Bundle-NonWGSTestOrderForm-FetalScenario-Example

Example of a Non-WGS test request sent to the central broker, as described in the Clinical Scenario:Fetus Management

Bundle
{
"resourceType": "Bundle",
"id": "Bundle-NonWGSTestOrderForm-FetalScenario-Example",
"type": "transaction",
"entry": [
{
"fullUrl": "http://example.org/fhir/PractitionerRole/PractitionerRole-LoisLaneKingstonClinicalGenetics-Example",
"resource": {
"resourceType": "PractitionerRole",
"id": "PractitionerRole-LoisLaneKingstonClinicalGenetics-Example",
"practitioner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/sds-user-id",
"value": "9999999999"
},
"display": "Dr. Lois Lane"
},
"organization": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
},
"display": "Kingston Hospital NHS Foundation Trust"
},
"specialty": [
{
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode",
"code": "311",
"display": "Clinical Genetics"
}
]
}
],
"telecom": [
{
"system": "phone",
"value": "02068457781"
},
{
"system": "email",
"value": "lois.lane1@nhs.net"
},
{
"system": "email",
"value": "clinicalgeneticskingston@nhs.net",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-comment",
"valueString": "reporting"
}
]
},
{
"system": "email",
"value": "fetalmedicinekingston@nhs.net",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-comment",
"valueString": "reporting"
}
]
},
{
"system": "email",
"value": "gptestpracticekingston@nhs.net",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/contactpoint-comment",
"valueString": "reporting"
}
]
}
]
},
"request": {
"method": "POST",
"url": "PractitionerRole"
}
},
{
"fullUrl": "http://example.org/fhir/Patient/Patient-RyanneBoulder-Example",
"resource": {
"resourceType": "Patient",
"id": "Patient-RyanneBoulder-Example",
"extension": [
{
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-AdministrativeGender",
"code": "F",
"display": "Female"
}
]
}
},
{
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-EthnicCategoryEngland",
"code": "A",
"display": "White - British"
}
]
}
}
],
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687",
"extension": [
{
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland",
"version": "1.1.1",
"code": "01",
"display": "Number present and verified"
}
]
}
}
]
},
{
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
],
"name": [
{
"given": [
"Ryanne"
],
"family": "Boulder"
}
],
"birthDate": "1980-09-02",
"deceasedBoolean": false,
"address": [
{
"line": [
"53 Eastwick Pack Avenue",
"Leatherhead",
"Surrey"
],
"postalCode": "KT23 3NP"
}
],
"generalPractitioner": [
{
"identifier": {
"system": "https://fhir.hl7.org.uk/Id/gmp-number",
"value": "G9999999"
},
"display": "Dr. Aero Smith"
},
{
"identifier": {
"system": "https://fhir.hl7.org.uk/Id/ODS-code",
"value": "AP123"
},
"display": "anywhere place"
}
],
"link": [
{
"other": {
"reference": "https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449307687"
},
"type": "seealso"
},
{
"other": {
"reference": "RelatedPerson/RelatedPerson-RyanneBoulder-Example"
},
"type": "seealso"
}
]
},
"request": {
"method": "POST",
"url": "Patient",
"ifNoneExist": "Patient?identifier=https://fhir.nhs.uk/Id/nhs-number|9449307687"
}
},
{
"fullUrl": "http://example.org/fhir/Patient/Patient-FoetusOfRyanneBoulder-Example",
"resource": {
"resourceType": "Patient",
"id": "Patient-FoetusOfRyanneBoulder-Example",
"extension": [
{
"url": "http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus",
"valueCode": "unknown"
}
],
"identifier": [
{
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "FT-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
],
"gender": "unknown"
},
"request": {
"method": "POST",
"url": "Patient",
"ifNoneExist": "Patient?identifier=urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24|FT-RWT13521"
}
},
{
"fullUrl": "http://example.org/fhir/Patient/Patient-RyanneBoulderPartner-Example",
"resource": {
"resourceType": "Patient",
"id": "Patient-RyanneBoulderPartner-Example",
"identifier": [
{
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "P-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
],
"gender": "unknown",
"link": [
{
"other": {
"reference": "RelatedPerson/RelatedPerson-RyanneBoulderPartner-Example"
},
"type": "seealso"
}
]
},
"request": {
"method": "POST",
"url": "Patient",
"ifNoneExist": "Patient?identifier=urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24|P-RWT13521"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-GenomicEthnicity-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-GenomicEthnicity-Example",
"status": "preliminary",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "723621000000103",
"display": "Ethnicity"
}
]
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"valueString": "unknown"
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example",
"resource": {
"resourceType": "ServiceRequest",
"id": "ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example",
