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.

Extensions

The extensions created specifically for use in Genomics are listed below. Some of the extensions listed may still be in draft and pending further changes once requirements for the GMS have been finalised.

Extensions

Extension: Alternate Reference

Usage

A generic extension used to replicate the changes within R5 to support adding a reference to image or data source(DocumentReference).

Note:

Reference to DocumentReference resources pointing to the Genomic Data Files used as the basis for the report. Usage of this field over extension:supporting-info is pending further investigation.

Context of Use

DiagnosticReport

Tree View

AlternateReference (Extension)	C		Extension	Element id Extension Short description Alternative reference (target type is wrong) Definition Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions. Comments Given that a reference SHALL have a display or reference, using this extension implies that there's a display present. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..0	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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/StructureDefinition/alternate-reference Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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(Resource)	Data type Reference(Resource)

Detailed Descriptions

Extension
Short	Alternative reference (target type is wrong)
Definition	Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.
Cardinality	0..1
Comments	Given that a reference SHALL have a display or reference, using this extension implies that there's a display present.
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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..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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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/StructureDefinition/alternate-reference
Mappings	rim: N/A
Extension.value[x]
Short	Value of extension
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	Reference(Resource)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		0..1
Extension.id	string	0..1
Extension.extension	Extension	0..0
Extension.url	uri	1..1
Extension.value[x]	Reference(Resource)	1..1

XML View

</extension>

</extension>

</extension>

</extension>

</identifier>

</telecom>

</contact>

</coding>

</jurisdiction>

<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />

</mapping>

</context>

</extension>

<path value="Extension" />
<short value="Alternative reference (target type is wrong)" />
<definition value="Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions." />
<comment value="Given that a reference SHALL have a display or reference, using this extension implies that there's a display present." />
<min value="0" />
<max value="1" />
<base>
<path value="Extension" />
<min value="0" />
<max value="*" />
</base>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />

</element>

<path value="Extension.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>

</element>

</discriminator>

</slicing>

<base>

<path value="Element.extension" />
<min value="0" />
<max value="*" />

</base>

<type>

</type>

<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />

</constraint>

<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />

</constraint>

</element>

<path value="Extension.url" />
<representation value="xmlAttr" />
<short value="identifies the meaning of the extension" />
<definition value="Source of the definition for the extension code - a logical name or a URL." />
<comment value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<fixedUri value="http://hl7.org/fhir/StructureDefinition/alternate-reference" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>

</element>

<base>

<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />

</base>

<type>

</type>

<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />

</constraint>

</mapping>

</element>

</snapshot>

<path value="Extension" />
<short value="Alternative reference (target type is wrong)" />
<definition value="Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions." />
<comment value="Given that a reference SHALL have a display or reference, using this extension implies that there's a display present." />
<min value="0" />
<max value="1" />

</element>

</element>

</element>

<type>

</type>

</element>

</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",

"id": "alternate-reference",

"extension": [

{

"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",

"valueCode": "fhir"

{

"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",

"valueInteger": 2

{

"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",

"valueCode": "trial-use"

{

"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics",

"valueCode": "can-bind"

}

"url": "http://hl7.org/fhir/StructureDefinition/alternate-reference",

"identifier": [

{

"system": "urn:ietf:rfc:3986",

"value": "urn:oid:2.16.840.1.113883.4.642.5.1662"

}

"version": "5.3.0-ballot-tc1",

"name": "AlternateReference",

"title": "Alternate Reference",

"status": "active",

"experimental": false,

"date": "2014-04-27",

"publisher": "HL7 International / FHIR Infrastructure",

"contact": [

{

"telecom": [

{

"system": "url",

"value": "http://www.hl7.org/Special/committees/fiwg"

}

]

}

"description": "Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.",

"jurisdiction": [

{

"coding": [

{

"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",

"code": "001"

}

]

}

"fhirVersion": "4.0.1",

"mapping": [

{

"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"

}

"kind": "complex-type",

"abstract": false,

"context": [

{

"type": "element",

"expression": "Reference"

}

"type": "Extension",

"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",

"derivation": "constraint",

"snapshot": {

"extension": [

{

"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",

"valueString": "4.0.1"

}

"element": [

{

"id": "Extension",
"path": "Extension",
"short": "Alternative reference (target type is wrong)",
"definition": "Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.",
"comment": "Given that a reference SHALL have a display or reference, using this extension implies that there's a display present.",
"min": 0,
"max": "1",
"base": {
"path": "Extension",
"min": 0,
"max": "*"
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false

{

"id": "Extension.id",

"path": "Extension.id",

"representation": [

"xmlAttr"

"short": "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.",

"min": 0,

"max": "1",

"base": {

"path": "Element.id",
"min": 0,
"max": "1"

"type": [

{

"extension": [

{

"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",

"valueUrl": "string"

}

"code": "http://hl7.org/fhirpath/System.String"

}

"isModifier": false,

"isSummary": false,

"mapping": [

{

"identity": "rim",

"map": "n/a"

}

]

{

"id": "Extension.extension",

"path": "Extension.extension",

"slicing": {

"discriminator": [

{

"type": "value",

"path": "url"

}

"description": "Extensions are always sliced by (at least) url",

"rules": "open"

"short": "Extension",

"definition": "An Extension",

"min": 0,

"max": "0",

"base": {

"path": "Element.extension",
"min": 0,
"max": "*"

