Please note:

This version of the UK Core is a development copy.
This contains BREAKING CHANGES as a result of the C&TA Sprint 7 Review, and STU2 Sequence ballot reconciliation.
This version is not yet reviewed for implementation. Other versions are available on the UK Core Version History Guide
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A summary of changes is available on the STU3 Sequence Change Log

StructureDefinition UKCore-Specimen

Canonical_URL	Status	Current_Version	Last_Updated	Description
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen	active	2.4.0	2023-12-12	This profile defines the UK constraints and extensions on the International FHIR resource Specimen.

Profile_Purpose
This profile allows the exchange of information about a sample to be used for analysis.

UKCoreSpecimen (Specimen)	I		Specimen	Element id Specimen Short description Sample for analysis Definition A sample to be used for analysis. Data type Specimen Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ukcore-spec-001: There SHALL be only one reference between `collection.collector` and the extension `collectionCollectorR5` `collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()` Mappings rim: Entity. Role, or Act rim: Role[classCode=SPEC]
id	Σ	0..1	string	There are no (further) constraints on this element Element id Specimen.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Specimen.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Specimen.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Specimen.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id Specimen.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Specimen.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
sampleCategory	I	0..1	Extension(CodeableConcept)	Element id Specimen.extension:sampleCategory Short description An extension to record the category of a sample. Alternate names extensions, user content Definition This extension allows the recording of the category of a sample for use within Genomics, whether it is a tumour or germline sample. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Specimen.identifier Short description External Identifier Definition Id for specimen. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: SPM-2 rim: .id
accessionIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Specimen.accessionIdentifier Short description Identifier assigned by the lab Definition The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: SPM-30 (v2.7+) rim: .participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id
status	S Σ ?!	0..1	codeBinding	Element id Specimen.status Short description The availability of the specimen sample. Definition The availability of the specimen. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding Codes providing the status/availability of a specimen. SpecimenStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.status v2: SPM-20 rim: status
type	S Σ	0..1	CodeableConceptBinding	Element id Specimen.type Short description The kind of material that forms the specimen. Definition The kind of material that forms the specimen. Comments The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems. Data type CodeableConcept Binding A code from the SNOMED CT UK Clinical Terminology coding system UKCoreSpecimenType (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.what[x] v2: SPM-4 and possibly SPM-5 rim: .code
subject	S Σ I	0..1	Reference(Patient \| Group \| Device \| Substance \| Location)	Element id Specimen.subject Short description Where the specimen came from. Definition Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device. Requirements Must know the subject context. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| Group \| Device \| Substance \| Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] rim: .scoper or .scoper.playsRole w5: FiveWs.subject
receivedTime	S Σ	0..1	dateTime	Element id Specimen.receivedTime Short description The time when specimen was received for processing. Definition Time when specimen was received for processing or testing. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.done[x] v2: SPM-18 rim: .participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime
parent	I	0..*	Reference(Specimen)	There are no (further) constraints on this element Element id Specimen.parent Short description Specimen from which this specimen originated Definition Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen. Comments The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample. Data type Reference(Specimen) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)
request	I	0..*	Reference(ServiceRequest)	There are no (further) constraints on this element Element id Specimen.request Short description Why the specimen was collected Definition Details concerning a service request that required a specimen to be collected. Comments The request may be explicit or implied such with a ServiceRequest that requires a blood draw. Data type Reference(ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.why[x] v2: ORC? OBR-2/3? rim: outboundRelationship[typeCode=FLFS].target
collection		0..1	BackboneElement	There are no (further) constraints on this element Element id Specimen.collection Short description Collection details Definition Details concerning the specimen collection. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SPM-14 rim: .participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id Specimen.collection.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
specialHandling	I	0..*	Extension(CodeableConcept)	Element id Specimen.collection.extension:specialHandling Short description This SHOULD be included if there is a high contamination risk reason for a sample / biopsy. Alternate names extensions, user content Definition Special handling during the collection, transport, or storage of the specimen. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL http://hl7.org/fhir/StructureDefinition/specimen-specialHandling Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
collector	Σ I	0..1	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id Specimen.collection.collector Short description Who collected the specimen Definition Person who collected the specimen. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.actor v2: PRT rim: .participation[typeCode=PFM].role