"extension": [
{
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-FundingCategory",
"code": "nhs-england",
"display": "NHS England"
}
]
}
}
],
"status": "active",
"intent": "order",
"category": [
{
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory",
"code": "rare-disease-non-wgs",
"display": "Rare Disease - Non-WGS"
}
]
},
{
"coding": [
{
"system": "https://fhir.nhs.uk/CodeSystem/reasonfortesting-genomics",
"code": "staging-or-prognosis",
"display": "Staging or Prognosis"
}
]
}
],
"priority": "urgent",
"code": {
"coding": [
{
"system": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory",
"code": "R21",
"display": "Fetal anomalies with a likely genetic cause",
"version": "7"
}
]
},
"subject": {
"reference": "Patient/Patient-FoetusOfRyanneBoulder-Example",
"identifier": {
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "FT-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
},
"authoredOn": "2023-09-25",
"requester": {
"reference": "PractitionerRole/PractitionerRole-LoisLaneKingstonClinicalGenetics-Example"
},
"supportingInfo": [
{
"reference": "Observation/Observation-HistoryOfFetalLoss-Example"
},
{
"reference": "Observation/Observation-NonConsanguinousUnion-Example"
},
{
"reference": "Observation/Observation-GenomicEthnicity-Example"
},
{
"reference": "Observation/Observation-PregnancyConfirmation-Example"
},
{
"reference": "Observation/Observation-NoTransplant-Example"
},
{
"reference": "Observation/Observation-NoFirstTrimesterFetalAnomalies-Example"
},
{
"reference": "Observation/Observation-NoSecondTrimesterFetalAnomalies-Example"
},
{
"reference": "Procedure/Procedure-InVitroFertilisation-Example"
},
{
"reference": "RelatedPerson/RelatedPerson-RyanneBoulder-Example"
},
{
"reference": "Patient/Patient-RyanneBoulder-Example"
},
{
"reference": "RelatedPerson/RelatedPerson-RyanneBoulderPartner-Example"
},
{
"reference": "Patient/Patient-RyanneBoulderPartner-Example"
},
{
"reference": "Specimen/Specimen-BloodEDTA-Example"
},
{
"reference": "Specimen/Specimen-RyanneBoulderSaliva-Example"
}
],
"note": [
{
"text": "Samples are to be provided at a later date"
},
{
"text": "No family history of relevant testing"
},
{
"text": "Free text for diagnosis/reason for referral, relevant information including family history, phenotypic details/ HPO Terms/ E.g. large echogenic kidneys with normal bladder"
}
]
},
"request": {
"method": "POST",
"url": "ServiceRequest"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-HistoryOfFetalLoss-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-HistoryOfFetalLoss-Example",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "161743003",
"display": "Past pregnancy history of stillbirth"
}
],
"text": "Is the testing for a fetal loss from 24+0 or more weeks of gestation?"
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"effectiveDateTime": "2023-09-25",
"valueBoolean": false
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-PregnancyConfirmation-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-PregnancyConfirmation-Example",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "77386006",
"display": "Pregnancy"
}
]
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "720451000000102",
"display": "Assisted conception"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "226081000000107",
"display": "Gestational age"
}
]
},
"valueQuantity": {
"value": 87,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "161714006",
"display": "Estimated date of delivery"
}
]
},
"valueDateTime": "2024-05-01"
}
],
"effectiveDateTime": "2023-09-25"
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-NonConsanguinousUnion-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-NonConsanguinousUnion-Example",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "160475008",
"display": "Family history: Consanguinity"
}
]
},
"subject": {
"reference": "Patient/Patient-FoetusOfRyanneBoulder-Example",
"identifier": {
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "FT-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
},
"effectiveDateTime": "2023-09-25",
"valueBoolean": false
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-NoTransplant-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-NoTransplant-Example",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "416128008",
"display": "No history of procedure"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "263903005",
"display": "Transplant"
}
]
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"effectiveDateTime": "2023-09-25"
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-NoFirstTrimesterFetalAnomalies-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-NoFirstTrimesterFetalAnomalies-Example",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "609520005",
"display": "Disorder of fetal structure"
}
],
"text": "First Trimester Anomalies?"