"type": [

{

"code": "Extension"

}

"constraint": [

{

"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"

{

"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"

}

"isModifier": false,

"isSummary": false

{

"id": "Extension.url",
"path": "Extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "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.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "http://hl7.org/fhir/StructureDefinition/alternate-reference",
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]

{

"id": "Extension.value[x]",

"path": "Extension.value[x]",

"short": "Value of extension",

"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",

"min": 1,

"max": "1",

"base": {

"path": "Extension.value[x]",
"min": 0,
"max": "1"

"type": [

{

"code": "Reference",

"targetProfile": [

"http://hl7.org/fhir/StructureDefinition/Resource"

]

}

"constraint": [

{

"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"

}

"isModifier": false,

"isSummary": false,

"mapping": [

{

"identity": "rim",

"map": "N/A"

}

]

}

]

"differential": {

"element": [

{

"id": "Extension",
"path": "Extension",
"short": "Alternative reference (target type is wrong)",
"definition": "Used when the target of the reference has a type that is not allowed by the definition of the element. In general, this should only arise when wrangling between versions using cross-version extensions.",
"comment": "Given that a reference SHALL have a display or reference, using this extension implies that there's a display present.",
"min": 0,
"max": "1"

{

"id": "Extension.extension",
"path": "Extension.extension",
"max": "0"

{

"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "http://hl7.org/fhir/StructureDefinition/alternate-reference"

{

"id": "Extension.value[x]",
"path": "Extension.value[x]",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Resource"
]
}
]

}

]

}

Example-Extension-GenomicTest-ParticipantCount

Propose a change to

Extension:BodyStructure Reference

Usage

An extension used to record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

Context of Use

Specimen

Tree View

BodyStructure Reference (Extension)	C		Extension	Element id Extension Short description Target anatomic location or structure Definition Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..0	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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/StructureDefinition/bodySite Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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)	Data type Reference(BodyStructure)

Detailed Descriptions

Extension
Short	Target anatomic location or structure
Definition	Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.
Cardinality	0..1
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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..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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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/StructureDefinition/bodySite
Mappings	rim: N/A
Extension.value[x]
Short	Value of extension
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	Reference(BodyStructure)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		0..1
Extension.id	string	0..1
Extension.extension	Extension	0..0
Extension.url	uri	1..1
Extension.value[x]	Reference(BodyStructure)	1..1

XML View

</extension>

</extension>

</telecom>

</contact>

<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />

</mapping>

</context>

<path value="Extension" />
<short value="Target anatomic location or structure" />
<definition value="Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case." />
<min value="0" />
<max value="1" />
<base>
<path value="Extension" />
<min value="0" />
<max value="*" />
</base>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />

</element>

<path value="Extension.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>

</element>

</discriminator>

</slicing>

<base>

<path value="Element.extension" />
<min value="0" />
<max value="*" />

</base>

<type>

</type>

<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />

</constraint>

<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />

</constraint>

</element>

<path value="Extension.url" />
<representation value="xmlAttr" />
<short value="identifies the meaning of the extension" />
<definition value="Source of the definition for the extension code - a logical name or a URL." />
<comment value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<fixedUri value="http://hl7.org/fhir/StructureDefinition/bodySite" />
<isModifier value="false" />
<isSummary value="false" />
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>

</element>

<base>

<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />

</base>

<type>

</type>

<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />

</constraint>

</mapping>

</element>

</snapshot>

<path value="Extension" />
<short value="Target anatomic location or structure" />
<definition value="Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case." />
<min value="0" />
<max value="1" />

</element>

</element>

</element>

<type>

</type>

</element>

</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "bodySite",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fhir"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 1
}
],
"url": "http://hl7.org/fhir/StructureDefinition/bodySite",
"version": "4.0.1",
"name": "BodyStructure Reference",
"title": "Body Site",
"status": "draft",
"date": "2013-12-05",
"publisher": "Health Level Seven International (FHIR Infrastructure)",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/fiwg"
}
]
}
],
"description": "Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.",
"fhirVersion": "4.0.1",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "Element"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "Target anatomic location or structure",
"definition": "Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.",
"min": 0,
"max": "1",
"base": {
"path": "Extension",
"min": 0,
"max": "*"
},
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "Extension.id",
"path": "Extension.id",
"representation": [
"xmlAttr"
],
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Extension.extension",
"path": "Extension.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "0",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "Extension.url",
"path": "Extension.url",
"representation": [
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "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.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "http://hl7.org/fhir/StructureDefinition/bodySite",
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "Value of extension",
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/BodyStructure"
]
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "Target anatomic location or structure",
"definition": "Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.",
"min": 0,
"max": "1"
},
{
"id": "Extension.extension",
"path": "Extension.extension",
"max": "0"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "http://hl7.org/fhir/StructureDefinition/bodySite"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/BodyStructure"
]
}
]
}
]
}

}

Examples

An example to illustrate the use of Extension:BodyStructure Reference.
Specimen-TissueResection-Example

ExtensionGenomicTestParticipantCount

Usage

An extension used to record the total number of participants in a group test request.(e.g. family, duo / trio).

Context of Use

ServiceRequest, RequestGroup

Canonical_URL	Status	Current_Version	Last_Updated	Description	Profile_Purpose
https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount	draft	0.1.0	2026-03-26	An Extension used to record the total number of participants in a group test request.(e.g. family, duo / trio).	This is a use case from Genomics, used to record the total number of participants in a family or group test request.

