

}

]

"specimen": {

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

}

{

"fullUrl": "urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db",

"resource": {

"resourceType": "Observation",

"id": "dacb177a-9501-4dcc-8b22-b941791ae0db",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873921000000106",
"display": "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "89837001",
"display": "Urinary bladder structure"

}

]

}

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "57789003",
"display": "Structure of urothelium"

}

]

}

]

}

{

"fullUrl": "urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f",

"resource": {

"resourceType": "Observation",

"id": "3f9730c8-5527-4f58-9865-55aef4dfa11f",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873931000000108",
"display": "Multi-cancer early detection second highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "64033007",
"display": "Kidney structure"

}

]

}

]

}

{

"fullUrl": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"resource": {

"resourceType": "Specimen",

"id": "756a8361-79ce-4561-afcb-a91fe19df123",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "available",

"type": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"collection": {

"collectedDateTime": "2020-09-23T11:00:00+00:00"

}

]

}

Example - Corrected Test

<meta>

</meta>

</identifier>

<fullUrl value="urn:uuid:a4409d7c-b613-477c-b623-87e60406c2f0" />
<resource>
<MessageHeader>
<id value="a4409d7c-b613-477c-b623-87e60406c2f0" />
<eventCoding>
<system value="http://snomed.info/sct" />
<code value="371528001" />
<display value="Pathology report" />
</eventCoding>
<destination>
<name value="Executive Agency - NHS ENGLAND - X26" />
<endpoint value="mesh-mailbox-nhs" />
<receiver>
<reference value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
</receiver>
</destination>
<sender>
<reference value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
</sender>
<source>
<endpoint value="mesh-mailbox-ScreeningOrg" />
</source>
<focus>
<!-- Goes to the DiagnosticReport -->
<reference value="urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
</focus>
<definition value="https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport" />
</MessageHeader>
</resource>

</entry>

<fullUrl value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
<resource>
<Organization>
<id value="d6407de7-0e86-45eb-93cb-035094aaa49e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="ABC123" />
</identifier>
<name value="Screening Organisation Ltd" />
<address>
<text value="Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<resource>
<Organization>
<id value="e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CLIA" />
<value value="ScreeningLab34D2231294CLIA" />
</identifier>
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CAP" />
<value value="ScreeningLab6793CAP" />
</identifier>
<name value="Screening Lab Name" />
<telecom>
<system value="phone" />
<value value="+18336942553" />
</telecom>
<telecom>
<system value="fax" />
<value value="+16509999000" />
</telecom>
<telecom>
<system value="email" />
<value value="customerservice@screeninglab.com" />
</telecom>
<address>
<text value="Screening Lab Name, The Lab, Anytown, AT66 7TY" />
</address>
<contact>
<name>
<text value="Ms Lab DIRECTOR" />
</name>
</contact>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<resource>
<Organization>
<id value="bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="X26" />
</identifier>
<name value="Executive Agency - NHS ENGLAND - X26" />
<address>
<line value="THE LEEDS GOVERNMENT HUB" />
<line value="7-8 WELLINGTON PLACE" />
<city value="LEEDS" />
<district value="WEST YORKSHIRE" />
<postalCode value="LS1 4AP" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<resource>
<Practitioner>
<id value="f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="3415870223" />
</identifier>
<name>
<text value="Dr. Daniel Davies" />
</name>
<address>
<text value="NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK" />
</address>
</Practitioner>
</resource>

</entry>

<fullUrl value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<resource>
<Patient>
<id value="8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<identifier>
<system value="https://ScreeningOrg/patient-id" />
<value value="NHS-AB12-CD34" />
</identifier>
</Patient>
</resource>

</entry>

<fullUrl value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
<resource>
<ServiceRequest>
<id value="d9df1431-22ac-462a-946a-f195f6c639af" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<requester>
<reference value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<display value="Dr. Daniel Davies" />
</requester>
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
</ServiceRequest>
</resource>

</entry>

<fullUrl value="urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
<resource>
<DiagnosticReport>
<id value="3d2f37fd-ca19-4199-9f72-4871cfe12df1" />
<extension url="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note">
<valueAnnotation>
<text value="Some Lab Comments" />
</valueAnnotation>
</extension>
<basedOn>
<reference value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
</basedOn>
<status value="corrected" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="721981007" />
<display value="Diagnostic studies report" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
<!-- result is the Observation grouper -->
<result>
<reference value="urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
</result>
<conclusion value="The test results report PDF document is the official source of the test result and contains important information regarding the test and the patient's test results. Please read the official report for complete results." />
<!-- The PDF report goes here -->
<presentedForm>
<contentType value="application/pdf" />
<data value="VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU=" />
</presentedForm>
</DiagnosticReport>
</resource>