id		0..1	string	There are no (further) constraints on this element Element id Specimen.collection.collector.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.collector.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
collectionCollectorR5	I	0..1	Extension(Reference(Patient \| RelatedPerson))	Element id Specimen.collection.collector.extension:collectionCollectorR5 Short description The person who collected the specimen. This is an R5 backport. Alternate names extensions, user content Definition Person who collected the specimen. This is an R5 backport Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(Patient \| RelatedPerson)) Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Specimen.collection.collector.extension:collectionCollectorR5.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.collector.extension:collectionCollectorR5.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Specimen.collection.collector.extension:collectionCollectorR5.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id Specimen.collection.collector.extension:collectionCollectorR5.value[x] Short description Person who collected the specimen. Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueReference			Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Data type Reference(Patient \| RelatedPerson)
reference	Σ I	0..1	string	There are no (further) constraints on this element Element id Specimen.collection.collector.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Specimen.collection.collector.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Specimen.collection.collector.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Specimen.collection.collector.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
collected[x]	Σ	0..1		There are no (further) constraints on this element Element id Specimen.collection.collected[x] Short description Collection time Definition Time when specimen was collected from subject - the physiologically relevant time. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.init v2: SPM-17 rim: .effectiveTime
collectedDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
collectedPeriod			Period	There are no (further) constraints on this element Data type Period
duration	Σ I	0..1	Duration	There are no (further) constraints on this element Element id Specimen.collection.duration Short description How long it took to collect specimen Definition The span of time over which the collection of a specimen occurred. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: PQ, IVL<PQ> depending on the values w5: FiveWs.init
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Specimen.collection.quantity Short description The quantity of specimen collected Definition The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: SPM-12 rim: .participation[typeCode=SBJ].role[classCode=SPEC].player.quantity
method		0..1	CodeableConcept	There are no (further) constraints on this element Element id Specimen.collection.method Short description Technique used to perform collection Definition A coded value specifying the technique that is used to perform the procedure. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The technique that is used to perform the procedure. FHIRSpecimenCollectionMethod (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-7 rim: .methodCode
bodySite		0..1	CodeableConceptBinding	Element id Specimen.collection.bodySite Short description Anatomical collection site Definition Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens. Comments If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension bodySite. Data type CodeableConcept Binding Codes describing anatomical locations. May include laterality. UKCoreSpecimenBodySite (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-8 and SPM-9 rim: .targetSiteCode
id		0..1	string	There are no (further) constraints on this element Element id Specimen.collection.bodySite.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.bodySite.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
bodySiteReference	I	0..1	Extension(Reference(BodyStructure))	Element id Specimen.collection.bodySite.extension:bodySiteReference Short description An extension to allow referencing to a BodyStructure. Alternate names extensions, user content Definition An extension to replicate the changes within R5 altering the data type of Specimen.collection.bodySite from CodeableConcept to CodeableReference (bodyStructure). Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(BodyStructure)) Extension URL https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Specimen.collection.bodySite.extension:bodySiteReference.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.collection.bodySite.extension:bodySiteReference.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Specimen.collection.bodySite.extension:bodySiteReference.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference Mappings rim: N/A
value[x]		1..1		Element id Specimen.collection.bodySite.extension:bodySiteReference.value[x] Short description A reference to a BodyStructure Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueReference			Reference(BodyStructure)	There are no (further) constraints on this element Data type Reference(BodyStructure)
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Specimen.collection.bodySite.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element id Specimen.collection.bodySite.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
fastingStatus[x]	Σ	0..1	Binding	There are no (further) constraints on this element Element id Specimen.collection.fastingStatus[x] Short description Whether or how long patient abstained from food and/or drink Definition Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection. Requirements Many diagnostic tests require fasting to facilitate accurate interpretation. Comments Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/time] in 2 hour Urine --12 hours fasting), or using a component observation `such as`Observation.component code` = LOINC 49541-6 (Fasting status - Reported). Binding Codes describing the fasting status of the patient. v2.0916 (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: OBR-
fastingStatusCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
fastingStatusDuration			Duration	There are no (further) constraints on this element Data type Duration