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "255246003",
"display": "First trimester"
}
]
}
}
],
"effectiveDateTime": "2023-09-25",
"valueBoolean": false
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/Observation/Observation-NoSecondTrimesterFetalAnomalies-Example",
"resource": {
"resourceType": "Observation",
"id": "Observation-NoSecondTrimesterFetalAnomalies-Example",
"status": "final",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "609520005",
"display": "Disorder of fetal structure"
}
],
"text": "Second Trimester Anomalies?"
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "255247007",
"display": "Second trimester"
}
]
}
}
],
"effectiveDateTime": "2023-09-25",
"valueBoolean": false
},
"request": {
"method": "POST",
"url": "Observation"
}
},
{
"fullUrl": "http://example.org/fhir/Procedure/Procedure-InVitroFertilisation-Example",
"resource": {
"resourceType": "Procedure",
"id": "Procedure-InVitroFertilisation-Example",
"status": "completed",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "52637005",
"display": "In vitro fertilisation"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"performedDateTime": "2023-09-25",
"note": [
{
"text": "Woman`s own egg"
}
]
},
"request": {
"method": "POST",
"url": "Procedure"
}
},
{
"fullUrl": "http://example.org/fhir/Specimen/Specimen-BloodEDTA-Example",
"resource": {
"resourceType": "Specimen",
"id": "Specimen-BloodEDTA-Example",
"identifier": [
{
"system": "https://fhir.kingstonhospital.nhs.uk/Id/specimenId",
"value": "ROA-69050-216738"
}
],
"status": "unavailable",
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"
}
]
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"request": [
{
"reference": "ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example"
}
],
"container": [
{
"additiveCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "69519002",
"display": "EDTA"
}
]
}
}
]
},
"request": {
"method": "POST",
"url": "Specimen"
}
},
{
"fullUrl": "http://example.org/fhir/Specimen/Specimen-RyanneBoulderSaliva-Example",
"resource": {
"resourceType": "Specimen",
"id": "Specimen-RyanneBoulderSaliva-Example",
"identifier": [
{
"system": "https://fhir.kingstonhospital.nhs.uk/Id/specimenId",
"value": "ROA-69050-216739"
}
],
"status": "available",
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "119342007",
"display": "Saliva specimen"
}
]
},
"subject": {
"reference": "Patient/Patient-RyanneBoulder-Example",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
},
"container": [
{
"description": "Container:ROA-69050-216739 contains Saliva for Mother"
}
],
"request": [
{
"reference": "ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example"
}
]
},
"request": {
"method": "POST",
"url": "Specimen"
}
},
{
"fullUrl": "http://example.org/fhir/RelatedPerson/RelatedPerson-RyanneBoulder-Example",
"resource": {
"resourceType": "RelatedPerson",
"id": "RelatedPerson-RyanneBoulder-Example",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9449307687"
}
],
"patient": {
"reference": "Patient/Patient-FoetusOfRyanneBoulder-Example",
"identifier": {
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "FT-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
},
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "NMTHF",
"display": "natural mother of fetus"
}
]
}
]
},
"request": {
"method": "POST",
"url": "RelatedPerson"
}
},
{
"fullUrl": "http://example.org/fhir/RelatedPerson/RelatedPerson-RyanneBoulderPartner-Example",
"resource": {
"resourceType": "RelatedPerson",
"id": "RelatedPerson-RyanneBoulderPartner-Example",
"identifier": [
{
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "P-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
],
"patient": {
"reference": "Patient/Patient-FoetusOfRyanneBoulder-Example",
"identifier": {
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
"value": "FT-RWT13521",
"assigner": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "RAX"
}
}
}
},
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "NFTHF",
"display": "natural father of fetus"
}
]
}
]
},
"request": {
"method": "POST",
"url": "RelatedPerson"
}
}
]
}
<Bundle xmlns="http://hl7.org/fhir">
<id value="Bundle-NonWGSTestOrderForm-FetalScenario-Example" />
<type value="transaction" />
<entry>
<fullUrl value="http://example.org/fhir/PractitionerRole/PractitionerRole-LoisLaneKingstonClinicalGenetics-Example" />
<resource>
<PractitionerRole>
<id value="PractitionerRole-LoisLaneKingstonClinicalGenetics-Example" />
<practitioner>
<identifier>
<system value="https://fhir.nhs.uk/Id/sds-user-id" />
<value value="9999999999" />
</identifier>
<display value="Dr. Lois Lane" />
</practitioner>
<organization>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
<display value="Kingston Hospital NHS Foundation Trust" />
</organization>
<specialty>
<coding>
<system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode" />
<code value="311" />
<display value="Clinical Genetics" />
</coding>
</specialty>
<telecom>
<system value="phone" />
<value value="02068457781" />
</telecom>
<telecom>
<system value="email" />
<value value="lois.lane1@nhs.net" />
</telecom>
<telecom>
<extension url="http://hl7.org/fhir/StructureDefinition/contactpoint-comment">