</entry>

<fullUrl value="urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
<resource>
<Observation>
<id value="9f7babcd-19cb-4063-b96b-61a20b2e07e6" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
<!-- the overall detected / not detected -->
<hasMember>
<reference value="urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4" />
</hasMember>
<!-- primary site -->
<hasMember>
<reference value="urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db" />
</hasMember>
<!-- secondary site -->
<hasMember>
<reference value="urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f" />
</hasMember>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4" />
<resource>
<Observation>
<id value="efae5859-28df-4e7d-be91-6df56d8215e4" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<basedOn>
<reference value="urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af" />
</basedOn>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854971000000106" />
<display value="Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2020-09-25T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="1854981000000108" />
<display value="Multi-cancer early detection signal detected" />
</coding>
</valueCodeableConcept>
<specimen>
<reference value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<display value="NHS9123123" />
</specimen>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db" />
<resource>
<Observation>
<id value="dacb177a-9501-4dcc-8b22-b941791ae0db" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873921000000106" />
<display value="Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2019-01-29T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="89837001" />
<display value="Urinary bladder structure (body structure)" />
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f" />
<resource>
<Observation>
<id value="3f9730c8-5527-4f58-9865-55aef4dfa11f" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1873931000000108" />
<display value="Multi-cancer early detection second highest scored cancer signal origin by machine learning-based classifier" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<issued value="2019-01-29T16:00:00+00:00" />
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="123037004" />
<display value="Body structure" />
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="414792005" />
<display value="Myeloid neoplasm (morphologic abnormality)" />
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>

</entry>

<fullUrl value="urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123" />
<resource>
<Specimen>
<id value="756a8361-79ce-4561-afcb-a91fe19df123" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="available" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119297000" />
<display value="Blood specimen" />
</coding>
</type>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<collection>
<collectedDateTime value="2020-09-23T11:00:00+00:00" />
</collection>
</Specimen>
</resource>

</entry>

</Bundle>

{

"resourceType": "Bundle",

"id": "MCED-CorrectedTest-Example",

"meta": {

"lastUpdated": "2020-09-20T10:34:00+00:00"

"identifier": {

"system": "https://tools.ietf.org/html/rfc4122",

"value": "f36927ef-7703-45ed-b0e5-6ec6723cf0f6"

"type": "message",

"entry": [

{

"fullUrl": "urn:uuid:a4409d7c-b613-477c-b623-87e60406c2f0",

"resource": {

"resourceType": "MessageHeader",

"id": "a4409d7c-b613-477c-b623-87e60406c2f0",

"eventCoding": {

"system": "http://snomed.info/sct",
"code": "371528001",
"display": "Pathology report"

"destination": [

{

"name": "Executive Agency - NHS ENGLAND - X26",

"endpoint": "mesh-mailbox-nhs",

"receiver": {

"reference": "urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e"

}

"sender": {

"reference": "urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e"

"source": {

"endpoint": "mesh-mailbox-ScreeningOrg"

"focus": [

{

"reference": "urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1"

}

"definition": "https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport"

}

{

"fullUrl": "urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e",

"resource": {

"resourceType": "Organization",

"id": "d6407de7-0e86-45eb-93cb-035094aaa49e",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "ABC123"

}

"name": "Screening Organisation Ltd",

"address": [

{

"text": "Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT"

}

]

}

{

"fullUrl": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"resource": {

"resourceType": "Organization",

"id": "e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"identifier": [

{

"system": "http://terminology.hl7.org/NamingSystem/CLIA",

"value": "ScreeningLab34D2231294CLIA"

{

"system": "http://terminology.hl7.org/NamingSystem/CAP",

"value": "ScreeningLab6793CAP"

}

"name": "Screening Lab Name",

"telecom": [

{

"system": "phone",

"value": "+18336942553"

{

"system": "fax",

"value": "+16509999000"

{

"system": "email",

"value": "customerservice@screeninglab.com"

}

"address": [

{

"text": "Screening Lab Name, The Lab, Anytown, AT66 7TY"

}

"contact": [

{

"name": {

"text": "Ms Lab DIRECTOR"

}

]

}

{

"fullUrl": "urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e",

"resource": {

"resourceType": "Organization",

"id": "bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/ods-organization-code",

"value": "X26"