processing		0..*	BackboneElement	There are no (further) constraints on this element Element id Specimen.processing Short description Processing and processing step details Definition Details concerning processing and processing steps for the specimen. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id Specimen.processing.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.processing.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.processing.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
description		0..1	string	There are no (further) constraints on this element Element id Specimen.processing.description Short description Textual description of procedure Definition Textual description of procedure. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .text
procedure		0..1	CodeableConcept	There are no (further) constraints on this element Element id Specimen.processing.procedure Short description Indicates the treatment step applied to the specimen Definition A coded value specifying the procedure used to process the specimen. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Type indicating the technique used to process the specimen. SpecimenProcessingProcedure (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .code
additive	I	0..*	Reference(Substance)	There are no (further) constraints on this element Element id Specimen.processing.additive Short description Material used in the processing step Definition Material used in the processing step. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Substance) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: SPM-6 rim: .participation[typeCode=CSM].role[classCode=ADTV].code
time[x]		0..1		There are no (further) constraints on this element Element id Specimen.processing.time[x] Short description Date and time of specimen processing Definition A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
timeDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
timePeriod			Period	There are no (further) constraints on this element Data type Period
container		0..*	BackboneElement	There are no (further) constraints on this element Element id Specimen.container Short description Direct container of specimen (tube/slide, etc.) Definition The container holding the specimen. The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .player.scopingRole[classCode=CONT].scoper
id		0..1	string	There are no (further) constraints on this element Element id Specimen.container.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	Element id Specimen.container.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
deviceR5	I	0..1	Extension(Reference(UKCoreDevice))	Element id Specimen.container.extension:deviceR5 Short description Device resource for the container. Alternate names extensions, user content Definition The device resource for the the container holding the specimen. If the container is in a holder then the referenced device will point to a parent device. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(UKCoreDevice)) Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.device Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
locationR5	I	0..1	Extension(Reference(UKCoreLocation))	Element id Specimen.container.extension:locationR5 Short description Where the container is. Alternate names extensions, user content Definition The location of the container holding the specimen. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(UKCoreLocation)) Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Specimen.container.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Specimen.container.identifier Short description Id for the container Definition Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier v2: SAC-3 rim: .id
description		0..1	string	There are no (further) constraints on this element Element id Specimen.container.description Short description Textual description of the container Definition Textual description of the container. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .desc
type		0..1	CodeableConceptBinding	Element id Specimen.container.type Short description Kind of container directly associated with specimen Definition The type of container associated with the specimen (e.g. slide, aliquot, etc.). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Type of specimen container. SpecimenContainerType (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-27 rim: .code
capacity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Specimen.container.capacity Short description Container volume or size Definition The capacity (volume or other measure) the container may contain. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20 rim: .quantity
specimenQuantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Specimen.container.specimenQuantity Short description Quantity of specimen within container Definition The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: SAC-23 (value) SAC-24 (units rim: .playedRole[classCode=CONT].quantity
additive[x]		0..1		There are no (further) constraints on this element Element id Specimen.container.additive[x] Short description Additive associated with container Definition Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA. Binding Substance added to specimen container. v2.0371 (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SAC-27 rim: .scopesRole[classCode=ADTV].player
additiveCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
additiveReference			Reference(Substance)	There are no (further) constraints on this element Data type Reference(Substance)
condition	Σ	0..*	CodeableConceptBinding	Element id Specimen.condition Short description State of the specimen Definition A mode or state of being that describes the nature of the specimen. Requirements The specimen condition can be used to assess its quality or appropriateness for a specific test. Comments Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test. Data type CodeableConcept Binding Codes describing the state of the specimen. UKCoreBiopsyState (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-24
note		0..*	Annotation	There are no (further) constraints on this element Element id Specimen.note Short description Comments Definition To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen). Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act v2: OBX rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Detailed Descriptions

