FHIR Genomics Implementation Guide

Notice

Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.

ServiceRequest-NonWGSTestOrderForm-OutOfCountry-Example

Example of a ServiceRequest. After being sent to the central broker, the ServiceRequest is assigned a unique identifier.

ServiceRequest

id : ServiceRequest-NonWGSTestOrderForm-OutOfCountry-Example

extension

url : https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage

value

coding

system : https://fhir.hl7.org.uk/CodeSystem/UKCore-FundingCategory

code : nhs-england

display : NHS England

extension

url : https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact

value

reference : PractitionerRole/PractitionerRole-AnnaLane-Example

status : active

intent : order

category

coding

system : https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory

code : cancer-non-wgs

display : Cancer - Non-WGS

priority : routine

code

coding

system : https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory

code : M3.2

display : Breast Cancer (Oncotype DX)

version : 9

subject

reference : Patient/Patient-KayBurbridge-Example

identifier

system : https://fhir.nhs.uk/Id/nhs-number

value : 8449303541

authoredOn : 2023-11-01T11:00:00Z

requester

reference : PractitionerRole/PractitionerRole-HazelSmithOncology-Example

reasonCode

coding

system : https://fhir.nhs.uk/CodeSystem/reasonfortesting-genomics

code : diagnostic

display : Diagnostic

performer

identifier

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

value : RLU

display : BIRMINGHAM WOMEN'S NHS FOUNDATION TRUST

supportingInfo

reference : Observation/Observation-CellularityKayBurbridge-Example

supportingInfo

reference : Observation/Observation-TumorTypeKayKayBurbridge-Example

supportingInfo

reference : Observation/Observation-NecrosisKayBurbridge-Example

supportingInfo

reference : Observation/Observation-NeoplasticCellKayBurbridge-Example

supportingInfo

reference : Condition/Condition-BreastCancer-Example

specimen

reference : Specimen/Specimen-TissueResection-Example

note

text : Free text for diagnosis/reason for referral, transplant, life status at time of request details/ e.g. e.g. ER positive, HER2 negative. lymph node negative, early breast cancer. Use exisiting tissue sample sent to lab

{
    "resourceType": "ServiceRequest",
    "id": "ServiceRequest-NonWGSTestOrderForm-OutOfCountry-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"
                    }
                ]
            }
        },
        {
            "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact",
            "valueReference": {
                "reference": "PractitionerRole/PractitionerRole-AnnaLane-Example"
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory",
                    "code": "cancer-non-wgs",
                    "display": "Cancer - Non-WGS"
                }
            ]
        }
    ],
    "priority": "routine",
    "code": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory",
                "code": "M3.2",
                "display": "Breast Cancer (Oncotype DX)",
                "version": "9"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-KayBurbridge-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "8449303541"
        }
    },
    "authoredOn": "2023-11-01T11:00:00Z",
    "requester": {
        "reference": "PractitionerRole/PractitionerRole-HazelSmithOncology-Example"
    },
    "reasonCode":  [
        {
            "coding":  [
                {
                    "system": "https://fhir.nhs.uk/CodeSystem/reasonfortesting-genomics",
                    "code": "diagnostic",
                    "display": "Diagnostic"
                }
            ]
        }
    ],
    "performer":  [
        {
            "identifier": {
                "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                "value": "RLU"
            },
            "display": "BIRMINGHAM WOMEN'S NHS FOUNDATION TRUST"
        }
    ],
    "supportingInfo":  [
        {
            "reference": "Observation/Observation-CellularityKayBurbridge-Example"
        },
        {
            "reference": "Observation/Observation-TumorTypeKayKayBurbridge-Example"
        },
        {
            "reference": "Observation/Observation-NecrosisKayBurbridge-Example"
        },
        {
            "reference": "Observation/Observation-NeoplasticCellKayBurbridge-Example"
        },
        {
            "reference": "Condition/Condition-BreastCancer-Example"
        }
    ],
    "specimen":  [
        {
            "reference": "Specimen/Specimen-TissueResection-Example"
        }
    ],
    "note":  [
        {
            "text": "Free text for diagnosis/reason for referral, transplant, life status at time of request details/ e.g. e.g. ER positive, HER2 negative. lymph node negative, early breast cancer. Use exisiting tissue sample sent to lab"
        }
    ]
}

<ServiceRequest xmlns="http://hl7.org/fhir">
    <id value="ServiceRequest-NonWGSTestOrderForm-OutOfCountry-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>
    <extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact">
        <valueReference>
            <reference value="PractitionerRole/PractitionerRole-AnnaLane-Example" />
        </valueReference>
    </extension>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory" />
            <code value="cancer-non-wgs" />
            <display value="Cancer - Non-WGS" />
        </coding>
    </category>
    <priority value="routine" />
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory" />
            <version value="9" />
            <code value="M3.2" />
            <display value="Breast Cancer (Oncotype DX)" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-KayBurbridge-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="8449303541" />
        </identifier>
    </subject>
    <authoredOn value="2023-11-01T11:00:00Z" />
    <requester>
        <reference value="PractitionerRole/PractitionerRole-HazelSmithOncology-Example" />
    </requester>
    <performer>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
            <value value="RLU" />
        </identifier>
        <display value="BIRMINGHAM WOMEN&#39;S NHS FOUNDATION TRUST" />
    </performer>
    <reasonCode>
        <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/reasonfortesting-genomics" />
            <code value="diagnostic" />
            <display value="Diagnostic" />
        </coding>
    </reasonCode>
    <supportingInfo>
        <reference value="Observation/Observation-CellularityKayBurbridge-Example" />
    </supportingInfo>
    <supportingInfo>
        <reference value="Observation/Observation-TumorTypeKayKayBurbridge-Example" />
    </supportingInfo>
    <supportingInfo>
        <reference value="Observation/Observation-NecrosisKayBurbridge-Example" />
    </supportingInfo>
    <supportingInfo>
        <reference value="Observation/Observation-NeoplasticCellKayBurbridge-Example" />
    </supportingInfo>
    <supportingInfo>
        <reference value="Condition/Condition-BreastCancer-Example" />
    </supportingInfo>
    <specimen>
        <reference value="Specimen/Specimen-TissueResection-Example" />
    </specimen>
    <note>
        <text value="Free text for diagnosis/reason for referral, transplant, life status at time of request details/ e.g. e.g. ER positive, HER2 negative. lymph node negative, early breast cancer. Use exisiting tissue sample sent to lab" />
    </note>
</ServiceRequest>

Notice

ServiceRequest-NonWGSTestOrderForm-OutOfCountry-Example

Propose a change to ServiceRequest-NonWGSTestOrderForm-OutOfCountry-Example