<valueString value="reporting" />
</extension>
<system value="email" />
<value value="clinicalgeneticskingston@nhs.net" />
</telecom>
<telecom>
<extension url="http://hl7.org/fhir/StructureDefinition/contactpoint-comment">
<valueString value="reporting" />
</extension>
<system value="email" />
<value value="fetalmedicinekingston@nhs.net" />
</telecom>
<telecom>
<extension url="http://hl7.org/fhir/StructureDefinition/contactpoint-comment">
<valueString value="reporting" />
</extension>
<system value="email" />
<value value="gptestpracticekingston@nhs.net" />
</telecom>
</PractitionerRole>
</resource>
<request>
<method value="POST" />
<url value="PractitionerRole" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Patient/Patient-RyanneBoulder-Example" />
<resource>
<Patient>
<id value="Patient-RyanneBoulder-Example" />
<extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-AdministrativeGender" />
<code value="F" />
<display value="Female" />
</coding>
</valueCodeableConcept>
</extension>
<extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory">
<valueCodeableConcept>
<coding>
<system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-EthnicCategoryEngland" />
<code value="A" />
<display value="White - British" />
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus">
<valueCodeableConcept>
<coding>
<system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland" />
<version value="1.1.1" />
<code value="01" />
<display value="Number present and verified" />
</coding>
</valueCodeableConcept>
</extension>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
<name>
<family value="Boulder" />
<given value="Ryanne" />
</name>
<birthDate value="1980-09-02" />
<deceasedBoolean value="false" />
<address>
<line value="53 Eastwick Pack Avenue" />
<line value="Leatherhead" />
<line value="Surrey" />
<postalCode value="KT23 3NP" />
</address>
<generalPractitioner>
<identifier>
<system value="https://fhir.hl7.org.uk/Id/gmp-number" />
<value value="G9999999" />
</identifier>
<display value="Dr. Aero Smith" />
</generalPractitioner>
<generalPractitioner>
<identifier>
<system value="https://fhir.hl7.org.uk/Id/ODS-code" />
<value value="AP123" />
</identifier>
<display value="anywhere place" />
</generalPractitioner>
<link>
<other>
<reference value="https://api.service.nhs.uk/personal-demographics/FHIR/R4/Patient/9449307687" />
</other>
<type value="seealso" />
</link>
<link>
<other>
<reference value="RelatedPerson/RelatedPerson-RyanneBoulder-Example" />
</other>
<type value="seealso" />
</link>
</Patient>
</resource>
<request>
<method value="POST" />
<url value="Patient" />
<ifNoneExist value="Patient?identifier=https://fhir.nhs.uk/Id/nhs-number|9449307687" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Patient/Patient-FoetusOfRyanneBoulder-Example" />
<resource>
<Patient>
<id value="Patient-FoetusOfRyanneBoulder-Example" />
<extension url="http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus">
<valueCode value="unknown" />
</extension>
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="FT-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
<gender value="unknown" />
</Patient>
</resource>
<request>
<method value="POST" />
<url value="Patient" />
<ifNoneExist value="Patient?identifier=urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24|FT-RWT13521" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Patient/Patient-RyanneBoulderPartner-Example" />
<resource>
<Patient>
<id value="Patient-RyanneBoulderPartner-Example" />
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="P-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
<gender value="unknown" />
<link>
<other>
<reference value="RelatedPerson/RelatedPerson-RyanneBoulderPartner-Example" />
</other>
<type value="seealso" />
</link>
</Patient>
</resource>
<request>
<method value="POST" />
<url value="Patient" />
<ifNoneExist value="Patient?identifier=urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24|P-RWT13521" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-GenomicEthnicity-Example" />
<resource>
<Observation>
<id value="Observation-GenomicEthnicity-Example" />
<status value="preliminary" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="723621000000103" />
<display value="Ethnicity" />
</coding>
</code>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<valueString value="unknown" />
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example" />
<resource>
<ServiceRequest>
<id value="ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example" />
<extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage">
<valueCodeableConcept>
<coding>
<system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-FundingCategory" />
<code value="nhs-england" />
<display value="NHS England" />
</coding>
</valueCodeableConcept>
</extension>
<status value="active" />
<intent value="order" />
<category>
<coding>
<system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory" />
<code value="rare-disease-non-wgs" />
<display value="Rare Disease - Non-WGS" />
</coding>
</category>
<category>
<coding>
<system value="https://fhir.nhs.uk/CodeSystem/reasonfortesting-genomics" />
<code value="staging-or-prognosis" />