Tree View

ExtensionGenomicTestParticipantCount (Extension)	C		Extension	There are no (further) constraints on this element Element id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..0	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount Mappings rim: N/A
value[x]		0..1		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueInteger			integer	Data type integer

Detailed Descriptions

Extension
Short	Optional Extensions Element
Definition	Optional Extension Element - found in all resources.
Cardinality	0..*
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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..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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount
Mappings	rim: N/A
Extension.value[x]
Short	Value of extension
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	0..1
Type	integer
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..
Extension.extension		..0
Extension.url		..
Extension.value[x]	integer	..

XML View

<id value="Extension-GenomicTest-ParticipantCount" />
<url value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount" />
<version value="0.1.0" />
<name value="ExtensionGenomicTestParticipantCount" />
<title value="Extension Genomic Test ParticipantCount" />
<status value="draft" />
<date value="2026-03-26" />
<publisher value="NHS England" />
<contact>
<name value="NHS England" />
<telecom>
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="An Extension used to record the total number of participants in a group test request.(e.g. family, duo / trio)." />
<purpose value="This is a use case from Genomics, used to record the total number of participants in a family or group test request." />
<copyright value="Copyright © 2026+ NHS England 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 value="4.0.1" />
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="RequestGroup" />
</context>
<context>
<type value="element" />
<expression value="ServiceRequest" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension.extension">
<path value="Extension.extension" />
<max value="0" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<type>
<code value="integer" />
</type>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-GenomicTest-ParticipantCount",
"url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount",
"version": "0.1.0",
"name": "ExtensionGenomicTestParticipantCount",
"title": "Extension Genomic Test ParticipantCount",
"status": "draft",
"date": "2026-03-26",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work",
"rank": 1
}
]
}
],
"description": "An Extension used to record the total number of participants in a group test request.(e.g. family, duo / trio).",
"purpose": "This is a use case from Genomics, used to record the total number of participants in a family or group test request.",
"copyright": "Copyright © 2026+ NHS England 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": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "RequestGroup"
},
{
"type": "element",
"expression": "ServiceRequest"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension.extension",
"path": "Extension.extension",
"max": "0"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"type": [
{
"code": "integer"
}
]
}
]
}

}

Example-Extension-GenomicTest-ParticipantCount

Propose a change to ExtensionGenomicTestParticipantCount

ExtensionGenomicTestCodeVersion

Usage

The DGTS (Genomic Test Services) and PanelApp both maintain release versions and individual test code versions. The Extension-GenomicTestCode-Version has been provided to record specific test code version number.

Context of Use

ServiceRequest

Canonical_URL	Status	Current_Version	Last_Updated	Description	Profile_Purpose
https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version	draft	0.1.0	2025-10-21	An Extension used to record the version of the Genomic Test being ordered. E.g, "system": "https://nhsgms-panelapp.genomicsengland.co.uk", code": "R31",valueDecimal": 7.0	This is a use case from Genomics, used to record the test code version of the Genomic Test being ordered.

Tree View

ExtensionGenomicTestCodeVersion (Extension)	C		Extension	There are no (further) constraints on this element Element id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..0	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version Mappings rim: N/A
value[x]		0..1		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueDecimal			decimal	Data type decimal

Detailed Descriptions

Extension
Short	Optional Extensions Element
Definition	Optional Extension Element - found in all resources.
Cardinality	0..*
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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..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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version
Mappings	rim: N/A
Extension.value[x]
Short	Value of extension
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	0..1
Type	decimal
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..
Extension.extension		..0
Extension.url		..
Extension.value[x]	decimal	..

XML View

<id value="Extension-GenomicTestCode-Version" />
<url value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
<version value="0.1.0" />
<name value="ExtensionGenomicTestCodeVersion" />
<title value="Extension Genomic Test Code Version" />
<status value="draft" />
<date value="2025-10-21" />
<publisher value="NHS England" />
<contact>
<name value="NHS England" />
<telecom>
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
</telecom>
</contact>
<description value="An Extension used to record the version of the Genomic Test being ordered. E.g, "system": "https://nhsgms-panelapp.genomicsengland.co.uk", code": "R31",valueDecimal": 7.0" />
<purpose value="This is a use case from Genomics, used to record the test code version of the Genomic Test being ordered. " />
<copyright value="Copyright © 2025+ NHS England 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 value="4.0.1" />
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="Coding" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension.extension">
<path value="Extension.extension" />
<max value="0" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<type>
<code value="decimal" />
</type>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-GenomicTestCode-Version",
"url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version",
"version": "0.1.0",
"name": "ExtensionGenomicTestCodeVersion",
"title": "Extension Genomic Test Code Version",
"status": "draft",
"date": "2025-10-21",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net"
}
]
}
],
"description": "An Extension used to record the version of the Genomic Test being ordered. E.g, \"system\": \"https://nhsgms-panelapp.genomicsengland.co.uk\", code\": \"R31\",valueDecimal\": 7.0",
"purpose": "This is a use case from Genomics, used to record the test code version of the Genomic Test being ordered. ",
"copyright": "Copyright © 2025+ NHS England 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": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "Coding"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension.extension",
"path": "Extension.extension",
"max": "0"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"type": [
{
"code": "decimal"
}
]
}
]
}

}

https://simplifier.net/guide/fhir-genomics-implementation-guide/home/fhirassets/profiles/all-profiles/ukcore-servicerequest.page.md?version=current#orderDetail

Propose a change to ExtensionGenomicTestCodeVersion

Extension-UKCore-AdditionalContact

Usage

An extension to support recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician.