Specimen
Definition	A sample to be used for analysis.
Cardinality	0...*
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ukcore-spec-001: There SHALL be only one reference between `collection.collector` and the extension `collectionCollectorR5` `collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()`
Mappings	rim: Entity. Role, or Act rim: Role[classCode=SPEC]
Specimen.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	string
Summary	True
Comments	The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Specimen.meta
Definition	The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Cardinality	0...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
Specimen.implicitRules
Definition	A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Comments	Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
Specimen.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. CommonLanguages (preferred)
Comments	Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
Specimen.text
Definition	A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A rim: Act.text?
Specimen.contained
Definition	These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Mappings	rim: Entity. Role, or Act rim: N/A
Specimen.extension
Definition	May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.extension:sampleCategory
Definition	This extension allows the recording of the category of a sample for use within Genomics, whether it is a tumour or germline sample.
Cardinality	0...1
Type	Extension(CodeableConcept)
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.identifier
Definition	Id for specimen.
Cardinality	0...*
Type	Identifier
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: SPM-2 rim: .id
Specimen.accessionIdentifier
Definition	The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.
Cardinality	0...1
Type	Identifier
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: SPM-30 (v2.7+) rim: .participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id
Specimen.status
Definition	The availability of the specimen.
Cardinality	0...1
Type	code
Binding	Codes providing the status/availability of a specimen. SpecimenStatus (required)
Must Support	True
Modifier	True
Summary	True
Comments	This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a w5: FiveWs.status v2: SPM-20 rim: status
Specimen.type
Definition	The kind of material that forms the specimen.
Cardinality	0...1
Type	CodeableConcept
Binding	A code from the SNOMED CT UK Clinical Terminology coding system UKCoreSpecimenType (preferred)
Must Support	True
Summary	True
Comments	The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.what[x] v2: SPM-4 and possibly SPM-5 rim: .code
Specimen.subject
Definition	Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.
Cardinality	0...1
Type	Reference(Patient \| Group \| Device \| Substance \| Location)
Must Support	True
Summary	True
Requirements	Must know the subject context.
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] rim: .scoper or .scoper.playsRole w5: FiveWs.subject
Specimen.receivedTime
Definition	Time when specimen was received for processing or testing.
Cardinality	0...1
Type	dateTime
Must Support	True
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a w5: FiveWs.done[x] v2: SPM-18 rim: .participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime
Specimen.parent
Definition	Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen.
Cardinality	0...*
Type	Reference(Specimen)
Comments	The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)
Specimen.request
Definition	Details concerning a service request that required a specimen to be collected.
Cardinality	0...*
Type	Reference(ServiceRequest)
Comments	The request may be explicit or implied such with a ServiceRequest that requires a blood draw.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.why[x] v2: ORC? OBR-2/3? rim: outboundRelationship[typeCode=FLFS].target
Specimen.collection
Definition	Details concerning the specimen collection.
Cardinality	0...1
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: SPM-14 rim: .participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]
Specimen.collection.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.collection.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.extension:specialHandling
Definition	Special handling during the collection, transport, or storage of the specimen.
Cardinality	0...*
Type	Extension(CodeableConcept)
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector
Definition	Person who collected the specimen.
Cardinality	0...1
Type	Reference(Practitioner \| PractitionerRole)
Summary	True
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.actor v2: PRT rim: .participation[typeCode=PFM].role
Specimen.collection.collector.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.collection.collector.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector.extension:collectionCollectorR5
Definition	Person who collected the specimen. This is an R5 backport
Cardinality	0...1
Type	Extension(Reference(Patient \| RelatedPerson))
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector.extension:collectionCollectorR5.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.collection.collector.extension:collectionCollectorR5.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector.extension:collectionCollectorR5.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Cardinality	1...1
Type	uri
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value	http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector
Mappings	rim: N/A
Specimen.collection.collector.extension:collectionCollectorR5.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality	1...1
Type	Reference(Patient \| RelatedPerson)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector.reference
Definition	A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Cardinality	0...1
Type	string
Summary	True
Comments	Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector.type
Definition	The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Cardinality	0...1
Type	uri
Binding	Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)
Summary	True
Comments	This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
Specimen.collection.collector.identifier
Definition	An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Cardinality	0...1
Type	Identifier
Summary	True
Comments	When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation\|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
Specimen.collection.collector.display
Definition	Plain text narrative that identifies the resource in addition to the resource reference.
Cardinality	0...1
Type	string
Summary	True
Comments	This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
Specimen.collection.collected[x]
Definition	Time when specimen was collected from subject - the physiologically relevant time.
Cardinality	0...1
Type	dateTime
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a w5: FiveWs.init v2: SPM-17 rim: .effectiveTime
Specimen.collection.duration
Definition	The span of time over which the collection of a specimen occurred.
Cardinality	0...1
Type	Duration
Summary	True
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. `code.exists() implies ((system = %ucum) and value.exists())`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: PQ, IVL<PQ> depending on the values w5: FiveWs.init
Specimen.collection.quantity
Definition	The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.
Cardinality	0...1
