Test Request

Purpose

Elements are included for the billing approach, TAT/SLA tracking and prioritisation. To confirm validity of urgency and apply lower level prioritisation. To know which test has been requested, which further tests are required within this request and how many patients are being tested within this request.

Notes

Mapped to ServiceRequest, extensions are still in review. CI and CITT codes for genomic tests are pending addition to SNOMED-CT

Mapping

ID Source Data item Target FHIR Element HL7v2.5.1 Mapping Description
TR-002 Test request - Payment status ServiceRequest.extension:coverage IN1-15 How the test request is funded. The current ValueSet for this field is pending addition to UK Core
TR-004 Test request - Requesting reason rare disease ServiceRequest.category Likely ORC-29 (TBC) The reason for a rare disease genomic test.
TR-038 Test request - Requesting reason cancer ServiceRequest.category Likely ORC-29 (TBC) The reason for a cancer genomic test.
TR-040 Test request - Test code / id issuing service ServiceRequest.reasonCode.coding.system or ServiceRequest.code.coding.system (depending on whether the code is a genomic test or package code) OBR-31.3/OBR-4.3 The service from which requested genomic packages and/or genomic tests are sourced from. Will default to “NHSE Genomics” (or similar) for an initial period. Used to futureproof the standard given that it may be beneficial to expand the Genomic Order Management Core Broker to additional bodies outside NHSE in the future.
TR-021 Test request - Genomic package id ServiceRequest.reasonCode.coding.code OBR-31.1 The group id for the requested test from the stated test code issuing service.
TR-022 Test request - Genomic package name ServiceRequest.reasonCode.coding.display OBR-31.2 The group id name for the requested test from the stated test code issuing service.
TR-024 Test request - Genomic test id ServiceRequest.code.coding.code OBR-4.1 The test id for the requested test from the stated test code issuing service.
TR-025 Test request - Genomic test name ServiceRequest.code.coding.display OBR-4.2 The test id name for the requested test from the stated test code issuing service.
TR-027 Test request - Additional panels - Genomic test id Additional ServiceRequest.orderDetail.coding.code elements Additional OBR-4.1 segments The ids of additional genomic tests to the primary tests.
TR-045 Test request - Additional panels - Genomic test id name Additional ServiceRequest.orderDetail.coding.display elements Additional OBR-4.2 segments The name of additional genomic tests to the primary tests.
TR-028 Test request - Target type ServiceRequest.orderDetail.coding.system OBR-4.3 Type of target to test.
TR-029 Test request - Target detail ServiceRequest.orderDetail.coding.code OBR-4.1 Detail of target to test.
TR-019 Test request - Performer ODS code ServiceRequest.performer Normally the recipient of the OML message, potentially could be recorded under ORC-3.2 ODS code of the first organisation which receives the genomic test request.
TR-011 Test request - Count of patients to be tested ServiceRequest.extension:participantCount N/A - for HL7v2, each patient test request SHOULD be sent using a new OML^O21 message Count of patients to be tested.
TR-012 Test request - Urgency reason ServiceRequest.priority.extension:priorityReason N/A could possibly use TQ1-10 If urgent, the test request urgency reason.
TR-013 Test request - Reason for reanalysis Additional ServiceRequest.category elements Likely ORC-29 (TBC) The reason for a genomic test.
TR-014 Test request - Detail of reason for reanalysis ServiceRequest.supportingInfo elements (if structured, ServiceRequest.note if unstructured TBC) NTE segments linked to OBR segment for reanalysis reason The detail associated to the reason reanalysis has been requested.
TR-015 Test request - Type of reanalysis ServiceRequest.orderDetail Additional NTE segments attached to OBR The type of reanalysis which has been requested.
TR-017 Test request - Is urgent ServiceRequest.priority TQ1-9 Confirmation if the test request is urgent.
TR-035 Test request - Purpose of linking ServiceRequest.basedOn.display (for linking to prior orders, familal orders e.g. duo/trio are expected to be inferred from linkage via a requisition) Potentially under the NTE segment for the order prior The reason a given test request has been linked to another test request.
TR-036 Test request - Central email address for reporting Additional PractitionerRole.telecom:system=email (referenced from ServiceRequest.requester) marked with extension:contactpoint-comment indicating reporting, may need to be additionally indicated in subscription depending on notification method used (This element may be replaced with a backport of the ServiceRequest-order-callback-phone-number extension pending investigation) Additional CTD segment (CTD-5.4) Central email address for contingency in the event of not being able to obtain a report via the requester.
TR-020 Test request - Genomic report delivery method PractitionerRole.telecom.rank=1 (referenced from ServiceRequest.requester) (This element may be replaced with a backport of the ServiceRequest-order-callback-phone-number extension pending investigation) CTD-6 Report preferred delivery method.
TR-030 Test request - Add private genomic request and report to NHS record TBC Consent where decision=permit/deny (default=deny), action=disclose, resourceType=DiagnosticReport, policy=https://transform.england.nhs.uk/information-governance/guidance/information-sharing-between-private-healthcare-services-and-nhs-england/ Potentially NTE segment related to OBR Confirmation if the content of a private genomic test request should be added to an NHS record.
TR-031 Test request - Test request form version ServiceRequest.meta.tag This mapping is still being investigated and requires system/code from source application to be populated Potentially NTE segment related to OBR Version of the test order form completed and submitted.
TR-032 Test request - File / Link to file ServiceRequest.supportingInfo referencing DocumentReference containing/pointing to file TBC N/A though could be captured in OBX-5 for order prior as encapsulated data Upload of a file or a link to a file for adding documents such as previous genomic reports to a test order.
TR-033 Test request - File detail DocumentReference.type/description Part of Order prior OBX-5 encapsulated data Detail to provide context to an uploaded file or document link.
TR-034 Test request - Clinical utility ServiceRequest.category TBC OBR-31 Clinical benefit to patient of obtaining a requested genomic report.
TR-039 Test request - Linked test request reference ServiceRequest.basedOn ORC-8 The reference to any associated test requests
TR-044 Test request - DGTS test rare and inherited disease clinical specialty ServiceRequest.reasonCode OBR-24 (Note the HL7v2 codelist does not match the DGTS CodeSystem for clinical specialty) The rare disease specialty a given test is being requested for.