Context of Use

ServiceRequest

Tree View

ExtensionUKCoreAdditionalContact (Extension)	C		Extension	Element id Extension Short description Details of an additional contact Definition Details of an additional contact, who should be contacted regarding questions arising from the service request. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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-AdditionalContact Mappings rim: N/A
value[x]		1..1		Element id Extension.value[x] Short description A link to a the resource to be contacted. Definition A link to the Organization, Practitioner, or PractitionerRole resource to be contacted. Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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(Organization \| Practitioner \| PractitionerRole)	Data type Reference(Organization \| Practitioner \| PractitionerRole)

Detailed Descriptions

Extension
Short	Details of an additional contact
Definition	Details of an additional contact, who should be contacted regarding questions arising from the service request.
Cardinality	0..*
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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-AdditionalContact
Mappings	rim: N/A
Extension.value[x]
Short	A link to a the resource to be contacted.
Definition	A link to the Organization, Practitioner, or PractitionerRole resource to be contacted.
Cardinality	1..1
Type	Reference(Organization \| Practitioner \| PractitionerRole)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..
Extension.url		..
Extension.value[x]	Reference(Organization \| Practitioner \| PractitionerRole)	1..

XML View

<id value="Extension-UKCore-AdditionalContact" />
<url value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact" />
<version value="1.1.0" />
<name value="ExtensionUKCoreAdditionalContact" />
<title value="Extension UK Core Additional Contact" />
<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="An extension to support recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician." />
<purpose value="This is a Genomics use case to record who should be contacted regarding questions arising from a Genomics Test Order, along with their contact details, which differs from requester and responsibleClinician." />
<copyright value="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 value="4.0.1" />
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="ServiceRequest" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<short value="Details of an additional contact" />
<definition value="Details of an additional contact, who should be contacted regarding questions arising from the service request." />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<short value="A link to a the resource to be contacted." />
<definition value="A link to the Organization, Practitioner, or PractitionerRole resource to be contacted." />
<min value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
</type>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-AdditionalContact",
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact",
"version": "1.1.0",
"name": "ExtensionUKCoreAdditionalContact",
"title": "Extension UK Core Additional Contact",
"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": "An extension to support recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician.",
"purpose": "This is a Genomics use case to record who should be contacted regarding questions arising from a Genomics Test Order, along with their contact details, which differs from requester and responsibleClinician.",
"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",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "ServiceRequest"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "Details of an additional contact",
"definition": "Details of an additional contact, who should be contacted regarding questions arising from the service request."
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "A link to a the resource to be contacted.",
"definition": "A link to the Organization, Practitioner, or PractitionerRole resource to be contacted.",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole"
]
}
]
}
]
}

}

Examples

Additional Contact - An example to illustrate providing an additional contact with a service request.

Extension-UKCore-AdditionalContact-Example

Propose a change to Extension-UKCore-AdditionalContact

Extension-UKCore-ConditionBodyStructure

Usage

An extension to replicate the changes within R6 to support adding a reference to the body part affected by the diagnosed condition.

Context of Use

Condition

Tree View

ExtensionUKCoreConditionBodyStructure (Extension)	C		Extension	There are no (further) constraints on this element Element id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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/6.0/StructureDefinition/extension-Condition.bodyStructure Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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)	Data type Reference(BodyStructure)

Detailed Descriptions

Extension
Short	Optional Extensions Element
Definition	Optional Extension Element - found in all resources.
Cardinality	0..1
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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/6.0/StructureDefinition/extension-Condition.bodyStructure
Mappings	rim: N/A
Extension.value[x]
Short	Value of extension
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	Reference(BodyStructure)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..1
Extension.url		..
Extension.value[x]	Reference(BodyStructure)	1..

XML View

<id value="Extension-UKCore-ConditionBodyStructure" />
<url value="http://hl7.org/fhir/6.0/StructureDefinition/extension-Condition.bodyStructure" />
<version value="0.0.1" />
<name value="ExtensionUKCoreConditionBodyStructure" />
<title value="Extension UK Core Condition Body Structure" />
<status value="draft" />
<date value="2024-06-07" />
<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="An extension to replicate the changes within R6 to support adding a reference to the body part affected by the diagnosed condition." />
<purpose value="This is a Genomics use case to support the backporting of R6 functionality to provide reference to the BodyStructure affected by a Condition." />
<copyright value="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 value="4.0.1" />
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="Condition" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<max value="1" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="http://hl7.org/fhir/6.0/StructureDefinition/extension-Condition.bodyStructure" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<min value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure" />
</type>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-ConditionBodyStructure",
"url": "http://hl7.org/fhir/6.0/StructureDefinition/extension-Condition.bodyStructure",
"version": "0.0.1",
"name": "ExtensionUKCoreConditionBodyStructure",
"title": "Extension UK Core Condition Body Structure",
"status": "draft",
"date": "2024-06-07",
"publisher": "HL7 UK",
"contact": [
{
"name": "HL7 UK",
"telecom": [
{
"system": "email",
"value": "ukcore@hl7.org.uk",
"use": "work",
"rank": 1
}
]
}
],
"description": "An extension to replicate the changes within R6 to support adding a reference to the body part affected by the diagnosed condition.",
"purpose": "This is a Genomics use case to support the backporting of R6 functionality to provide reference to the BodyStructure affected by a Condition.",
"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",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "Condition"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"max": "1"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "http://hl7.org/fhir/6.0/StructureDefinition/extension-Condition.bodyStructure"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/BodyStructure"
]
}
]
}
]
}

}

Propose a change to Extension-UKCore-ConditionBodyStructure

Extension-UKCore-Coverage

Usage

This extends the Service Request Resource to support the exchange of information describing the method of funding for the Service Request.