<display value="Staging or Prognosis" />
</coding>
</category>
<priority value="urgent" />
<code>
<coding>
<system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory" />
<version value="7" />
<code value="R21" />
<display value="Fetal anomalies with a likely genetic cause" />
</coding>
</code>
<subject>
<reference value="Patient/Patient-FoetusOfRyanneBoulder-Example" />
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="FT-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
</subject>
<authoredOn value="2023-09-25" />
<requester>
<reference value="PractitionerRole/PractitionerRole-LoisLaneKingstonClinicalGenetics-Example" />
</requester>
<supportingInfo>
<reference value="Observation/Observation-HistoryOfFetalLoss-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Observation/Observation-NonConsanguinousUnion-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Observation/Observation-GenomicEthnicity-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Observation/Observation-PregnancyConfirmation-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Observation/Observation-NoTransplant-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Observation/Observation-NoFirstTrimesterFetalAnomalies-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Observation/Observation-NoSecondTrimesterFetalAnomalies-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Procedure/Procedure-InVitroFertilisation-Example" />
</supportingInfo>
<supportingInfo>
<reference value="RelatedPerson/RelatedPerson-RyanneBoulder-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Patient/Patient-RyanneBoulder-Example" />
</supportingInfo>
<supportingInfo>
<reference value="RelatedPerson/RelatedPerson-RyanneBoulderPartner-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Patient/Patient-RyanneBoulderPartner-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Specimen/Specimen-BloodEDTA-Example" />
</supportingInfo>
<supportingInfo>
<reference value="Specimen/Specimen-RyanneBoulderSaliva-Example" />
</supportingInfo>
<note>
<text value="Samples are to be provided at a later date" />
</note>
<note>
<text value="No family history of relevant testing" />
</note>
<note>
<text value="Free text for diagnosis/reason for referral, relevant information including family history, phenotypic details/ HPO Terms/ E.g. large echogenic kidneys with normal bladder" />
</note>
</ServiceRequest>
</resource>
<request>
<method value="POST" />
<url value="ServiceRequest" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-HistoryOfFetalLoss-Example" />
<resource>
<Observation>
<id value="Observation-HistoryOfFetalLoss-Example" />
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="161743003" />
<display value="Past pregnancy history of stillbirth" />
</coding>
<text value="Is the testing for a fetal loss from 24+0 or more weeks of gestation?" />
</code>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<effectiveDateTime value="2023-09-25" />
<valueBoolean value="false" />
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-PregnancyConfirmation-Example" />
<resource>
<Observation>
<id value="Observation-PregnancyConfirmation-Example" />
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="77386006" />
<display value="Pregnancy" />
</coding>
</code>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<effectiveDateTime value="2023-09-25" />
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="720451000000102" />
<display value="Assisted conception" />
</coding>
</code>
</component>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="226081000000107" />
<display value="Gestational age" />
</coding>
</code>
<valueQuantity>
<value value="87" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</valueQuantity>
</component>
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="161714006" />
<display value="Estimated date of delivery" />
</coding>
</code>
<valueDateTime value="2024-05-01" />
</component>
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-NonConsanguinousUnion-Example" />
<resource>
<Observation>
<id value="Observation-NonConsanguinousUnion-Example" />
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="160475008" />
<display value="Family history: Consanguinity" />
</coding>
</code>
<subject>
<reference value="Patient/Patient-FoetusOfRyanneBoulder-Example" />
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="FT-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
</subject>
<effectiveDateTime value="2023-09-25" />
<valueBoolean value="false" />
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-NoTransplant-Example" />
<resource>
<Observation>
<id value="Observation-NoTransplant-Example" />
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="416128008" />
<display value="No history of procedure" />
</coding>
</code>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<effectiveDateTime value="2023-09-25" />
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="263903005" />
<display value="Transplant" />
</coding>
</valueCodeableConcept>
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-NoFirstTrimesterFetalAnomalies-Example" />
<resource>
<Observation>
<id value="Observation-NoFirstTrimesterFetalAnomalies-Example" />