Type	SimpleQuantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: SPM-12 rim: .participation[typeCode=SBJ].role[classCode=SPEC].player.quantity
Specimen.collection.method
Definition	A coded value specifying the technique that is used to perform the procedure.
Cardinality	0...1
Type	CodeableConcept
Binding	The technique that is used to perform the procedure. FHIRSpecimenCollectionMethod (example)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-7 rim: .methodCode
Specimen.collection.bodySite
Definition	Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.
Cardinality	0...1
Type	CodeableConcept
Binding	Codes describing anatomical locations. May include laterality. UKCoreSpecimenBodySite (preferred)
Comments	If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension bodySite.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-8 and SPM-9 rim: .targetSiteCode
Specimen.collection.bodySite.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.collection.bodySite.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.bodySite.extension:bodySiteReference
Definition	An extension to replicate the changes within R5 altering the data type of Specimen.collection.bodySite from CodeableConcept to CodeableReference (bodyStructure).
Cardinality	0...1
Type	Extension(Reference(BodyStructure))
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.bodySite.extension:bodySiteReference.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.collection.bodySite.extension:bodySiteReference.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.collection.bodySite.extension:bodySiteReference.url
Definition	Source of the definition for the extension code - a logical name or a URL.
Cardinality	1...1
Type	uri
Comments	The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value	https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference
Mappings	rim: N/A
Specimen.collection.bodySite.extension:bodySiteReference.value[x]
Definition	Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality	1...1
Type	Reference(BodyStructure)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: N/A
Specimen.collection.bodySite.coding
Definition	A reference to a code defined by a terminology system.
Cardinality	0...*
Type	Coding
Summary	True
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Specimen.collection.bodySite.text
Definition	A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality	0...1
Type	string
Summary	True
Requirements	The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments	Very often the text is the same as a displayName of one of the codings.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Specimen.collection.fastingStatus[x]
Definition	Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection.
Cardinality	0...1
Type	CodeableConcept
Binding	Codes describing the fasting status of the patient. v2.0916 (extensible)
Summary	True
Requirements	Many diagnostic tests require fasting to facilitate accurate interpretation.
Comments	Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/time] in 2 hour Urine --12 hours fasting), or using a component observation `such as`Observation.component code` = LOINC 49541-6 (Fasting status - Reported).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: OBR-
Specimen.processing
Definition	Details concerning processing and processing steps for the specimen.
Cardinality	0...*
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]
Specimen.processing.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.processing.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.processing.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.processing.description
Definition	Textual description of procedure.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .text
Specimen.processing.procedure
Definition	A coded value specifying the procedure used to process the specimen.
Cardinality	0...1
Type	CodeableConcept
Binding	Type indicating the technique used to process the specimen. SpecimenProcessingProcedure (example)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .code
Specimen.processing.additive
Definition	Material used in the processing step.
Cardinality	0...*
Type	Reference(Substance)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: SPM-6 rim: .participation[typeCode=CSM].role[classCode=ADTV].code
Specimen.processing.time[x]
Definition	A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .effectiveTime
Specimen.container
Definition	The container holding the specimen. The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here.
Cardinality	0...*
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .player.scopingRole[classCode=CONT].scoper
Specimen.container.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Specimen.container.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.container.extension:deviceR5
Definition	The device resource for the the container holding the specimen. If the container is in a holder then the referenced device will point to a parent device.
Cardinality	0...1
Type	Extension(Reference(UKCoreDevice))
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.container.extension:locationR5
Definition	The location of the container holding the specimen.
Cardinality	0...1
Type	Extension(Reference(UKCoreLocation))
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.container.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
Specimen.container.identifier
Definition	Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.
Cardinality	0...*
Type	Identifier
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier v2: SAC-3 rim: .id
Specimen.container.description
Definition	Textual description of the container.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a rim: .desc
Specimen.container.type
Definition	The type of container associated with the specimen (e.g. slide, aliquot, etc.).
Cardinality	0...1
Type	CodeableConcept
Binding	Type of specimen container. SpecimenContainerType (preferred)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-27 rim: .code
Specimen.container.capacity
Definition	The capacity (volume or other measure) the container may contain.
Cardinality	0...1
Type	SimpleQuantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20 rim: .quantity
Specimen.container.specimenQuantity
Definition	The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.
Cardinality	0...1
Type	SimpleQuantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: SAC-23 (value) SAC-24 (units rim: .playedRole[classCode=CONT].quantity
Specimen.container.additive[x]
Definition	Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.
Cardinality	0...1
Type	CodeableConcept
Binding	Substance added to specimen container. v2.0371 (example)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: SAC-27 rim: .scopesRole[classCode=ADTV].player
Specimen.condition
Definition	A mode or state of being that describes the nature of the specimen.
Cardinality	0...*
Type	CodeableConcept
Binding	Codes describing the state of the specimen. UKCoreBiopsyState (extensible)
Summary	True
Requirements	The specimen condition can be used to assess its quality or appropriateness for a specific test.
Comments	Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: SPM-24
Specimen.note
Definition	To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).
Cardinality	0...*
Type	Annotation
Comments	For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: N/A rim: Act v2: OBX rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Table View