Context of Use

ServiceRequest

Tree View

ExtensionUKCoreCoverage (Extension)	C		Extension	Element id Extension Short description The funding category for the Service Request Definition The funding category for the Service Request. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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-Coverage Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description This describes the funding category for a service request. Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding A set of codes that define the funding category for a service request. UKCoreFundingCategory (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueCodeableConcept			CodeableConcept	Data type CodeableConcept

Detailed Descriptions

Extension
Short	The funding category for the Service Request
Definition	The funding category for the Service Request.
Cardinality	0..*
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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-Coverage
Mappings	rim: N/A
Extension.value[x]
Short	This describes the funding category for a service request.
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	CodeableConcept
Binding	A set of codes that define the funding category for a service request. UKCoreFundingCategory (extensible)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..
Extension.url		..
Extension.value[x]	CodeableConcept	1..

XML View

<id value="Extension-UKCore-Coverage" />
<url value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage" />
<version value="1.0.0" />
<name value="ExtensionUKCoreCoverage" />
<title value="Extension UK Core Coverage" />
<status value="active" />
<date value="2023-04-28" />
<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 extends the Service Request Resource to support the exchange of information describing the method of funding for the Service Request." />
<purpose value="This extension is a Genomics use case to record the funding category for a ServiceRequest. It is expected this will be populated with a code indicating whether the service request is part of NHS coverage or private, and will be used for reimbursement purposes by receiving labs." />
<copyright value="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 value="4.0.1" />
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="ServiceRequest" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<short value="The funding category for the Service Request" />
<definition value="The funding category for the Service Request." />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<short value="This describes the funding category for a service request." />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
<binding>
<strength value="extensible" />
<description value="A set of codes that define the funding category for a service request." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-FundingCategory" />
</binding>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-Coverage",
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage",
"version": "1.0.0",
"name": "ExtensionUKCoreCoverage",
"title": "Extension UK Core Coverage",
"status": "active",
"date": "2023-04-28",
"publisher": "HL7 UK",
"contact": [
{
"name": "HL7 UK",
"telecom": [
{
"system": "email",
"value": "ukcore@hl7.org.uk",
"use": "work",
"rank": 1
}
]
}
],
"description": "This extends the Service Request Resource to support the exchange of information describing the method of funding for the Service Request.",
"purpose": "This extension is a Genomics use case to record the funding category for a ServiceRequest. It is expected this will be populated with a code indicating whether the service request is part of NHS coverage or private, and will be used for reimbursement purposes by receiving labs.",
"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",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "ServiceRequest"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "The funding category for the Service Request",
"definition": "The funding category for the Service Request."
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "This describes the funding category for a service request.",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "extensible",
"description": "A set of codes that define the funding category for a service request.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-FundingCategory"
}
}
]
}

}

Examples

Coverage- An example to illustrate the extension for a service request, to state the the coverage of the funding for this request.

Extension-UKCore-Coverage-Example

Propose a change to Extension-UKCore-Coverage

Extension Specific Guidance

There is a binding within this extension to a ValueSet-Genomic-Coverage.

Extension-UKCore-NHSNumberUnavailableReason

Usage

This extends the Patient resource to support the exchange of information about the reason why a patient does not have an NHS Number.

Context of Use

Patient

Tree View

ExtensionUKCoreNHSNumberUnavailableReason (Extension)	C		Extension	Element id Extension Short description The reason why a patient does not have an NHS Number Definition The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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-NHSNumberUnavailableReason Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description The reason why a patient does not have an NHS Number Definition The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient. Binding UKCoreNHSNumberUnavailableReason (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueCodeableConcept			CodeableConcept	Data type CodeableConcept

Detailed Descriptions

Extension
Short	The reason why a patient does not have an NHS Number
Definition	The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.
Cardinality	0..1
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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-NHSNumberUnavailableReason
Mappings	rim: N/A
Extension.value[x]
Short	The reason why a patient does not have an NHS Number
Definition	The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.
Cardinality	1..1
Type	CodeableConcept
Binding	UKCoreNHSNumberUnavailableReason (extensible)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..1
Extension.url		..
Extension.value[x]	CodeableConcept	1..