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="609520005" />
<display value="Disorder of fetal structure" />
</coding>
<text value="First Trimester Anomalies?" />
</code>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<effectiveDateTime value="2023-09-25" />
<valueBoolean value="false" />
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="255246003" />
<display value="First trimester" />
</coding>
</code>
</component>
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/Observation-NoSecondTrimesterFetalAnomalies-Example" />
<resource>
<Observation>
<id value="Observation-NoSecondTrimesterFetalAnomalies-Example" />
<status value="final" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="609520005" />
<display value="Disorder of fetal structure" />
</coding>
<text value="Second Trimester Anomalies?" />
</code>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<effectiveDateTime value="2023-09-25" />
<valueBoolean value="false" />
<component>
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="255247007" />
<display value="Second trimester" />
</coding>
</code>
</component>
</Observation>
</resource>
<request>
<method value="POST" />
<url value="Observation" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Procedure/Procedure-InVitroFertilisation-Example" />
<resource>
<Procedure>
<id value="Procedure-InVitroFertilisation-Example" />
<status value="completed" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="52637005" />
<display value="In vitro fertilisation" />
</coding>
</code>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<performedDateTime value="2023-09-25" />
<note>
<text value="Woman`s own egg" />
</note>
</Procedure>
</resource>
<request>
<method value="POST" />
<url value="Procedure" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Specimen/Specimen-BloodEDTA-Example" />
<resource>
<Specimen>
<id value="Specimen-BloodEDTA-Example" />
<identifier>
<system value="https://fhir.kingstonhospital.nhs.uk/Id/specimenId" />
<value value="ROA-69050-216738" />
</identifier>
<status value="unavailable" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119297000" />
<display value="Blood specimen" />
</coding>
</type>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<request>
<reference value="ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example" />
</request>
<container>
<additiveCodeableConcept>
<coding>
<system value="http://snomed.info/sct" />
<code value="69519002" />
<display value="EDTA" />
</coding>
</additiveCodeableConcept>
</container>
</Specimen>
</resource>
<request>
<method value="POST" />
<url value="Specimen" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Specimen/Specimen-RyanneBoulderSaliva-Example" />
<resource>
<Specimen>
<id value="Specimen-RyanneBoulderSaliva-Example" />
<identifier>
<system value="https://fhir.kingstonhospital.nhs.uk/Id/specimenId" />
<value value="ROA-69050-216739" />
</identifier>
<status value="available" />
<type>
<coding>
<system value="http://snomed.info/sct" />
<code value="119342007" />
<display value="Saliva specimen" />
</coding>
</type>
<subject>
<reference value="Patient/Patient-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
</subject>
<request>
<reference value="ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FetalScenario-Example" />
</request>
<container>
<description value="Container:ROA-69050-216739 contains Saliva for Mother" />
</container>
</Specimen>
</resource>
<request>
<method value="POST" />
<url value="Specimen" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/RelatedPerson/RelatedPerson-RyanneBoulder-Example" />
<resource>
<RelatedPerson>
<id value="RelatedPerson-RyanneBoulder-Example" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9449307687" />
</identifier>
<patient>
<reference value="Patient/Patient-FoetusOfRyanneBoulder-Example" />
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="FT-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
</patient>
<relationship>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode" />
<code value="NMTHF" />
<display value="natural mother of fetus" />
</coding>
</relationship>
</RelatedPerson>
</resource>
<request>
<method value="POST" />
<url value="RelatedPerson" />
</request>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/RelatedPerson/RelatedPerson-RyanneBoulderPartner-Example" />
<resource>
<RelatedPerson>
<id value="RelatedPerson-RyanneBoulderPartner-Example" />
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="P-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
<patient>
<reference value="Patient/Patient-FoetusOfRyanneBoulder-Example" />
<identifier>
<system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
<value value="FT-RWT13521" />
<assigner>
<identifier>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
<value value="RAX" />
</identifier>
</assigner>
</identifier>
</patient>
<relationship>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode" />
<code value="NFTHF" />
<display value="natural father of fetus" />
</coding>
</relationship>
</RelatedPerson>
</resource>
<request>
<method value="POST" />
<url value="RelatedPerson" />
</request>
</entry>
</Bundle>