Specimen		..
Specimen.extension	Extension	..1
Specimen.status		..
Specimen.type		..
Specimen.subject		..
Specimen.receivedTime		..
Specimen.collection		..
Specimen.collection.extension	Extension	..
Specimen.collection.collector		..
Specimen.collection.collector.extension	Extension	..1
Specimen.collection.collector.extension.value[x]		..
Specimen.collection.bodySite		..
Specimen.collection.bodySite.extension	Extension	..1
Specimen.collection.bodySite.extension.value[x]		..
Specimen.container		..
Specimen.container.extension		0..
Specimen.container.extension	Extension	0..1
Specimen.container.extension	Extension	0..1
Specimen.container.type		..
Specimen.condition		..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-Specimen" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
    <version value="2.4.0" />
    <name value="UKCoreSpecimen" />
    <title value="UK Core Specimen" />
    <status value="active" />
    <date value="2023-12-12" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [Specimen](https://hl7.org/fhir/R4/Specimen.html)." />
    <purpose value="This profile allows the exchange of information about a sample to be used for analysis." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="Specimen" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Specimen" />
    <derivation value="constraint" />
    <differential>
        <element id="Specimen">
            <path value="Specimen" />
            <constraint>
                <key value="ukcore-spec-001" />
                <severity value="error" />
                <human value="There SHALL be only one reference between `collection.collector` and the extension `collectionCollectorR5`" />
                <expression value="collection.collector.reference.empty() or collection.collector.extension(&#39;http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector&#39;).empty()" />
            </constraint>
        </element>
        <element id="Specimen.extension:sampleCategory">
            <path value="Specimen.extension" />
            <sliceName value="sampleCategory" />
            <short value="An extension to record the category of a sample." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="Specimen.status">
            <path value="Specimen.status" />
            <short value="The availability of the specimen sample." />
            <mustSupport value="true" />
        </element>
        <element id="Specimen.type">
            <path value="Specimen.type" />
            <short value="The kind of material that forms the specimen." />
            <mustSupport value="true" />
            <binding>
                <strength value="preferred" />
                <description value="A code from the SNOMED CT UK Clinical Terminology coding system" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenType" />
            </binding>
        </element>
        <element id="Specimen.subject">
            <path value="Specimen.subject" />
            <short value="Where the specimen came from." />
            <mustSupport value="true" />
        </element>
        <element id="Specimen.receivedTime">
            <path value="Specimen.receivedTime" />
            <short value="The time when specimen was received for processing." />
            <mustSupport value="true" />
        </element>
        <element id="Specimen.collection.extension:specialHandling">
            <path value="Specimen.collection.extension" />
            <sliceName value="specialHandling" />
            <short value="This SHOULD be included if there is a high contamination risk reason for a sample / biopsy." />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/StructureDefinition/specimen-specialHandling" />
            </type>
        </element>
        <element id="Specimen.collection.collector.extension:collectionCollectorR5">
            <path value="Specimen.collection.collector.extension" />
            <sliceName value="collectionCollectorR5" />
            <short value="The person who collected the specimen. This is an R5 backport." />
            <definition value="Person who collected the specimen. This is an R5 backport" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="Specimen.collection.collector.extension:collectionCollectorR5.value[x]">
            <path value="Specimen.collection.collector.extension.value[x]" />
        </element>
        <element id="Specimen.collection.bodySite">
            <path value="Specimen.collection.bodySite" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenBodySite" />
            </binding>
        </element>
        <element id="Specimen.collection.bodySite.extension:bodySiteReference">
            <path value="Specimen.collection.bodySite.extension" />
            <sliceName value="bodySiteReference" />
            <short value="An extension to allow referencing to a BodyStructure." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="Specimen.collection.bodySite.extension:bodySiteReference.value[x]">
            <path value="Specimen.collection.bodySite.extension.value[x]" />
            <short value="A reference to a BodyStructure" />
        </element>
        <element id="Specimen.container.extension">
            <path value="Specimen.container.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="0" />
        </element>
        <element id="Specimen.container.extension:deviceR5">
            <path value="Specimen.container.extension" />
            <sliceName value="deviceR5" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.device" />
            </type>
        </element>
        <element id="Specimen.container.extension:locationR5">
            <path value="Specimen.container.extension" />
            <sliceName value="locationR5" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location" />
            </type>
        </element>
        <element id="Specimen.container.type">
            <path value="Specimen.container.type" />