XML View

<id value="Extension-UKCore-NHSNumberUnavailableReason" />
<url value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason" />
<version value="1.0.0" />
<name value="ExtensionUKCoreNHSNumberUnavailableReason" />
<title value="Extension UK Core NHS Number Unavailable Reason" />
<status value="active" />
<date value="2023-04-28" />
<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 extends the Patient resource to support the exchange of information about the reason why a patient does not have an NHS Number." />
<purpose value="This extension is a Genomics use case to record why an NHS Number for the patient has not been provided within a test request. This differs from NHS Number trace status as this indicates reason." />
<copyright value="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 value="4.0.1" />
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="Patient" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<short value="The reason why a patient does not have an NHS Number" />
<definition value="The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient." />
<max value="1" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<short value="The reason why a patient does not have an NHS Number" />
<definition value="The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient." />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
<binding>
<strength value="extensible" />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-NHSNumberUnavailableReason" />
</binding>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-NHSNumberUnavailableReason",
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason",
"version": "1.0.0",
"name": "ExtensionUKCoreNHSNumberUnavailableReason",
"title": "Extension UK Core NHS Number Unavailable Reason",
"status": "active",
"date": "2023-04-28",
"publisher": "HL7 UK",
"contact": [
{
"name": "HL7 UK",
"telecom": [
{
"system": "email",
"value": "ukcore@hl7.org.uk",
"use": "work",
"rank": 1
}
]
}
],
"description": "This extends the Patient resource to support the exchange of information about the reason why a patient does not have an NHS Number.",
"purpose": "This extension is a Genomics use case to record why an NHS Number for the patient has not been provided within a test request. This differs from NHS Number trace status as this indicates reason.",
"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",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "Patient"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "The reason why a patient does not have an NHS Number",
"definition": "The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.",
"max": "1"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberUnavailableReason"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "The reason why a patient does not have an NHS Number",
"definition": "The reason why a patient does not have an NHS Number. For example if this patient is an overseas patient.",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "extensible",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-NHSNumberUnavailableReason"
}
}
]
}

}

Examples

NHS Number Unavailable Reason- An example of the extension which states the reason a patient's NHS number is unavailable.

Example-UKCore-Extension-NHSNumberUnavailableReason

Propose a change to Extension-UKCore-NHSNumberUnavailableReason

Extension Specific Guidance

There is a binding within this extension to a ValueSet-Genomic-NHSNumber-Unavailable-Reason.

Extension-UKCore-PatientFetalStatus

Usage

An extension to support recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician.

Context of Use

Patient

Tree View

ExtensionUKCorePatientFetalStatus (Extension)	C		Extension	Element id Extension Short description An indicator on the fetal status of a baby. Definition Typically used in maternity where the patient record may be created before the birth of the baby. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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/6.0/StructureDefinition/extension-Patient.fetalStatus Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding FetalStatus (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueCode			code	Data type code

Detailed Descriptions

Extension
Short	An indicator on the fetal status of a baby.
Definition	Typically used in maternity where the patient record may be created before the birth of the baby.
Cardinality	0..1
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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/6.0/StructureDefinition/extension-Patient.fetalStatus
Mappings	rim: N/A
Extension.value[x]
Short	Value of extension
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	code
Binding	FetalStatus (required)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..1
Extension.url		..
Extension.value[x]	code	1..

XML View

<id value="Extension-UKCore-PatientFetalStatus" />
<url value="http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus" />
<version value="0.0.1" />
<name value="ExtensionUKCorePatientFetalStatus" />
<title value="Extension UK Core Patient Fetal Status" />
<status value="draft" />
<date value="2024-07-23" />
<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="An extension to replicate the changes within R5 to record the born status of fetus (Patient)" />
<purpose value="This is a Genomics use case to support the backporting of R5 functionality to record the born status of fetus (Patient)" />
<copyright value="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 value="4.0.1" />
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="Patient" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<short value="An indicator on the fetal status of a baby." />
<definition value="Typically used in maternity where the patient record may be created before the birth of the baby." />
<max value="1" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<min value="1" />
<type>
<code value="code" />
</type>
<binding>
<strength value="required" />
<valueSet value="http://hl7.org/fhir/ValueSet/patient-fetalstatus" />
</binding>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-PatientFetalStatus",
"url": "http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus",
"version": "0.0.1",
"name": "ExtensionUKCorePatientFetalStatus",
"title": "Extension UK Core Patient Fetal Status",
"status": "draft",
"date": "2024-07-23",
"publisher": "HL7 UK",
"contact": [
{
"name": "HL7 UK",
"telecom": [
{
"system": "email",
"value": "ukcore@hl7.org.uk",
"use": "work",
"rank": 1
}
]
}
],
"description": "An extension to replicate the changes within R5 to record the born status of fetus (Patient)",
"purpose": "This is a Genomics use case to support the backporting of R5 functionality to record the born status of fetus (Patient)",
"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",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "Patient"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "An indicator on the fetal status of a baby.",
"definition": "Typically used in maternity where the patient record may be created before the birth of the baby.",
"max": "1"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "http://hl7.org/fhir/6.0/StructureDefinition/extension-Patient.fetalStatus"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"min": 1,
"type": [
{
"code": "code"
}
],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/patient-fetalstatus"
}
}
]
}

}

Propose a change to Extension-UKCore-PatientFetalStatus

Extension-UKCore-PriorityReason

Usage

This extends the Service Request Resource to support the underlying reason why a Service Request is urgent.

Context of Use

ServiceRequest

Tree View

ExtensionUKCorePriorityReason (Extension)	C		Extension	Element id Extension Short description A SNOMED CT concept representing the reason a Service Request is urgent. Definition A SNOMED CT concept representing the reason a Service Request is urgent Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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-PriorityReason Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description This describes the reason a service request is urgent Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding A set of codes that define the reason why a service request is urgent. UKCoreServiceRequestReasonCode (preferred) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueCodeableConcept			CodeableConcept	Data type CodeableConcept

Detailed Descriptions

Extension
Short	A SNOMED CT concept representing the reason a Service Request is urgent.
Definition	A SNOMED CT concept representing the reason a Service Request is urgent
Cardinality	0..*
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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-PriorityReason
Mappings	rim: N/A
Extension.value[x]
Short	This describes the reason a service request is urgent
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	CodeableConcept
Binding	A set of codes that define the reason why a service request is urgent. UKCoreServiceRequestReasonCode (preferred)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..
Extension.url		..
Extension.value[x]	CodeableConcept	1..

XML View

<id value="Extension-UKCore-PriorityReason" />
<url value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason" />
<version value="1.0.0" />
<name value="ExtensionUKCorePriorityReason" />
<title value="Extension UK Core Priority Reason" />
<status value="active" />
<date value="2023-04-28" />
<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 extends the Service Request Resource to support the underlying reason why a Service Request is urgent." />
<purpose value="This is a Genomics use case to record the reason why an urgent test has been requested. This differs from supportingInfo in that it does not necessarily indicate why the test is being requested." />
<copyright value="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 value="4.0.1" />
<mapping>
<identity value="rim" />
<uri value="http://hl7.org/v3" />
<name value="RIM Mapping" />
</mapping>
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="ServiceRequest.priority" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<short value="A SNOMED CT concept representing the reason a Service Request is urgent." />
<definition value="A SNOMED CT concept representing the reason a Service Request is urgent" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<short value="This describes the reason a service request is urgent" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
<binding>
<strength value="preferred" />
<description value="A set of codes that define the reason why a service request is urgent." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode" />
</binding>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-PriorityReason",
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason",
"version": "1.0.0",
"name": "ExtensionUKCorePriorityReason",
"title": "Extension UK Core Priority Reason",
"status": "active",
"date": "2023-04-28",
"publisher": "HL7 UK",
"contact": [
{
"name": "HL7 UK",
"telecom": [
{
"system": "email",
"value": "ukcore@hl7.org.uk",
"use": "work",
"rank": 1
}
]
}
],
"description": "This extends the Service Request Resource to support the underlying reason why a Service Request is urgent.",
"purpose": "This is a Genomics use case to record the reason why an urgent test has been requested. This differs from supportingInfo in that it does not necessarily indicate why the test is being requested.",
"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",
"mapping": [
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "ServiceRequest.priority"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "A SNOMED CT concept representing the reason a Service Request is urgent.",
"definition": "A SNOMED CT concept representing the reason a Service Request is urgent"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "This describes the reason a service request is urgent",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "preferred",
"description": "A set of codes that define the reason why a service request is urgent.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode"
}
}
]
}

}

Propose a change to Extension-UKCore-PriorityReason

ExtensionGenomicPatientRole

Usage

An Extension used to identify the role of the patient (ServiceRequest.subject) in a genomic test (e.g. either as proband or consultand).

Context of Use

Patient

Canonical_URL	Status	Current_Version	Last_Updated	Description	Profile_Purpose
https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role	draft	0.1.0	2025-12-17	An Extension used to identify the role of the patient (ServiceRequest.subject) in a genomic test (e.g. either as proband or consultand).	This is a use case from Genomics, used to record the role of the patient (ServiceRequest.subject) in a genomic test .

Tree View

ExtensionGenomicPatientRole (Extension)	C		Extension	There are no (further) constraints on this element Element id Extension Short description Optional Extensions Element Definition Optional Extension Element - found in all resources. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..0	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description An Extension used to identify the role of the subject patient in the genomic test (proband vs consultand) Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding GenomicsPatientRole (required) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueCodeableConcept			CodeableConcept	Data type CodeableConcept

Detailed Descriptions

Extension
Short	Optional Extensions Element
Definition	Optional Extension Element - found in all resources.
Cardinality	0..1
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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..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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role
Mappings	rim: N/A
Extension.value[x]
Short	An Extension used to identify the role of the subject patient in the genomic test (proband vs consultand)
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	CodeableConcept
Binding	GenomicsPatientRole (required)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..1
Extension.extension		..0
Extension.url		..
Extension.value[x]	CodeableConcept	1..

XML View

<id value="Extension-Genomic-Patient-Role" />
<url value="https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role" />
<version value="0.1.0" />
<name value="ExtensionGenomicPatientRole" />
<title value="Extension Genomic Patient Role" />
<status value="draft" />
<date value="2025-12-17" />
<publisher value="NHS England" />
<contact>
<name value="NHS England" />
<telecom>
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="An Extension used to identify the role of the patient (ServiceRequest.subject)  in a genomic test (e.g. either as proband or consultand)." />
<purpose value="This is a use case from Genomics, used to record the role of the patient (ServiceRequest.subject)  in a genomic test ." />
<copyright value="Copyright © 2025+ NHS England 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 value="4.0.1" />
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="ServiceRequest" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<max value="1" />
</element>
<element id="Extension.extension">
<path value="Extension.extension" />
<max value="0" />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<short value="An Extension used to identify the role of the subject patient in the genomic test (proband vs consultand)" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
<binding>
<strength value="required" />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-patient-role" />
</binding>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-Genomic-Patient-Role",
"url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role",
"version": "0.1.0",
"name": "ExtensionGenomicPatientRole",
"title": "Extension Genomic Patient Role",
"status": "draft",
"date": "2025-12-17",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work",
"rank": 1
}
]
}
],
"description": "An Extension used to identify the role of the patient (ServiceRequest.subject)  in a genomic test (e.g. either as proband or consultand).",
"purpose": "This is a use case from Genomics, used to record the role of the patient (ServiceRequest.subject)  in a genomic test .",
"copyright": "Copyright © 2025+ NHS England 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": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "ServiceRequest"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"max": "1"
},
{
"id": "Extension.extension",
"path": "Extension.extension",
"max": "0"
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "An Extension used to identify the role of the subject patient in the genomic test (proband vs consultand)",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "required",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-patient-role"
}
}
]
}

}

https://simplifier.net/guide/fhir-genomics-implementation-guide/home/fhirassets/profiles/all-profiles/ukcore-servicerequest.page.md?version=current#extension:genomicPatientRole

Propose a change to ExtensionGenomicPatientRole

Extension-UKCore-SampleCategory

Usage

An extension to record the category of genome sequencing sample.

Context of Use

Specimen

Tree View

ExtensionUKCoreSampleCategory (Extension)	C		Extension	Element id Extension Short description An extension to record the category of the sample. Definition This extension allows the recording of the category of a sample for use within Genomics, whether it is a tumour or germline sample. Data type Extension Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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 Extension.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	C	0..*	Extension	There are no (further) constraints on this element Element id Extension.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 Slicing Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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	Element id Extension.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-SampleCategory Mappings rim: N/A
value[x]		1..1	Binding	Element id Extension.value[x] Short description A set of codes to record the category of the sample Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Binding A set of codes to record the category of the sample UKCoreSampleCategory (extensible) Conditions The cardinality or value of this element may be affected by these constraints: ele-1 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
valueCodeableConcept			CodeableConcept	Data type CodeableConcept

Detailed Descriptions

Extension
Short	An extension to record the category of the sample.
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..*
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.id
Short	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.
Cardinality	0..1
Type	string
Mappings	rim: n/a
Extension.extension
Short	Additional content defined by implementations
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) Extensions are always sliced by (at least) url
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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
Extension.url
Short	identifies the meaning of the extension
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-SampleCategory
Mappings	rim: N/A
Extension.value[x]
Short	A set of codes to record the category of the sample
Definition	Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality	1..1
Type	CodeableConcept
Binding	A set of codes to record the category of the sample UKCoreSampleCategory (extensible)
Conditions	The cardinality or value of this element may be affected by these constraints: ele-1
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

Table View

Extension		..
Extension.url		..
Extension.value[x]	CodeableConcept	1..

XML View

<id value="Extension-UKCore-SampleCategory" />
<url value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory" />
<version value="1.1.0" />
<name value="ExtensionUKCoreSampleCategory" />
<title value="Extension UK Core Sample Category" />
<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="An extension to record the category of genome sequencing sample." />
<purpose value="This extension is a Genomics use case to categorise the genome sequencing sample type, whether it is a tumour or germline Sample. This is different to Specimen.type which, for genomics, records the tissue of origin." />
<copyright value="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 value="4.0.1" />
<kind value="complex-type" />
<abstract value="false" />
<context>
<type value="element" />
<expression value="Specimen" />
</context>
<type value="Extension" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
<derivation value="constraint" />
<differential>
<element id="Extension">
<path value="Extension" />
<short value="An extension to record the category of the sample." />
<definition value="This extension allows the recording of the category of a sample for use within Genomics, whether it is a tumour or germline sample." />
</element>
<element id="Extension.url">
<path value="Extension.url" />
<fixedUri value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory" />
</element>
<element id="Extension.value[x]">
<path value="Extension.value[x]" />
<short value="A set of codes to record the category of the sample" />
<min value="1" />
<type>
<code value="CodeableConcept" />
</type>
<binding>
<strength value="extensible" />
<description value="A set of codes to record the category of the sample" />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SampleCategory" />
</binding>
</element>
</differential>

</StructureDefinition>

JSON View

{

"resourceType": "StructureDefinition",
"id": "Extension-UKCore-SampleCategory",
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory",
"version": "1.1.0",
"name": "ExtensionUKCoreSampleCategory",
"title": "Extension UK Core Sample Category",
"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": "An extension to record the category of genome sequencing sample.",
"purpose": "This extension is a Genomics use case to categorise the genome sequencing sample type, whether it is a tumour or germline Sample. This is different to Specimen.type which, for genomics, records the tissue of origin.",
"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": "complex-type",
"abstract": false,
"context": [
{
"type": "element",
"expression": "Specimen"
}
],
"type": "Extension",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Extension",
"path": "Extension",
"short": "An extension to record the category of the sample.",
"definition": "This extension allows the recording of the category of a sample for use within Genomics, whether it is a tumour or germline sample."
},
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory"
},
{
"id": "Extension.value[x]",
"path": "Extension.value[x]",
"short": "A set of codes to record the category of the sample",
"min": 1,
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"strength": "extensible",
"description": "A set of codes to record the category of the sample",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SampleCategory"
}
}
]
}

}

Examples

Specimen-PheobeSmitham-Example