}

"name": "Executive Agency - NHS ENGLAND - X26",

"address": [

{

"line": [
"THE LEEDS GOVERNMENT HUB",
"7-8 WELLINGTON PLACE"
],
"city": "LEEDS",
"district": "WEST YORKSHIRE",
"postalCode": "LS1 4AP"

}

]

}

{

"fullUrl": "urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01",

"resource": {

"resourceType": "Practitioner",

"id": "f25e9d63-6a4e-4de6-b9dc-c912fda62b01",

"identifier": [

{

"system": "https://fhir.nhs.uk/Id/sds-user-id",

"value": "3415870223"

}

"name": [

{

"text": "Dr. Daniel Davies"

}

"address": [

{

"text": "NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK"

}

]

}

{

"fullUrl": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"resource": {

"resourceType": "Patient",

"id": "8d6c2cd5-0eec-496a-88d0-3785a135df09",

"identifier": [

{

"system": "https://ScreeningOrg/patient-id",

"value": "NHS-AB12-CD34"

}

]

}

{

"fullUrl": "urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af",

"resource": {

"resourceType": "ServiceRequest",

"id": "d9df1431-22ac-462a-946a-f195f6c639af",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "active",

"intent": "order",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"requester": {

"reference": "urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01",

"display": "Dr. Daniel Davies"

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

]

}

{

"fullUrl": "urn:uuid:3d2f37fd-ca19-4199-9f72-4871cfe12df1",

"resource": {

"resourceType": "DiagnosticReport",

"id": "3d2f37fd-ca19-4199-9f72-4871cfe12df1",

"extension": [

{

"url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note",

"text": "Some Lab Comments"

}

"basedOn": [

{

"reference": "urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af"

}

"status": "corrected",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"specimen": [

{

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

}

"result": [

{

"reference": "urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6"

}

{

"contentType": "application/pdf",

"data": "VGhlIEdSQUlMIFBERiBnb2VzIGhlcmU="

}

]

}

{

"fullUrl": "urn:uuid:9f7babcd-19cb-4063-b96b-61a20b2e07e6",

"resource": {

"resourceType": "Observation",

"id": "9f7babcd-19cb-4063-b96b-61a20b2e07e6",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1148754001",
"display": "Screening for neoplasm"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"specimen": {

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

"hasMember": [

{

"reference": "urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4"

{

"reference": "urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db"

{

"reference": "urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f"

}

]

}

{

"fullUrl": "urn:uuid:efae5859-28df-4e7d-be91-6df56d8215e4",

"resource": {

"resourceType": "Observation",

"id": "efae5859-28df-4e7d-be91-6df56d8215e4",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"basedOn": [

{

"reference": "urn:uuid:d9df1431-22ac-462a-946a-f195f6c639af"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854971000000106",
"display": "Qualitative result of cancer methylation profile in cell free deoxyribonucleic acid by next generation sequencing"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2020-09-25T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1854981000000108",
"display": "Multi-cancer early detection signal detected"

}

]

"specimen": {

"reference": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"display": "NHS9123123"

}

{

"fullUrl": "urn:uuid:dacb177a-9501-4dcc-8b22-b941791ae0db",

"resource": {

"resourceType": "Observation",

"id": "dacb177a-9501-4dcc-8b22-b941791ae0db",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873921000000106",
"display": "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "89837001",
"display": "Urinary bladder structure (body structure)"

}

]

}

]

}

{

"fullUrl": "urn:uuid:3f9730c8-5527-4f58-9865-55aef4dfa11f",

"resource": {

"resourceType": "Observation",

"id": "3f9730c8-5527-4f58-9865-55aef4dfa11f",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "final",

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "1873931000000108",
"display": "Multi-cancer early detection second highest scored cancer signal origin by machine learning-based classifier"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"issued": "2019-01-29T16:00:00+00:00",

"performer": [

{

"reference": "urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1",

"display": "Screening Lab"

}

"component": [

{

"code": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "123037004",
"display": "Body structure"

}

]

"coding": [

{

"system": "http://snomed.info/sct",
"code": "414792005",
"display": "Myeloid neoplasm (morphologic abnormality)"

}

]

}

]

}

{

"fullUrl": "urn:uuid:756a8361-79ce-4561-afcb-a91fe19df123",

"resource": {

"resourceType": "Specimen",

"id": "756a8361-79ce-4561-afcb-a91fe19df123",

"identifier": [

{

"system": "http://ScreeningOrg/request-id",

"value": "NHS9123123"