            <binding>
                <strength value="preferred" />
            </binding>
        </element>
        <element id="Specimen.condition">
            <path value="Specimen.condition" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-BiopsyState" />
            </binding>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-Specimen",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen",
    "version": "2.4.0",
    "name": "UKCoreSpecimen",
    "title": "UK Core Specimen",
    "status": "active",
    "date": "2023-12-12",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [Specimen](https://hl7.org/fhir/R4/Specimen.html).",
    "purpose": "This profile allows the exchange of information about a sample to be used for analysis.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Specimen",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Specimen",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Specimen",
                "path": "Specimen",
                "constraint":  [
                    {
                        "key": "ukcore-spec-001",
                        "severity": "error",
                        "human": "There SHALL be only one reference between `collection.collector` and the extension `collectionCollectorR5`",
                        "expression": "collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()"
                    }
                ]
            },
            {
                "id": "Specimen.extension:sampleCategory",
                "path": "Specimen.extension",
                "sliceName": "sampleCategory",
                "short": "An extension to record the category of a sample.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "Specimen.status",
                "path": "Specimen.status",
                "short": "The availability of the specimen sample.",
                "mustSupport": true
            },
            {
                "id": "Specimen.type",
                "path": "Specimen.type",
                "short": "The kind of material that forms the specimen.",
                "mustSupport": true,
                "binding": {
                    "strength": "preferred",
                    "description": "A code from the SNOMED CT UK Clinical Terminology coding system",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenType"
                }
            },
            {
                "id": "Specimen.subject",
                "path": "Specimen.subject",
                "short": "Where the specimen came from.",
                "mustSupport": true
            },
            {
                "id": "Specimen.receivedTime",
                "path": "Specimen.receivedTime",
                "short": "The time when specimen was received for processing.",
                "mustSupport": true
            },
            {
                "id": "Specimen.collection.extension:specialHandling",
                "path": "Specimen.collection.extension",
                "sliceName": "specialHandling",
                "short": "This SHOULD be included if there is a high contamination risk reason for a sample / biopsy.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/specimen-specialHandling"
                        ]
                    }
                ]
            },
            {
                "id": "Specimen.collection.collector.extension:collectionCollectorR5",
                "path": "Specimen.collection.collector.extension",
                "sliceName": "collectionCollectorR5",
                "short": "The person who collected the specimen. This is an R5 backport.",
                "definition": "Person who collected the specimen. This is an R5 backport",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "Specimen.collection.collector.extension:collectionCollectorR5.value[x]",
                "path": "Specimen.collection.collector.extension.value[x]"
            },
            {
                "id": "Specimen.collection.bodySite",
                "path": "Specimen.collection.bodySite",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenBodySite"
                }
            },
            {
                "id": "Specimen.collection.bodySite.extension:bodySiteReference",
                "path": "Specimen.collection.bodySite.extension",
                "sliceName": "bodySiteReference",
                "short": "An extension to allow referencing to a BodyStructure.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "Specimen.collection.bodySite.extension:bodySiteReference.value[x]",
                "path": "Specimen.collection.bodySite.extension.value[x]",
                "short": "A reference to a BodyStructure"
            },
            {
                "id": "Specimen.container.extension",
                "path": "Specimen.container.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "min": 0
            },
            {
                "id": "Specimen.container.extension:deviceR5",
                "path": "Specimen.container.extension",
                "sliceName": "deviceR5",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.device"
                        ]
                    }
                ]
            },
            {
                "id": "Specimen.container.extension:locationR5",
                "path": "Specimen.container.extension",
                "sliceName": "locationR5",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location"
                        ]
                    }
                ]
            },
            {
                "id": "Specimen.container.type",
                "path": "Specimen.container.type",
                "binding": {
                    "strength": "preferred"
                }
            },
            {
                "id": "Specimen.condition",
                "path": "Specimen.condition",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BiopsyState"
                }
            }
        ]
    }
}