}

"status": "available",

"type": {

"coding": [

{

"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"

}

]

"subject": {

"reference": "urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09",

"display": "NHS-AB12-CD34"

"collection": {

"collectedDateTime": "2020-09-23T11:00:00+00:00"

}

]

}

Example - Cancelled Test

<meta>

</meta>

</identifier>

<fullUrl value="urn:uuid:a4409d7c-b613-477c-b623-87e60406c2f0" />
<resource>
<MessageHeader>
<id value="a4409d7c-b613-477c-b623-87e60406c2f0" />
<eventCoding>
<system value="http://snomed.info/sct" />
<code value="371528001" />
<display value="Pathology report" />
</eventCoding>
<destination>
<name value="Executive Agency - NHS ENGLAND - X26" />
<endpoint value="mesh-mailbox-nhs" />
<receiver>
<reference value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
</receiver>
</destination>
<sender>
<reference value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
</sender>
<source>
<endpoint value="mesh-mailbox-ScreeningOrg" />
</source>
<focus>
<!-- Goes to the DiagnosticReport -->
<reference value="urn:uuid:821bee1c-367f-484b-a02b-ec625afef0df" />
</focus>
<definition value="https://fhir.nhs.uk/England/MessageDefinition/England-MCED-TestReport" />
</MessageHeader>
</resource>

</entry>

<fullUrl value="urn:uuid:d6407de7-0e86-45eb-93cb-035094aaa49e" />
<resource>
<Organization>
<id value="d6407de7-0e86-45eb-93cb-035094aaa49e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="ABC123" />
</identifier>
<name value="Screening Organisation Ltd" />
<address>
<text value="Screening Organisation Ltd, Floor 1, High Rise, Anytown, AT5 5TT" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<resource>
<Organization>
<id value="e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CLIA" />
<value value="ScreeningLab34D2231294CLIA" />
</identifier>
<identifier>
<system value="http://terminology.hl7.org/NamingSystem/CAP" />
<value value="ScreeningLab6793CAP" />
</identifier>
<name value="Screening Lab Name" />
<telecom>
<system value="phone" />
<value value="+18336942553" />
</telecom>
<telecom>
<system value="fax" />
<value value="+16509999000" />
</telecom>
<telecom>
<system value="email" />
<value value="customerservice@screeninglab.com" />
</telecom>
<address>
<text value="Screening Lab Name, The Lab, Anytown, AT66 7TY" />
</address>
<contact>
<name>
<text value="Ms Lab DIRECTOR" />
</name>
</contact>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<resource>
<Organization>
<id value="bf7a76d3-5b44-4194-a9e0-d1cc1ea5e50e" />
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="X26" />
</identifier>
<name value="Executive Agency - NHS ENGLAND - X26" />
<address>
<line value="THE LEEDS GOVERNMENT HUB" />
<line value="7-8 WELLINGTON PLACE" />
<city value="LEEDS" />
<district value="WEST YORKSHIRE" />
<postalCode value="LS1 4AP" />
</address>
</Organization>
</resource>

</entry>

<fullUrl value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<resource>
<Practitioner>
<id value="f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="3415870223" />
</identifier>
<name>
<text value="Dr. Daniel Davies" />
</name>
<address>
<text value="NHS England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK" />
</address>
</Practitioner>
</resource>

</entry>

<fullUrl value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<resource>
<Patient>
<id value="8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<identifier>
<system value="https://ScreeningOrg/patient-id" />
<value value="NHS-AB12-CD34" />
</identifier>
</Patient>
</resource>

</entry>

<fullUrl value="urn:uuid:239336bc-734c-47b8-9c72-6239556b46ad" />
<resource>
<ServiceRequest>
<id value="d9df1431-22ac-462a-946a-f195f6c639af" />
<identifier>
<system value="http://ScreeningOrg/request-id" />
<value value="NHS9123123" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="1148754001" />
<display value="Screening for neoplasm" />
</coding>
</code>
<subject>
<reference value="urn:uuid:8d6c2cd5-0eec-496a-88d0-3785a135df09" />
<display value="NHS-AB12-CD34" />
</subject>
<requester>
<reference value="urn:uuid:f25e9d63-6a4e-4de6-b9dc-c912fda62b01" />
<display value="Dr. Daniel Davies" />
</requester>
<performer>
<reference value="urn:uuid:e78b5421-8d55-4f61-8cbf-bee1c69513f1" />
<display value="Screening Lab" />
</performer>
</ServiceRequest>
</resource>

</entry>

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