Feedback

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Report issue for UKCore-Specimen, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Examples

Blood Specimen - An example to illustrate a blood specimen for a patient.
Example UKCore-Specimen-BloodSpecimen

Composition Reference - An example to illustrate the pre-adopted R5 element via an extension, which is used to reference a Patient or RelatedPerson within Specimen.collection.collector.
Example UKCore-Extension-CollectionCollector

High Risk Specimen - An example to illustrate using the HL7 core-defined Extension specimen-specialHandling to record why a specimen should be treated as a high risk.
Example UKCore-Extension-SpecialHandling

Median Cubital Vein - An example to illustrate the extension for a referenced body site.
Example UKCore-Extension-BodySiteReference

Sample Category - An example to illustrate the extension to show the Genomics classification of a sample.
Example UKCore-Extension-SampleCategory

Urine Sample - An example to illustrate a urine specimen for a patient.
Example UKCore-Specimen-UrineSpecimen

Example Usage Scenarios

The following are example usage scenarios for the UK Core Specimen profile:

Query for specimen information
Exchange specimen information used in Observations and DiagnosticReport

Profile Specific Implementation Guidance:

Mandatory and Must Support Data Elements

The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.

Element	Reason
`Specimen.status`	The availability of the specimen sample.
`Specimen.type`	The kind of material that forms the specimen.
`Specimen.subject`	Where the specimen came from.
`Specimen.receivedTime`	The time when specimen was received for processing.

Extensions

More information about the extensions can be found using the links below.

Extension	Context	Link	Comment
bodySiteReference	Specimen. collection.bodySite	Extension UKCore-BodySiteReference	An extension to replicate the changes within R5 allowing the data type of Specimen.collection.bodySite to act as a CodeableReference (BodyStructure).
collectionCollector	Specimen. collection.collector	Extension UKCore-SpecimenCollectionCollector	An extension to replicate the changes within R5 allowing the data type of Specimen.collection.collector to reference Patient and RelatedPerson. For more details, see Pre-adopted R5 Elements.
sampleCategory	Specimen	Extension UKCore-SampleCategory	An extension to record the Category of a sample.
specialHandling	Specimen.collection	HL7 core-defined Extension specimen-specialHandling	This SHOULD be included if there is a high contamination risk reason for a sample/biopsy. Note: There is no binding defined within this HL7 extension.

Bindings (differential)

More information about the bindings to UK Core ValueSets can be found below.

Context	Strength	Link
Specimen.type	preferred	https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenType
Specimen.collection.bodySite	preferred	https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenBodySite
Specimen.condition	extensible	https://fhir.hl7.org.uk/ValueSet/UKCore-BiopsyState

Specimen.extension:sampleCategory

extensible

ValueSet UKCore-SampleCategory

Constraints (differential)

More information about the constraints on the UKCore-Specimen profile can be found below.

Key	Severity	Expression	Human_Description
ukcore-spec-001	error	collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()	There SHALL be only one reference between `collection.collector` and the extension `collectionCollectorR5`

`type`

If a SNOMED CT concept from the ValueSet UKCore-SpecimenType is used, and the concept is a descendant of "105590001 | Substance", Specimen.collection.method and Specimen.collection.bodySite SHOULD be populated.

`subject`

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:

`parent`

The resource being referenced SHALL conform to the following Profile UKCore-Specimen.

`request`

The resource being referenced SHALL conform to the following Profile UKCore-ServiceRequest.

`collection`

`Specimen.collection.collector`

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:

`Specimen.collection.bodySite`

If Specimen.collection.bodySite.coding and Extension UKCore-BodySiteReference are both are present, they are expected to be consistent with each other - e.g. the concept is to a code for headache, and the resource reference describes a headache.

`processing`

It is expected that Specimen.processing SHOULD be populated where the specimen is an extracted sample for testing, obtained from a raw sample.

`note`

The resource referenced in Specimen.note.authorReference SHALL conform to one of the following: