StructureDefinition NHSEngland-Specimen-Genomics

Used to capture information on Samples which will undergo or have undergone processing for genomic testing.

Within FHIR R4, there is no way to capture location against a sample to aid tracking, one of the key requirements of the Genomic Medicine Service. Investigation of a possible solution through backporting the container.location element within R5 is currently being investigated. Until this backport is adopted by UK Core, the location of samples, including interactions to manage and track samples, will be performed through changes to Task resources generated on submission of a ServiceRequest.

A diagram illustrating the links between resources is provided below (Duo Scenario)

Note: links from ServiceRequest.supportingInfo to samples collected after submission are pending further investigation

Profile url FHIR Module Normative Status
https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics NHS England Genomics trial-use

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomicsactive0.3.02026-04-16

This profile defines the Genomics constraints and extensions on the UK Core FHIR resource Specimen.


Tree View

idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
sampleCategoryC0..1Extension(CodeableConcept)
modifierExtension?! C0..*Extension
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics)
id0..1string
extensionC0..*Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization) | Reference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics)
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ C0..1Period
id0..1string
extensionC0..*Extension
referenceΣ C0..0string
typeΣ0..1uriBinding
identifierΣ1..1IdentifierFixed Value
displayΣ0..1string
accessionIdentifierΣ0..0Identifier
statusS Σ ?!1..1codeBinding
typeS Σ1..1CodeableConceptBinding
subjectS Σ C1..1Reference(NHSEngland_Patient_Genomics)
receivedTimeS Σ0..1dateTime
parentC0..1Reference(NHSEngland_Specimen_Genomics)
requestC1..1Reference(NHSEngland_ServiceRequest_Genomics)
id0..1string
specialHandlingC0..*Extension(CodeableConcept)Binding
modifierExtensionΣ ?! C0..*Extension
id0..1string
id0..1string
extensionC0..*Extension
url1..1uriFixed Value
valueReferenceReference(Patient | RelatedPerson)
referenceΣ C0..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
collectedDateTimedateTime
collectedPeriodPeriod
durationΣ C0..1Duration
quantityC0..1SimpleQuantity
method0..1CodeableConcept
id0..1string
id0..1string
extensionC0..*Extension
url1..1uriFixed Value
valueReferenceReference(BodyStructure)
bodyStructureReferenceC0..1Extension(Reference(BodyStructure))
codingΣ0..*Coding
textΣ0..1string
fastingStatusCodeableConceptCodeableConcept
fastingStatusDurationDuration
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
description0..1string
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
additiveC0..*Reference(Substance)
timeDateTimedateTime
timePeriodPeriod
id0..1string
specimenContainerLocationR5C0..1Extension(Reference(Profile_R5_Location_R4 | Location))
modifierExtensionΣ ?! C0..*Extension
identifierΣ0..*Identifier
description0..1string
type0..1CodeableConceptBinding
capacityC0..1SimpleQuantity
specimenQuantityC0..1SimpleQuantity
additiveCodeableConceptCodeableConcept
additiveReferenceReference(Substance)
conditionΣ0..1CodeableConceptBinding
note0..*Annotation

Detailed Descriptions

Specimen
ShortSample for analysis
Definition

A sample to be used for analysis.

Cardinality0..*
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • ukcore-spec-001: There SHALL be only one reference between collection.collector and the extension collectionCollectorR5
    collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: Role[classCode=SPEC]
Specimen.id
ShortLogical id of this artifact
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Cardinality0..1
Typeid
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

ConditionsThe 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
Specimen.meta
ShortMetadata about the resource
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe 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
Specimen.implicitRules
ShortA set of rules under which this content was created
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

ConditionsThe 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
Specimen.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

ConditionsThe 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
Specimen.text
ShortText summary of the resource, for human interpretation
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

ConditionsThe 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
  • rim: Act.text?
Specimen.contained
ShortContained, inline Resources
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
Specimen.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.extension:sampleCategory
ShortAn extension to record the category of the sample.
Definition

Allows the categorisation of a sample into either tumour or germline. Required for WGS Cancer Testing, though not currently part of the Order Management MDS. Additional terms may be added upon review though the valueCodeableConcept.text field MAY be used as a free text representation if needed.

Cardinality0..1
TypeExtension(CodeableConcept)
Aliasextensions, 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.

ConditionsThe 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
Specimen.modifierExtension
ShortExtensions that cannot be ignored
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe 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
Specimen.identifier
ShortExternal Identifier
Definition

Multiple identifiers MAY be assigned to a sample as it travels between labs. Each lab SHOULD append their local identifier to the identifier array if needed, ensuring either the system or assigner, is able to disambiguate any identifiers from possibly overlapping numbers from other organizations. Assigner is preferred in this case (see identifier example on the UKCore-Patient page for further guidance) Note: accessionIdentifier is unused by the Genomic Medicine Service to facilitate movement of samples across organizational boundaries.

Cardinality1..*
TypeIdentifier
SummaryTrue
Slicing

Unordered, Open, by system(Pattern)

ConditionsThe 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
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: SPM-2
  • rim: .id
Specimen.identifier.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.identifier.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe 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
  • v2: N/A
  • rim: Role.code or implied by context
Specimen.identifier.type
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
Specimen.identifier.system
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality0..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

ConditionsThe 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())
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Specimen.identifier.value
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality0..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

ConditionsThe 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())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Specimen.identifier.period
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

ConditionsThe 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())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
Specimen.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
Specimen.identifier:identifierGMSSpecimen
ShortExternal Identifier
Definition

Id for specimen.

Cardinality0..1
TypeIdentifier
SummaryTrue
ConditionsThe 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
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: SPM-2
  • rim: .id
Specimen.identifier:identifierGMSSpecimen.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.identifier:identifierGMSSpecimen.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.identifier:identifierGMSSpecimen.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe 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
  • v2: N/A
  • rim: Role.code or implied by context
Specimen.identifier:identifierGMSSpecimen.type
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..0
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
Specimen.identifier:identifierGMSSpecimen.system
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

ConditionsThe 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())
Fixed Value
https://fhir.nhs.uk/Id/GMSSpecimen
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Specimen.identifier:identifierGMSSpecimen.value
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality1..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

ConditionsThe 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())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Specimen.identifier:identifierGMSSpecimen.period
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..0
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

ConditionsThe 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())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
Specimen.identifier:identifierGMSSpecimen.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization) | Reference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
Specimen.identifier:localIdentifier
ShortExternal Identifier
Definition

Id for specimen.

Cardinality0..*
TypeIdentifier
SummaryTrue
ConditionsThe 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
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: SPM-2
  • rim: .id
Specimen.identifier:localIdentifier.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.identifier:localIdentifier.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.identifier:localIdentifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe 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
  • v2: N/A
  • rim: Role.code or implied by context
Specimen.identifier:localIdentifier.type
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
Specimen.identifier:localIdentifier.system
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

ConditionsThe 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())
Fixed Value
https://fhir.nhs.uk/local-identifier/specimen
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Specimen.identifier:localIdentifier.value
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality1..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

ConditionsThe 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())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Specimen.identifier:localIdentifier.period
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

ConditionsThe 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())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
Specimen.identifier:localIdentifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality1..1
TypeReference(Organization) | Reference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
Specimen.identifier:localIdentifier.assigner.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.identifier:localIdentifier.assigner.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.identifier:localIdentifier.assigner.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Cardinality0..0
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-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
Specimen.identifier:localIdentifier.assigner.type
ShortType the reference refers to (e.g. "Patient")
Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Cardinality0..1
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

ConditionsThe 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
Specimen.identifier:localIdentifier.assigner.identifier
ShortLogical reference, when literal reference is not known
Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

ConditionsThe 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())
Fixed Value
{
  "system": "https://fhir.nhs.uk/Id/ods-organization-code"
}
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
Specimen.identifier:localIdentifier.assigner.display
ShortText alternative for the resource
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality0..1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

ConditionsThe 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
Specimen.accessionIdentifier
ShortIdentifier assigned by the lab
Definition

The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.

Cardinality0..0
TypeIdentifier
SummaryTrue
ConditionsThe 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
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: SPM-30 (v2.7+)
  • rim: .participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id
Specimen.status
Shortavailable | unavailable | unsatisfactory | entered-in-error
Definition

If a Specimen has not been collected, the status SHOULD be marked as 'unavailable'. If the quality of the Specimen is such that it cannot be processed, the status SHOULD be 'unsatisfactory' (this is equivalent to a QC status of Failed). If the Specimen passes quality control, the status SHOULD be set as 'available'

Cardinality1..1
Typecode
Binding

Codes providing the status/availability of a specimen.

SpecimenStatus (required)

Must SupportTrue
ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

ConditionsThe 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
  • w5: FiveWs.status
  • v2: SPM-20
  • rim: status
Specimen.type
ShortKind of material that forms the specimen
Definition

The sample type, SNOMED CT preferred. Used to differentiate between raw and extracted (DNA) samples. ConceptMaps for the allowed values for primary (raw) and final (extracted DNA) samples upon release of MDSv1.04, to aid identification of whether a sample is primary vs. final

Cardinality1..1
TypeCodeableConcept
Binding

A code from the SNOMED CT UK Clinical Terminology coding system

UKCoreSpecimenType (preferred)

Must SupportTrue
SummaryTrue
Comments

The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • v2: SPM-4 and possibly SPM-5
  • rim: .code
Specimen.subject
ShortWhere the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device
Definition

SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient. Samples collected from a Fetus SHOULD reference a Patient resource for the Fetus. This should then be linked to relevant maternal/paternal resources through the RelatedPerson resource. Further information can be found on the Fetus Management clinical scenario. It is not envisaged that samples would need to be linked to more than one person e.g. both fetus and mother, though this assumption will be tested within the Alpha phase of the Genomic Medicine Service.

Cardinality1..1
TypeReference(NHSEngland_Patient_Genomics)
Must SupportTrue
SummaryTrue
Requirements

Must know the subject context.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.subject[x]
  • rim: .scoper or .scoper.playsRole
  • w5: FiveWs.subject
Specimen.receivedTime
ShortThe time when specimen was received for processing
Definition

SHOULD be updated upon receipt at a destination lab

Cardinality0..1
TypedateTime
Must SupportTrue
SummaryTrue
ConditionsThe 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
  • w5: FiveWs.done[x]
  • v2: SPM-18
  • rim: .participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime
Specimen.parent
ShortSpecimen from which this specimen originated
Definition

If a sample has been split into multiple parts, such as DNA being extracted from a primary sample, each SHOULD be represented using an additional Specimen resource, referencing the parent sample through the parent element. The central Order Management broker will only create Tasks for Specimen resources which do not have a parent element, i.e. primary samples. If required, clients can create Tasks for processing of derivative samples manually.

MAY also be used to record the Block identifier for FFPE/Tissue samples, using the reference.identifier element, where a reference to a Specimen resource is not required.

Cardinality0..1
TypeReference(NHSEngland_Specimen_Genomics)
Comments

The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)
Specimen.request
ShortWhy the specimen was collected
Definition

SHALL be provided. This SHOULD be a reference to the request which initiated collection of the sample. SHALL NOT be updated if the sample is used for another test e.g. for re-analysis. In the case that a Specimen needs to be processed as part of a new request, e.g. using a sample in storage, the ServiceRequest SHALL reference the pre-existing sample via ServiceRequest.specimen.

Cardinality1..1
TypeReference(NHSEngland_ServiceRequest_Genomics)
Comments

The request may be explicit or implied such with a ServiceRequest that requires a blood draw.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.why[x]
  • v2: ORC? OBR-2/3?
  • rim: outboundRelationship[typeCode=FLFS].target
Specimen.collection
ShortCollection details
Definition

Additional information which can be collected about the circumstances under which as sample was collected, if relevant. This include extensions for specialHandling of the sample, e.g. due to high risk of infection, as well as an extension to bodySite to extend the coding to a BodyStructure reference, for more detailed collection of structural information e.g. where tumour morphology and topography need to be collected (only required where morphology and topography are required. Where the collector is an Organization, or where the individual is not known, ODS codes MAY be used as identifiers in place of SDS-User-IDs. However, if referencing a resource, the PractitionerRole resource SHOULD still be referenced. In this case the PractitionerRole.identifier and PractitionerRole.practitioner reference would not be filled, leaving only the reference to an Organization from PractitionerRole.organization.

Cardinality0..1
TypeBackboneElement
ConditionsThe 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
  • v2: SPM-14
  • rim: .participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]
Specimen.collection.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.collection.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.collection.extension:specialHandling
ShortSpecial handling of the specimen
Definition

Special handling during the collection, transport, or storage of the specimen.

Cardinality0..*
TypeExtension(CodeableConcept)
Binding

GenomicsSpecimenCollectionSpecialHandling (preferred)

Aliasextensions, 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.

ConditionsThe 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
Specimen.collection.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe 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
Specimen.collection.collector
ShortWho collected the specimen
Definition

Person who collected the specimen.

Cardinality0..1
TypeReference(NHSEngland_PractitionerRole_Genomics)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.actor
  • v2: PRT
  • rim: .participation[typeCode=PFM].role
Specimen.collection.collector.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.collection.collector.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.collection.collector.extension:collectionCollectorR5
ShortPerson who collected the specimen
Definition

Person who collected the specimen. This is an R5 backport

Cardinality0..1
TypeExtension(Reference(Patient | RelatedPerson))
Aliasextensions, 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.

ConditionsThe 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
Specimen.collection.collector.extension:collectionCollectorR5.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.collection.collector.extension:collectionCollectorR5.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.collection.collector.extension:collectionCollectorR5.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector
Mappings
  • rim: N/A
Specimen.collection.collector.extension:collectionCollectorR5.value[x]
ShortPerson who collected the specimen
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality1..1
TypeReference(Patient | RelatedPerson)
ConditionsThe 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
Specimen.collection.collector.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Cardinality0..1
Typestring
SummaryTrue
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-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
Specimen.collection.collector.type
ShortType the reference refers to (e.g. "Patient")
Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Cardinality0..1
Typeuri
Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

ConditionsThe 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
Specimen.collection.collector.identifier
ShortLogical reference, when literal reference is not known
Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Cardinality0..1
TypeIdentifier
SummaryTrue
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

ConditionsThe 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
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
Specimen.collection.collector.display
ShortText alternative for the resource
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality0..1
Typestring
SummaryTrue
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

ConditionsThe 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
Specimen.collection.collected[x]
ShortCollection time
Definition

Time when specimen was collected from subject - the physiologically relevant time.

Cardinality1..1
TypedateTime | Period
SummaryTrue
ConditionsThe 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
  • w5: FiveWs.init
  • v2: SPM-17
  • rim: .effectiveTime
Specimen.collection.duration
ShortHow long it took to collect specimen
Definition

The span of time over which the collection of a specimen occurred.

Cardinality0..1
TypeDuration
SummaryTrue
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe 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())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • w5: FiveWs.init
Specimen.collection.quantity
ShortThe quantity of specimen collected
Definition

The Specimen.collection.quantity is the amount of the sample collected at collection time. This quantity does not change as the sample is processed.

The Specimen.container.specimenQuantity is the amount of sample remaining in a container, this is equivalent to GEL 1001 banked volume. This value should be updated as the specimen is used.

If a specimen is split, additional specimen resources SHOULD be created (referencing the parent specimen), with individual container.specimenQuantity values.

Cardinality0..1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe 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())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • v2: SPM-12
  • rim: .participation[typeCode=SBJ].role[classCode=SPEC].player.quantity
Specimen.collection.method
ShortTechnique used to perform collection
Definition

A coded value specifying the technique that is used to perform the procedure.

Cardinality0..1
TypeCodeableConcept
Binding

The technique that is used to perform the procedure.

FHIRSpecimenCollectionMethod (example)

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM-7
  • rim: .methodCode
Specimen.collection.bodySite
ShortAnatomical collection site
Definition

Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.

Cardinality0..1
TypeCodeableConcept
Binding

Codes describing anatomical locations. May include laterality.

UKCoreSpecimenBodySite (preferred)

Comments

If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension bodySite.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM-8 and SPM-9
  • rim: .targetSiteCode
Specimen.collection.bodySite.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.collection.bodySite.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.collection.bodySite.extension:bodySiteReference
ShortAn extension to allow referencing to a BodyStructure
Definition

An extension to replicate the changes within R5 altering the data type of Specimen.collection.bodySite from CodeableConcept to CodeableReference (bodyStructure).

Cardinality0..1
TypeExtension(Reference(BodyStructure))
Aliasextensions, 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.

ConditionsThe 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
Specimen.collection.bodySite.extension:bodySiteReference.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.collection.bodySite.extension:bodySiteReference.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.collection.bodySite.extension:bodySiteReference.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference
Mappings
  • rim: N/A
Specimen.collection.bodySite.extension:bodySiteReference.value[x]
ShortA reference to a BodyStructure
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality1..1
TypeReference(BodyStructure)
ConditionsThe 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
Specimen.collection.bodySite.extension:bodyStructureReference
ShortTarget 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.

Cardinality0..1
TypeExtension(Reference(BodyStructure))
Aliasextensions, 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.

ConditionsThe 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
Specimen.collection.bodySite.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe 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
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Specimen.collection.bodySite.text
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe 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
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Specimen.collection.fastingStatus[x]
ShortWhether or how long patient abstained from food and/or drink
Definition

Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection.

Cardinality0..1
TypeCodeableConcept | Duration
Binding

Codes describing the fasting status of the patient.

v2.0916 (extensible)

SummaryTrue
Requirements

Many diagnostic tests require fasting to facilitate accurate interpretation.

Comments

Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/​time] in 2 hour Urine --12 hours fasting), or using a component observation such asObservation.component code` = LOINC 49541-6 (Fasting status - Reported).

ConditionsThe 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
  • v2: OBR-
Specimen.processing
ShortProcessing and processing step details
Definition

SHOULD be updated if processing occurs on the sample which affects later use, e.g. additives added

Cardinality0..*
TypeBackboneElement
ConditionsThe 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: .participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]
Specimen.processing.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.processing.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.processing.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe 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
Specimen.processing.description
ShortTextual description of procedure
Definition

Textual description of procedure.

Cardinality0..1
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe 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: .text
Specimen.processing.procedure
ShortIndicates the treatment step applied to the specimen
Definition

A coded value specifying the procedure used to process the specimen.

Cardinality0..1
TypeCodeableConcept
Binding

Type indicating the technique used to process the specimen.

SpecimenProcessingProcedure (example)

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: .code
Specimen.processing.procedure.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.processing.procedure.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.processing.procedure.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Slicing

Unordered, Open, by system(Pattern)

ConditionsThe 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
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Specimen.processing.procedure.coding:codingSnomedCT
ShortCode defined by a terminology system
Definition

codes from https://fhir.nhs.uk/ConceptMap/genomics-samplepreparation

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe 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
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Specimen.processing.procedure.coding:codingSnomedCT.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.processing.procedure.coding:codingSnomedCT.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.processing.procedure.coding:codingSnomedCT.system
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality0..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe 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())
Fixed Value
http://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Specimen.processing.procedure.coding:codingSnomedCT.version
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe 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
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Specimen.processing.procedure.coding:codingSnomedCT.code
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe 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
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Specimen.processing.procedure.coding:codingSnomedCT.display
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality0..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe 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
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
Specimen.processing.procedure.coding:codingSnomedCT.userSelected
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe 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
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Specimen.processing.procedure.text
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe 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
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Specimen.processing.additive
ShortMaterial used in the processing step
Definition

Material used in the processing step.

Cardinality0..*
TypeReference(Substance)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe 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())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SPM-6
  • rim: .participation[typeCode=CSM].role[classCode=ADTV].code
Specimen.processing.time[x]
ShortDate and time of specimen processing
Definition

A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin.

Cardinality0..1
TypedateTime | Period
ConditionsThe 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: .effectiveTime
Specimen.container
ShortDirect container of specimen (tube/slide, etc.)
Definition

The UK Core STU3 version of Specimen backports the R5 changes to the container BackboneElement to support capturing of storage location for a sample (through container.location) and recursive capture of device identifiers (e.g. tube, well, rack, freezer through container.device). The container.identifier should match the identifier associated with the barcode for the tube/collection device. This can be searched using the container-id SearchParameter.

Additional examples/guidance will be provided within this IG once use of the fields has been appropriately tested.

Sample tracking information SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing, on either the output or input elements. This information MAY include consignment number, destination, date sent etc.

If known, the container type SHOULD be populated, using the example bound ValueSet, in SNOMED CT. If an appropraite code cannot be found, the specimen container type should be populated using free text, in Specimen.container.type.text. Additional container elements, such as capacity or specimenQuantity MAY be populated if known.

Cardinality0..1
TypeBackboneElement
ConditionsThe 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: .player.scopingRole[classCode=CONT].scoper
Specimen.container.id
ShortUnique 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.

Cardinality0..1
Typestring
Mappings
  • rim: n/a
Specimen.container.extension
ShortAdditional 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.

Cardinality0..*
TypeExtension
Aliasextensions, 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

ConditionsThe 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
Specimen.container.extension:specimenContainerLocationR5
ShortR5: Where the container is (new)
Definition

R5: Specimen.container.location (new:Reference(Location))

Cardinality0..1
TypeExtension(Reference(Profile_R5_Location_R4 | Location))
Aliasextensions, user content
Comments

Element Specimen.container.location has a context of Specimen.container based on following the parent source element upwards and mapping to Specimen. Element Specimen.container.location has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

ConditionsThe 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
Specimen.container.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe 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
Specimen.container.identifier
ShortId for the container
Definition

Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.

Cardinality0..*
TypeIdentifier
SummaryTrue
ConditionsThe 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
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • v2: SAC-3
  • rim: .id
Specimen.container.description
ShortTextual description of the container
Definition

Textual description of the container.

Cardinality0..1
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe 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: .desc
Specimen.container.type
ShortKind of container directly associated with specimen
Definition

The type of container associated with the specimen (e.g. slide, aliquot, etc.).

Cardinality0..1
TypeCodeableConcept
Binding

Type of specimen container.

SpecimenContainerType (preferred)

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM-27
  • rim: .code
Specimen.container.capacity
ShortContainer volume or size
Definition

The capacity (volume or other measure) the container may contain.

Cardinality0..1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe 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())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • v2: one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20
  • rim: .quantity
Specimen.container.specimenQuantity
ShortQuantity of specimen within container
Definition

The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.

Cardinality0..1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

ConditionsThe 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())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1: The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • v2: SAC-23 (value) SAC-24 (units
  • rim: .playedRole[classCode=CONT].quantity
Specimen.container.additive[x]
ShortAdditive associated with container
Definition

Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.

Cardinality0..1
TypeCodeableConcept | Reference(Substance)
Binding

Substance added to specimen container.

v2.0371 (example)

ConditionsThe 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
  • v2: SAC-27
  • rim: .scopesRole[classCode=ADTV].player
Specimen.condition
ShortState of the specimen
Definition

Used to record the condition of a specimen. Within Genomics, SHOULD be used to record the fixed/frozen state, using the UK Core bound ValueSet.

Cardinality0..1
TypeCodeableConcept
Binding

Codes describing the state of the specimen.

UKCoreBiopsyState (extensible)

SummaryTrue
Requirements

The specimen condition can be used to assess its quality or appropriateness for a specific test.

Comments

Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.

ConditionsThe 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
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM-24
Specimen.note
ShortComments
Definition

To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).

Cardinality0..*
TypeAnnotation
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

ConditionsThe 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
  • v2: N/A
  • rim: Act
  • v2: OBX
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Table View

Specimen0..*
Specimen.idid0..1
Specimen.metaMeta0..1
Specimen.implicitRulesuri0..1
Specimen.languagecode0..1
Specimen.textNarrative0..1
Specimen.containedResource0..*
Specimen.extensionExtension0..*
Specimen.extension:sampleCategoryExtension0..1
Specimen.modifierExtensionExtension0..*
Specimen.identifierIdentifier1..*
Specimen.identifier.idstring0..1
Specimen.identifier.extensionExtension0..*
Specimen.identifier.usecode0..1
Specimen.identifier.typeCodeableConcept0..1
Specimen.identifier.systemuri0..1
Specimen.identifier.valuestring0..1
Specimen.identifier.periodPeriod0..1
Specimen.identifier.assignerReference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics)0..1
Specimen.identifier:identifierGMSSpecimenIdentifier0..1
Specimen.identifier:identifierGMSSpecimen.idstring0..1
Specimen.identifier:identifierGMSSpecimen.extensionExtension0..*
Specimen.identifier:identifierGMSSpecimen.usecode0..0
Specimen.identifier:identifierGMSSpecimen.typeCodeableConcept0..0
Specimen.identifier:identifierGMSSpecimen.systemuri1..1
Specimen.identifier:identifierGMSSpecimen.valuestring1..1
Specimen.identifier:identifierGMSSpecimen.periodPeriod0..0
Specimen.identifier:identifierGMSSpecimen.assignerReference(Organization)0..0
Specimen.identifier:localIdentifierIdentifier0..*
Specimen.identifier:localIdentifier.idstring0..1
Specimen.identifier:localIdentifier.extensionExtension0..*
Specimen.identifier:localIdentifier.usecode0..1
Specimen.identifier:localIdentifier.typeCodeableConcept0..1
Specimen.identifier:localIdentifier.systemuri1..1
Specimen.identifier:localIdentifier.valuestring1..1
Specimen.identifier:localIdentifier.periodPeriod0..1
Specimen.identifier:localIdentifier.assignerReference(Organization)1..1
Specimen.identifier:localIdentifier.assigner.idstring0..1
Specimen.identifier:localIdentifier.assigner.extensionExtension0..*
Specimen.identifier:localIdentifier.assigner.referencestring0..0
Specimen.identifier:localIdentifier.assigner.typeuri0..1
Specimen.identifier:localIdentifier.assigner.identifierIdentifier1..1
Specimen.identifier:localIdentifier.assigner.displaystring0..1
Specimen.accessionIdentifierIdentifier0..0
Specimen.statuscode1..1
Specimen.typeCodeableConcept1..1
Specimen.subjectReference(NHSEngland_Patient_Genomics)1..1
Specimen.receivedTimedateTime0..1
Specimen.parentReference(NHSEngland_Specimen_Genomics)0..1
Specimen.requestReference(NHSEngland_ServiceRequest_Genomics)1..1
Specimen.collectionBackboneElement0..1
Specimen.collection.idstring0..1
Specimen.collection.extensionExtension0..*
Specimen.collection.extension:specialHandlingExtension0..*
Specimen.collection.modifierExtensionExtension0..*
Specimen.collection.collectorReference(NHSEngland_PractitionerRole_Genomics)0..1
Specimen.collection.collector.idstring0..1
Specimen.collection.collector.extensionExtension0..*
Specimen.collection.collector.extension:collectionCollectorR5Extension0..1
Specimen.collection.collector.extension:collectionCollectorR5.idstring0..1
Specimen.collection.collector.extension:collectionCollectorR5.extensionExtension0..*
Specimen.collection.collector.extension:collectionCollectorR5.urluri1..1
Specimen.collection.collector.extension:collectionCollectorR5.value[x]Reference(Patient | RelatedPerson)1..1
Specimen.collection.collector.referencestring0..1
Specimen.collection.collector.typeuri0..1
Specimen.collection.collector.identifierIdentifier0..1
Specimen.collection.collector.displaystring0..1
Specimen.collection.collected[x]dateTime | Period1..1
Specimen.collection.durationDuration0..1
Specimen.collection.quantitySimpleQuantity0..1
Specimen.collection.methodCodeableConcept0..1
Specimen.collection.bodySiteCodeableConcept0..1
Specimen.collection.bodySite.idstring0..1
Specimen.collection.bodySite.extensionExtension0..*
Specimen.collection.bodySite.extension:bodySiteReferenceExtension0..1
Specimen.collection.bodySite.extension:bodySiteReference.idstring0..1
Specimen.collection.bodySite.extension:bodySiteReference.extensionExtension0..*
Specimen.collection.bodySite.extension:bodySiteReference.urluri1..1
Specimen.collection.bodySite.extension:bodySiteReference.value[x]Reference(BodyStructure)1..1
Specimen.collection.bodySite.extension:bodyStructureReferenceExtension0..1
Specimen.collection.bodySite.codingCoding0..*
Specimen.collection.bodySite.textstring0..1
Specimen.collection.fastingStatus[x]CodeableConcept | Duration0..1
Specimen.processingBackboneElement0..*
Specimen.processing.idstring0..1
Specimen.processing.extensionExtension0..*
Specimen.processing.modifierExtensionExtension0..*
Specimen.processing.descriptionstring0..1
Specimen.processing.procedureCodeableConcept0..1
Specimen.processing.procedure.idstring0..1
Specimen.processing.procedure.extensionExtension0..*
Specimen.processing.procedure.codingCoding0..*
Specimen.processing.procedure.coding:codingSnomedCTCoding0..*
Specimen.processing.procedure.coding:codingSnomedCT.idstring0..1
Specimen.processing.procedure.coding:codingSnomedCT.extensionExtension0..*
Specimen.processing.procedure.coding:codingSnomedCT.systemuri0..1
Specimen.processing.procedure.coding:codingSnomedCT.versionstring0..1
Specimen.processing.procedure.coding:codingSnomedCT.codecode0..1
Specimen.processing.procedure.coding:codingSnomedCT.displaystring0..1
Specimen.processing.procedure.coding:codingSnomedCT.userSelectedboolean0..1
Specimen.processing.procedure.textstring0..1
Specimen.processing.additiveReference(Substance)0..*
Specimen.processing.time[x]dateTime | Period0..1
Specimen.containerBackboneElement0..1
Specimen.container.idstring0..1
Specimen.container.extensionExtension0..*
Specimen.container.extension:specimenContainerLocationR5Extension0..1
Specimen.container.modifierExtensionExtension0..*
Specimen.container.identifierIdentifier0..*
Specimen.container.descriptionstring0..1
Specimen.container.typeCodeableConcept0..1
Specimen.container.capacitySimpleQuantity0..1
Specimen.container.specimenQuantitySimpleQuantity0..1
Specimen.container.additive[x]CodeableConcept | Reference(Substance)0..1
Specimen.conditionCodeableConcept0..1
Specimen.noteAnnotation0..*

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="NHSEngland-Specimen-Genomics" />
<url value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics" />
<version value="0.3.0" />
<name value="NHSEngland_Specimen_Genomics" />
<title value="NHSEngland Specimen Genomics" />
<status value="active" />
<date value="2026-04-16" />
<publisher value="NHS England" />
<name value="NHS England" />
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="This profile defines the Genomics constraints and extensions on the UK Core FHIR resource [Specimen](https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen)." />
<purpose value="Used to capture information on Samples which will undergo or have undergone processing for genomic testing." />
<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="resource" />
<abstract value="false" />
<type value="Specimen" />
<baseDefinition value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
<derivation value="constraint" />
<element id="Specimen">
<path value="Specimen" />
<short value="Sample for analysis" />
<definition value="A sample to be used for analysis." />
<min value="0" />
<max value="*" />
<path value="Specimen" />
<min value="0" />
<max value="*" />
</base>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-3" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="ukcore-spec-001" />
<severity value="error" />
<human value="There SHALL be only one reference between collection.collector and the extension collectionCollectorR5" />
<expression value="collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()" />
<source value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
</constraint>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<identity value="rim" />
<map value="Role[classCode=SPEC]" />
</mapping>
</element>
<element id="Specimen.id">
<path value="Specimen.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id" />
</extension>
<code value="id" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.meta">
<path value="Specimen.meta" />
<short value="Metadata about the resource" />
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
<min value="0" />
<max value="1" />
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<code value="Meta" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.implicitRules">
<path value="Specimen.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
<min value="0" />
<max value="1" />
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.language">
<path value="Specimen.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
<min value="0" />
<max value="1" />
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<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>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.text">
<path value="Specimen.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<code value="Narrative" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="Specimen.contained">
<path value="Specimen.contained" />
<short value="Contained, inline Resources" />
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<code value="Resource" />
</type>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.extension">
<path value="Specimen.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.extension:sampleCategory">
<path value="Specimen.extension" />
<sliceName value="sampleCategory" />
<short value="An extension to record the category of the sample." />
<definition value="Allows the categorisation of a sample into either tumour or germline. Required for WGS Cancer Testing, though not currently part of the Order Management MDS. Additional terms may be added upon review though the valueCodeableConcept.text field MAY be used as a free text representation if needed." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.modifierExtension">
<path value="Specimen.modifierExtension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Extensions that cannot be ignored" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier">
<path value="Specimen.identifier" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="External Identifier" />
<definition value="Multiple identifiers MAY be assigned to a sample as it travels between labs. Each lab SHOULD append their local identifier to the identifier array if needed, ensuring either the system or assigner, is able to disambiguate any identifiers from possibly overlapping numbers from other organizations. Assigner is preferred in this case (see identifier example on the UKCore-Patient page for further guidance)\nNote: accessionIdentifier is unused by the Genomic Medicine Service to facilitate movement of samples across organizational boundaries." />
<min value="1" />
<max value="*" />
<path value="Specimen.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="SPM-2" />
</mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
</element>
<element id="Specimen.identifier.id">
<path value="Specimen.identifier.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.identifier.extension">
<path value="Specimen.identifier.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier.use">
<path value="Specimen.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Specimen.identifier.type">
<path value="Specimen.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Specimen.identifier.system">
<path value="Specimen.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." />
<min value="0" />
<max value="1" />
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="Specimen.identifier.value">
<path value="Specimen.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
<min value="0" />
<max value="1" />
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Specimen.identifier.period">
<path value="Specimen.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="1" />
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<code value="Period" />
</type>
<condition value="ele-1" />
<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="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Specimen.identifier.assigner">
<path value="Specimen.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
<min value="0" />
<max value="1" />
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen">
<path value="Specimen.identifier" />
<sliceName value="identifierGMSSpecimen" />
<short value="External Identifier" />
<definition value="Id for specimen." />
<min value="0" />
<max value="1" />
<path value="Specimen.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="SPM-2" />
</mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.id">
<path value="Specimen.identifier.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.extension">
<path value="Specimen.identifier.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.use">
<path value="Specimen.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="0" />
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.type">
<path value="Specimen.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="0" />
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.system">
<path value="Specimen.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." />
<min value="1" />
<max value="1" />
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/Id/GMSSpecimen" />
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.value">
<path value="Specimen.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
<min value="1" />
<max value="1" />
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.period">
<path value="Specimen.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="0" />
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<code value="Period" />
</type>
<condition value="ele-1" />
<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="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.assigner">
<path value="Specimen.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
<min value="0" />
<max value="0" />
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier">
<path value="Specimen.identifier" />
<sliceName value="localIdentifier" />
<short value="External Identifier" />
<definition value="Id for specimen." />
<min value="0" />
<max value="*" />
<path value="Specimen.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="SPM-2" />
</mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.id">
<path value="Specimen.identifier.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.extension">
<path value="Specimen.identifier.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.use">
<path value="Specimen.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.type">
<path value="Specimen.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.system">
<path value="Specimen.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers." />
<min value="1" />
<max value="1" />
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/local-identifier/specimen" />
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.value">
<path value="Specimen.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe." />
<min value="1" />
<max value="1" />
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.period">
<path value="Specimen.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="1" />
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<code value="Period" />
</type>
<condition value="ele-1" />
<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="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner">
<path value="Specimen.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization." />
<min value="1" />
<max value="1" />
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner.id">
<path value="Specimen.identifier.assigner.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner.extension">
<path value="Specimen.identifier.assigner.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner.reference">
<path value="Specimen.identifier.assigner.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." />
<min value="0" />
<max value="0" />
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner.type">
<path value="Specimen.identifier.assigner.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
<comment value="This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified." />
<min value="0" />
<max value="1" />
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner.identifier">
<path value="Specimen.identifier.assigner.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)." />
<min value="1" />
<max value="1" />
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<code value="Identifier" />
</type>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
</fixedIdentifier>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="Specimen.identifier:localIdentifier.assigner.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Specimen.identifier.assigner.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it." />
<min value="0" />
<max value="1" />
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.accessionIdentifier">
<path value="Specimen.accessionIdentifier" />
<short value="Identifier assigned by the lab" />
<definition value="The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures." />
<min value="0" />
<max value="0" />
<path value="Specimen.accessionIdentifier" />
<min value="0" />
<max value="1" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="SPM-30 (v2.7+)" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id" />
</mapping>
</element>
<element id="Specimen.status">
<path value="Specimen.status" />
<short value="available | unavailable | unsatisfactory | entered-in-error" />
<definition value="If a Specimen has not been collected, the status SHOULD be marked as 'unavailable'. If the quality of the Specimen is such that it cannot be processed, the status SHOULD be 'unsatisfactory' (this is equivalent to a QC status of Failed). If the Specimen passes quality control, the status SHOULD be set as 'available'" />
<comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
<min value="1" />
<max value="1" />
<path value="Specimen.status" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<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>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenStatus" />
</extension>
<strength value="required" />
<description value="Codes providing the status/availability of a specimen." />
<valueSet value="http://hl7.org/fhir/ValueSet/specimen-status|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<identity value="v2" />
<map value="SPM-20" />
</mapping>
<identity value="rim" />
<map value="status" />
</mapping>
</element>
<element id="Specimen.type">
<path value="Specimen.type" />
<short value="Kind of material that forms the specimen" />
<definition value="The sample type, SNOMED CT preferred. Used to differentiate between raw and extracted (DNA) samples.\nConceptMaps for the allowed values for primary (raw) and final (extracted DNA) samples upon release of MDSv1.04, to aid identification of whether a sample is primary vs. final" />
<comment value="The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems." />
<min value="1" />
<max value="1" />
<path value="Specimen.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenType" />
</extension>
<strength value="preferred" />
<description value="A code from the SNOMED CT UK Clinical Terminology coding system" />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenType" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="SPM-4 and possibly SPM-5" />
</mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
</element>
<element id="Specimen.subject">
<path value="Specimen.subject" />
<short value="Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device" />
<definition value="SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient.\nSamples collected from a Fetus SHOULD reference a Patient resource for the Fetus. This should then be linked to relevant maternal/paternal resources through the RelatedPerson resource. Further information can be found on the Fetus Management clinical scenario. It is not envisaged that samples would need to be linked to more than one person e.g. both fetus and mother, though this assumption will be tested within the Alpha phase of the Genomic Medicine Service." />
<comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
<requirements value="Must know the subject context." />
<min value="1" />
<max value="1" />
<path value="Specimen.subject" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<identity value="rim" />
<map value=".scoper or .scoper.playsRole" />
</mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="Specimen.receivedTime">
<path value="Specimen.receivedTime" />
<short value="The time when specimen was received for processing" />
<definition value="SHOULD be updated upon receipt at a destination lab" />
<min value="0" />
<max value="1" />
<path value="Specimen.receivedTime" />
<min value="0" />
<max value="1" />
</base>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<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>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<identity value="v2" />
<map value="SPM-18" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime" />
</mapping>
</element>
<element id="Specimen.parent">
<path value="Specimen.parent" />
<short value="Specimen from which this specimen originated" />
<definition value="If a sample has been split into multiple parts, such as DNA being extracted from a primary sample, each SHOULD be represented using an additional Specimen resource, referencing the parent sample through the parent element.\nThe central Order Management broker will only create Tasks for Specimen resources which do not have a parent element, i.e. primary samples. If required, clients can create Tasks for processing of derivative samples manually.\n\nMAY also be used to record the Block identifier for FFPE/Tissue samples, using the reference.identifier element, where a reference to a Specimen resource is not required." />
<comment value="The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample." />
<min value="0" />
<max value="1" />
<path value="Specimen.parent" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="rim" />
<map value=".scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)" />
</mapping>
</element>
<element id="Specimen.request">
<path value="Specimen.request" />
<short value="Why the specimen was collected" />
<definition value="SHALL be provided. This SHOULD be a reference to the request which initiated collection of the sample. SHALL NOT be updated if the sample is used for another test e.g. for re-analysis. In the case that a Specimen needs to be processed as part of a new request, e.g. using a sample in storage, the ServiceRequest SHALL reference the pre-existing sample via ServiceRequest.specimen." />
<comment value="The request may be explicit or implied such with a ServiceRequest that requires a blood draw." />
<min value="1" />
<max value="1" />
<path value="Specimen.request" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<identity value="v2" />
<map value="ORC? OBR-2/3?" />
</mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=FLFS].target" />
</mapping>
</element>
<element id="Specimen.collection">
<path value="Specimen.collection" />
<short value="Collection details" />
<definition value="Additional information which can be collected about the circumstances under which as sample was collected, if relevant. This include extensions for specialHandling of the sample, e.g. due to high risk of infection, as well as an extension to bodySite to extend the coding to a BodyStructure reference, for more detailed collection of structural information e.g. where tumour morphology and topography need to be collected (only required where morphology and topography are required.\nWhere the collector is an Organization, or where the individual is not known, ODS codes MAY be used as identifiers in place of SDS-User-IDs. However, if referencing a resource, the PractitionerRole resource SHOULD still be referenced. In this case the PractitionerRole.identifier and PractitionerRole.practitioner reference would not be filled, leaving only the reference to an Organization from PractitionerRole.organization." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection" />
<min value="0" />
<max value="1" />
</base>
<code value="BackboneElement" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="SPM-14" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]" />
</mapping>
</element>
<element id="Specimen.collection.id">
<path value="Specimen.collection.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.collection.extension">
<path value="Specimen.collection.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.extension:specialHandling">
<path value="Specimen.collection.extension" />
<sliceName value="specialHandling" />
<short value="Special handling of the specimen" />
<definition value="Special handling during the collection, transport, or storage of the specimen." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/specimen-specialHandling" />
</type>
<condition value="ele-1" />
<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>
<strength value="preferred" />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-specimen-collection-specialhandling" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.modifierExtension">
<path value="Specimen.collection.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector">
<path value="Specimen.collection.collector" />
<short value="Who collected the specimen" />
<definition value="Person who collected the specimen." />
<comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection.collector" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<identity value="v2" />
<map value="PRT" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=PFM].role" />
</mapping>
</element>
<element id="Specimen.collection.collector.id">
<path value="Specimen.collection.collector.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.collection.collector.extension">
<path value="Specimen.collection.collector.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.extension:collectionCollectorR5">
<path value="Specimen.collection.collector.extension" />
<sliceName value="collectionCollectorR5" />
<short value="Person who collected the specimen" />
<definition value="Person who collected the specimen. This is an R5 backport" />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.extension:collectionCollectorR5.id">
<path value="Specimen.collection.collector.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.collection.collector.extension:collectionCollectorR5.extension">
<path value="Specimen.collection.collector.extension.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.extension:collectionCollectorR5.url">
<path value="Specimen.collection.collector.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" />
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<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/5.0/StructureDefinition/extension-Specimen.collection.collector" />
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.extension:collectionCollectorR5.value[x]">
<path value="Specimen.collection.collector.extension.value[x]" />
<short value="Person who collected the specimen" />
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
<min value="1" />
<max value="1" />
<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.reference">
<path value="Specimen.collection.collector.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server." />
<min value="0" />
<max value="1" />
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.type">
<path value="Specimen.collection.collector.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)." />
<comment value="This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified." />
<min value="0" />
<max value="1" />
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collector.identifier">
<path value="Specimen.collection.collector.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)." />
<min value="0" />
<max value="1" />
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="Specimen.collection.collector.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Specimen.collection.collector.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it." />
<min value="0" />
<max value="1" />
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.collected[x]">
<path value="Specimen.collection.collected[x]" />
<short value="Collection time" />
<definition value="Time when specimen was collected from subject - the physiologically relevant time." />
<min value="1" />
<max value="1" />
<path value="Specimen.collection.collected[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="dateTime" />
</type>
<code value="Period" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="w5" />
<map value="FiveWs.init" />
</mapping>
<identity value="v2" />
<map value="SPM-17" />
</mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
</element>
<element id="Specimen.collection.duration">
<path value="Specimen.collection.duration" />
<short value="How long it took to collect specimen" />
<definition value="The span of time over which the collection of a specimen occurred." />
<comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection.duration" />
<min value="0" />
<max value="1" />
</base>
<code value="Duration" />
</type>
<condition value="ele-1" />
<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="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<key value="drt-1" />
<severity value="error" />
<human value="There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM." />
<expression value="code.exists() implies ((system = %ucum) and value.exists())" />
<xpath value="(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org')" />
<source value="http://hl7.org/fhir/StructureDefinition/Duration" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ> depending on the values" />
</mapping>
<identity value="w5" />
<map value="FiveWs.init" />
</mapping>
</element>
<element id="Specimen.collection.quantity">
<path value="Specimen.collection.quantity" />
<short value="The quantity of specimen collected" />
<definition value="The Specimen.collection.quantity is the amount of the sample collected at collection time. This quantity does not change as the sample is processed.\n\nThe Specimen.container.specimenQuantity is the amount of sample remaining in a container, this is equivalent to GEL 1001 banked volume. This value should be updated as the specimen is used.\n\nIf a specimen is split, additional specimen resources SHOULD be created (referencing the parent specimen), with individual container.specimenQuantity values." />
<comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection.quantity" />
<min value="0" />
<max value="1" />
</base>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</type>
<condition value="ele-1" />
<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="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<xpath value="not(exists(f:comparator))" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
<identity value="v2" />
<map value="SPM-12" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].role[classCode=SPEC].player.quantity" />
</mapping>
</element>
<element id="Specimen.collection.method">
<path value="Specimen.collection.method" />
<short value="Technique used to perform collection" />
<definition value="A coded value specifying the technique that is used to perform the procedure." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection.method" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenCollectionMethod" />
</extension>
<strength value="example" />
<description value="The technique that is used to perform the procedure." />
<valueSet value="http://hl7.org/fhir/ValueSet/specimen-collection-method" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="SPM-7" />
</mapping>
<identity value="rim" />
<map value=".methodCode" />
</mapping>
</element>
<element id="Specimen.collection.bodySite">
<path value="Specimen.collection.bodySite" />
<short value="Anatomical collection site" />
<definition value="Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens." />
<comment value="If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html)." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection.bodySite" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodySite" />
</extension>
<strength value="preferred" />
<description value="Codes describing anatomical locations. May include laterality." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenBodySite" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="SPM-8 and SPM-9" />
</mapping>
<identity value="rim" />
<map value=".targetSiteCode" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.id">
<path value="Specimen.collection.bodySite.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension">
<path value="Specimen.collection.bodySite.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension:bodySiteReference">
<path value="Specimen.collection.bodySite.extension" />
<sliceName value="bodySiteReference" />
<short value="An extension to allow referencing to a BodyStructure" />
<definition value="An extension to replicate the changes within R5 altering the data type of Specimen.collection.bodySite from CodeableConcept to CodeableReference (bodyStructure)." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension:bodySiteReference.id">
<path value="Specimen.collection.bodySite.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension:bodySiteReference.extension">
<path value="Specimen.collection.bodySite.extension.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension:bodySiteReference.url">
<path value="Specimen.collection.bodySite.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" />
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<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="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference" />
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension:bodySiteReference.value[x]">
<path value="Specimen.collection.bodySite.extension.value[x]" />
<short value="A reference to a BodyStructure" />
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
<min value="1" />
<max value="1" />
<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.extension:bodyStructureReference">
<path value="Specimen.collection.bodySite.extension" />
<sliceName value="bodyStructureReference" />
<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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/bodySite" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.coding">
<path value="Specimen.collection.bodySite.coding" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Specimen.collection.bodySite.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Specimen.collection.bodySite.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="Specimen.collection.fastingStatus[x]">
<path value="Specimen.collection.fastingStatus[x]" />
<short value="Whether or how long patient abstained from food and/or drink" />
<definition value="Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection." />
<comment value="Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/​time] in 2 hour Urine --12 hours fasting), or using a component observation ` such as `Observation.component code` = LOINC 49541-6 (Fasting status - Reported)." />
<requirements value="Many diagnostic tests require fasting to facilitate accurate interpretation." />
<min value="0" />
<max value="1" />
<path value="Specimen.collection.fastingStatus[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<code value="Duration" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FastingStatus" />
</extension>
<strength value="extensible" />
<description value="Codes describing the fasting status of the patient." />
<valueSet value="http://terminology.hl7.org/ValueSet/v2-0916" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="OBR-" />
</mapping>
</element>
<element id="Specimen.processing">
<path value="Specimen.processing" />
<short value="Processing and processing step details" />
<definition value="SHOULD be updated if processing occurs on the sample which affects later use, e.g. additives added" />
<min value="0" />
<max value="*" />
<path value="Specimen.processing" />
<min value="0" />
<max value="*" />
</base>
<code value="BackboneElement" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]" />
</mapping>
</element>
<element id="Specimen.processing.id">
<path value="Specimen.processing.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.processing.extension">
<path value="Specimen.processing.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.processing.modifierExtension">
<path value="Specimen.processing.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.processing.description">
<path value="Specimen.processing.description" />
<short value="Textual description of procedure" />
<definition value="Textual description of procedure." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="1" />
<path value="Specimen.processing.description" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
</element>
<element id="Specimen.processing.procedure">
<path value="Specimen.processing.procedure" />
<short value="Indicates the treatment step applied to the specimen" />
<definition value="A coded value specifying the procedure used to process the specimen." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<min value="0" />
<max value="1" />
<path value="Specimen.processing.procedure" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenProcessingProcedure" />
</extension>
<strength value="example" />
<description value="Type indicating the technique used to process the specimen." />
<valueSet value="http://hl7.org/fhir/ValueSet/specimen-processing-procedure" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
</element>
<element id="Specimen.processing.procedure.id">
<path value="Specimen.processing.procedure.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.processing.procedure.extension">
<path value="Specimen.processing.procedure.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding">
<path value="Specimen.processing.procedure.coding" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT">
<path value="Specimen.processing.procedure.coding" />
<sliceName value="codingSnomedCT" />
<short value="Code defined by a terminology system" />
<definition value="codes from https://fhir.nhs.uk/ConceptMap/genomics-samplepreparation" />
<comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.id">
<path value="Specimen.processing.procedure.coding.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.extension">
<path value="Specimen.processing.procedure.coding.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.system">
<path value="Specimen.processing.procedure.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="0" />
<max value="1" />
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="http://snomed.info/sct" />
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.version">
<path value="Specimen.processing.procedure.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
<min value="0" />
<max value="1" />
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.code">
<path value="Specimen.processing.procedure.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to refer to a particular code in the system." />
<min value="0" />
<max value="1" />
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Specimen.processing.procedure.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.userSelected">
<path value="Specimen.processing.procedure.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
<requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
<min value="0" />
<max value="1" />
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" />
</mapping>
</element>
<element id="Specimen.processing.procedure.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="Specimen.processing.procedure.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="Specimen.processing.additive">
<path value="Specimen.processing.additive" />
<short value="Material used in the processing step" />
<definition value="Material used in the processing step." />
<comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
<min value="0" />
<max value="*" />
<path value="Specimen.processing.additive" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance" />
</type>
<condition value="ele-1" />
<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="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="SPM-6" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=CSM].role[classCode=ADTV].code" />
</mapping>
</element>
<element id="Specimen.processing.time[x]">
<path value="Specimen.processing.time[x]" />
<short value="Date and time of specimen processing" />
<definition value="A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin." />
<min value="0" />
<max value="1" />
<path value="Specimen.processing.time[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="dateTime" />
</type>
<code value="Period" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
</element>
<element id="Specimen.container">
<path value="Specimen.container" />
<short value="Direct container of specimen (tube/slide, etc.)" />
<definition value="The UK Core STU3 version of Specimen backports the R5 changes to the container BackboneElement to support capturing of storage location for a sample (through `container.location`) and recursive capture of device identifiers (e.g. tube, well, rack, freezer through `container.device`).\nThe container.identifier should match the identifier associated with the barcode for the tube/collection device. This can be searched using the container-id SearchParameter.\n\nAdditional examples/guidance will be provided within this IG once use of the fields has been appropriately tested.\n\nSample tracking information SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing, on either the output or input elements. This information MAY include consignment number, destination, date sent etc.\n\nIf known, the container type SHOULD be populated, using the example bound ValueSet, in SNOMED CT. If an appropraite code cannot be found, the specimen container type should be populated using free text, in Specimen.container.type.text. Additional container elements, such as capacity or specimenQuantity MAY be populated if known." />
<min value="0" />
<max value="1" />
<path value="Specimen.container" />
<min value="0" />
<max value="*" />
</base>
<code value="BackboneElement" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value=".player.scopingRole[classCode=CONT].scoper" />
</mapping>
</element>
<element id="Specimen.container.id">
<path value="Specimen.container.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" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Specimen.container.extension">
<path value="Specimen.container.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.container.extension:specimenContainerLocationR5">
<path value="Specimen.container.extension" />
<sliceName value="specimenContainerLocationR5" />
<short value="R5: Where the container is (new)" />
<definition value="R5: `Specimen.container.location` (new:Reference(Location))" />
<comment value="Element `Specimen.container.location` has a context of Specimen.container based on following the parent source element upwards and mapping to `Specimen`.\nElement `Specimen.container.location` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.container.modifierExtension">
<path value="Specimen.container.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<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>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Specimen.container.identifier">
<path value="Specimen.container.identifier" />
<short value="Id for the container" />
<definition value="Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances." />
<min value="0" />
<max value="*" />
<path value="Specimen.container.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="v2" />
<map value="SAC-3" />
</mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
</element>
<element id="Specimen.container.description">
<path value="Specimen.container.description" />
<short value="Textual description of the container" />
<definition value="Textual description of the container." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="1" />
<path value="Specimen.container.description" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value=".desc" />
</mapping>
</element>
<element id="Specimen.container.type">
<path value="Specimen.container.type" />
<short value="Kind of container directly associated with specimen" />
<definition value="The type of container associated with the specimen (e.g. slide, aliquot, etc.)." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<min value="0" />
<max value="1" />
<path value="Specimen.container.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenContainerType" />
</extension>
<strength value="preferred" />
<description value="Type of specimen container." />
<valueSet value="http://hl7.org/fhir/ValueSet/specimen-container-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="SPM-27" />
</mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
</element>
<element id="Specimen.container.capacity">
<path value="Specimen.container.capacity" />
<short value="Container volume or size" />
<definition value="The capacity (volume or other measure) the container may contain." />
<comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
<min value="0" />
<max value="1" />
<path value="Specimen.container.capacity" />
<min value="0" />
<max value="1" />
</base>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</type>
<condition value="ele-1" />
<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="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<xpath value="not(exists(f:comparator))" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
<identity value="v2" />
<map value="one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20" />
</mapping>
<identity value="rim" />
<map value=".quantity" />
</mapping>
</element>
<element id="Specimen.container.specimenQuantity">
<path value="Specimen.container.specimenQuantity" />
<short value="Quantity of specimen within container" />
<definition value="The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type." />
<comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
<min value="0" />
<max value="1" />
<path value="Specimen.container.specimenQuantity" />
<min value="0" />
<max value="1" />
</base>
<code value="Quantity" />
<profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</type>
<condition value="ele-1" />
<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="qty-3" />
<severity value="error" />
<human value="If a code for the unit is present, the system SHALL also be present" />
<expression value="code.empty() or system.exists()" />
<xpath value="not(exists(f:code)) or exists(f:system)" />
<source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
</constraint>
<key value="sqty-1" />
<severity value="error" />
<human value="The comparator is not used on a SimpleQuantity" />
<expression value="comparator.empty()" />
<xpath value="not(exists(f:comparator))" />
<source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="SN (see also Range) or CQ" />
</mapping>
<identity value="rim" />
<map value="PQ, IVL<PQ>, MO, CO, depending on the values" />
</mapping>
<identity value="v2" />
<map value="SAC-23 (value) SAC-24 (units" />
</mapping>
<identity value="rim" />
<map value=".playedRole[classCode=CONT].quantity" />
</mapping>
</element>
<element id="Specimen.container.additive[x]">
<path value="Specimen.container.additive[x]" />
<short value="Additive associated with container" />
<definition value="Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA." />
<min value="0" />
<max value="1" />
<path value="Specimen.container.additive[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance" />
</type>
<condition value="ele-1" />
<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>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenContainerAdditive" />
</extension>
<strength value="example" />
<description value="Substance added to specimen container." />
<valueSet value="http://terminology.hl7.org/ValueSet/v2-0371" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="SAC-27" />
</mapping>
<identity value="rim" />
<map value=".scopesRole[classCode=ADTV].player" />
</mapping>
</element>
<element id="Specimen.condition">
<path value="Specimen.condition" />
<short value="State of the specimen" />
<definition value="Used to record the condition of a specimen. Within Genomics, SHOULD be used to record the fixed/frozen state, using the UK Core bound ValueSet." />
<comment value="Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test." />
<requirements value="The specimen condition can be used to assess its quality or appropriateness for a specific test." />
<min value="0" />
<max value="1" />
<path value="Specimen.condition" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<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>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="SpecimenCondition" />
</extension>
<strength value="extensible" />
<description value="Codes describing the state of the specimen." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-BiopsyState" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="SPM-24" />
</mapping>
</element>
<element id="Specimen.note">
<path value="Specimen.note" />
<short value="Comments" />
<definition value="To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen)." />
<comment value="For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
<min value="0" />
<max value="*" />
<path value="Specimen.note" />
<min value="0" />
<max value="*" />
</base>
<code value="Annotation" />
</type>
<condition value="ele-1" />
<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>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act" />
</mapping>
<identity value="v2" />
<map value="OBX" />
</mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value" />
</mapping>
</element>
</snapshot>
<element id="Specimen.extension:sampleCategory">
<path value="Specimen.extension" />
<sliceName value="sampleCategory" />
<definition value="Allows the categorisation of a sample into either tumour or germline. Required for WGS Cancer Testing, though not currently part of the Order Management MDS. Additional terms may be added upon review though the valueCodeableConcept.text field MAY be used as a free text representation if needed." />
</element>
<element id="Specimen.identifier">
<path value="Specimen.identifier" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<definition value="Multiple identifiers MAY be assigned to a sample as it travels between labs. Each lab SHOULD append their local identifier to the identifier array if needed, ensuring either the system or assigner, is able to disambiguate any identifiers from possibly overlapping numbers from other organizations. Assigner is preferred in this case (see identifier example on the UKCore-Patient page for further guidance)\nNote: accessionIdentifier is unused by the Genomic Medicine Service to facilitate movement of samples across organizational boundaries." />
<min value="1" />
</element>
<element id="Specimen.identifier.assigner">
<path value="Specimen.identifier.assigner" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics" />
</type>
</element>
<element id="Specimen.identifier:identifierGMSSpecimen">
<path value="Specimen.identifier" />
<sliceName value="identifierGMSSpecimen" />
<max value="1" />
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.use">
<path value="Specimen.identifier.use" />
<max value="0" />
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.type">
<path value="Specimen.identifier.type" />
<max value="0" />
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.system">
<path value="Specimen.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/Id/GMSSpecimen" />
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.value">
<path value="Specimen.identifier.value" />
<min value="1" />
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.period">
<path value="Specimen.identifier.period" />
<max value="0" />
</element>
<element id="Specimen.identifier:identifierGMSSpecimen.assigner">
<path value="Specimen.identifier.assigner" />
<max value="0" />
</element>
<element id="Specimen.identifier:localIdentifier">
<path value="Specimen.identifier" />
<sliceName value="localIdentifier" />
</element>
<element id="Specimen.identifier:localIdentifier.system">
<path value="Specimen.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/local-identifier/specimen" />
</element>
<element id="Specimen.identifier:localIdentifier.value">
<path value="Specimen.identifier.value" />
<min value="1" />
</element>
<element id="Specimen.identifier:localIdentifier.assigner">
<path value="Specimen.identifier.assigner" />
<min value="1" />
</element>
<element id="Specimen.identifier:localIdentifier.assigner.reference">
<path value="Specimen.identifier.assigner.reference" />
<max value="0" />
</element>
<element id="Specimen.identifier:localIdentifier.assigner.identifier">
<path value="Specimen.identifier.assigner.identifier" />
<min value="1" />
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
</fixedIdentifier>
</element>
<element id="Specimen.accessionIdentifier">
<path value="Specimen.accessionIdentifier" />
<max value="0" />
</element>
<element id="Specimen.status">
<path value="Specimen.status" />
<definition value="If a Specimen has not been collected, the status SHOULD be marked as 'unavailable'. If the quality of the Specimen is such that it cannot be processed, the status SHOULD be 'unsatisfactory' (this is equivalent to a QC status of Failed). If the Specimen passes quality control, the status SHOULD be set as 'available'" />
<min value="1" />
</element>
<element id="Specimen.type">
<path value="Specimen.type" />
<definition value="The sample type, SNOMED CT preferred. Used to differentiate between raw and extracted (DNA) samples.\nConceptMaps for the allowed values for primary (raw) and final (extracted DNA) samples upon release of MDSv1.04, to aid identification of whether a sample is primary vs. final" />
<min value="1" />
</element>
<element id="Specimen.subject">
<path value="Specimen.subject" />
<definition value="SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient.\nSamples collected from a Fetus SHOULD reference a Patient resource for the Fetus. This should then be linked to relevant maternal/paternal resources through the RelatedPerson resource. Further information can be found on the Fetus Management clinical scenario. It is not envisaged that samples would need to be linked to more than one person e.g. both fetus and mother, though this assumption will be tested within the Alpha phase of the Genomic Medicine Service." />
<min value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="Specimen.receivedTime">
<path value="Specimen.receivedTime" />
<definition value="SHOULD be updated upon receipt at a destination lab" />
</element>
<element id="Specimen.parent">
<path value="Specimen.parent" />
<definition value="If a sample has been split into multiple parts, such as DNA being extracted from a primary sample, each SHOULD be represented using an additional Specimen resource, referencing the parent sample through the parent element.\nThe central Order Management broker will only create Tasks for Specimen resources which do not have a parent element, i.e. primary samples. If required, clients can create Tasks for processing of derivative samples manually.\n\nMAY also be used to record the Block identifier for FFPE/Tissue samples, using the reference.identifier element, where a reference to a Specimen resource is not required." />
<max value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="Specimen.request">
<path value="Specimen.request" />
<definition value="SHALL be provided. This SHOULD be a reference to the request which initiated collection of the sample. SHALL NOT be updated if the sample is used for another test e.g. for re-analysis. In the case that a Specimen needs to be processed as part of a new request, e.g. using a sample in storage, the ServiceRequest SHALL reference the pre-existing sample via ServiceRequest.specimen." />
<min value="1" />
<max value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="Specimen.collection">
<path value="Specimen.collection" />
<definition value="Additional information which can be collected about the circumstances under which as sample was collected, if relevant. This include extensions for specialHandling of the sample, e.g. due to high risk of infection, as well as an extension to bodySite to extend the coding to a BodyStructure reference, for more detailed collection of structural information e.g. where tumour morphology and topography need to be collected (only required where morphology and topography are required.\nWhere the collector is an Organization, or where the individual is not known, ODS codes MAY be used as identifiers in place of SDS-User-IDs. However, if referencing a resource, the PractitionerRole resource SHOULD still be referenced. In this case the PractitionerRole.identifier and PractitionerRole.practitioner reference would not be filled, leaving only the reference to an Organization from PractitionerRole.organization." />
</element>
<element id="Specimen.collection.extension:specialHandling">
<path value="Specimen.collection.extension" />
<sliceName value="specialHandling" />
<strength value="preferred" />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-specimen-collection-specialhandling" />
</binding>
</element>
<element id="Specimen.collection.collector">
<path value="Specimen.collection.collector" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="Specimen.collection.collected[x]">
<path value="Specimen.collection.collected[x]" />
<min value="1" />
</element>
<element id="Specimen.collection.quantity">
<path value="Specimen.collection.quantity" />
<definition value="The Specimen.collection.quantity is the amount of the sample collected at collection time. This quantity does not change as the sample is processed.\n\nThe Specimen.container.specimenQuantity is the amount of sample remaining in a container, this is equivalent to GEL 1001 banked volume. This value should be updated as the specimen is used.\n\nIf a specimen is split, additional specimen resources SHOULD be created (referencing the parent specimen), with individual container.specimenQuantity values." />
</element>
<element id="Specimen.collection.bodySite.extension:bodyStructureReference">
<path value="Specimen.collection.bodySite.extension" />
<sliceName value="bodyStructureReference" />
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/bodySite" />
</type>
<isModifier value="false" />
</element>
<element id="Specimen.processing">
<path value="Specimen.processing" />
<definition value="SHOULD be updated if processing occurs on the sample which affects later use, e.g. additives added" />
</element>
<element id="Specimen.processing.procedure.coding">
<path value="Specimen.processing.procedure.coding" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT">
<path value="Specimen.processing.procedure.coding" />
<sliceName value="codingSnomedCT" />
<definition value="codes from https://fhir.nhs.uk/ConceptMap/genomics-samplepreparation" />
</element>
<element id="Specimen.processing.procedure.coding:codingSnomedCT.system">
<path value="Specimen.processing.procedure.coding.system" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="Specimen.container">
<path value="Specimen.container" />
<definition value="The UK Core STU3 version of Specimen backports the R5 changes to the container BackboneElement to support capturing of storage location for a sample (through `container.location`) and recursive capture of device identifiers (e.g. tube, well, rack, freezer through `container.device`).\nThe container.identifier should match the identifier associated with the barcode for the tube/collection device. This can be searched using the container-id SearchParameter.\n\nAdditional examples/guidance will be provided within this IG once use of the fields has been appropriately tested.\n\nSample tracking information SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing, on either the output or input elements. This information MAY include consignment number, destination, date sent etc.\n\nIf known, the container type SHOULD be populated, using the example bound ValueSet, in SNOMED CT. If an appropraite code cannot be found, the specimen container type should be populated using free text, in Specimen.container.type.text. Additional container elements, such as capacity or specimenQuantity MAY be populated if known." />
<max value="1" />
</element>
<element id="Specimen.container.extension:specimenContainerLocationR5">
<path value="Specimen.container.extension" />
<sliceName value="specimenContainerLocationR5" />
<code value="Extension" />
<profile value="http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location" />
</type>
</element>
<element id="Specimen.condition">
<path value="Specimen.condition" />
<definition value="Used to record the condition of a specimen. Within Genomics, SHOULD be used to record the fixed/frozen state, using the UK Core bound ValueSet." />
<max value="1" />
</element>
</differential>
</StructureDefinition>

JSON View

{
"resourceType": "StructureDefinition",
"id": "NHSEngland-Specimen-Genomics",
"url": "https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics",
"version": "0.3.0",
"name": "NHSEngland_Specimen_Genomics",
"title": "NHSEngland Specimen Genomics",
"status": "active",
"date": "2026-04-16",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work",
"rank": 1
}
]
}
],
"description": "This profile defines the Genomics constraints and extensions on the UK Core FHIR resource [Specimen](https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen).",
"purpose": "Used to capture information on Samples which will undergo or have undergone processing for genomic testing.",
"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": "resource",
"abstract": false,
"type": "Specimen",
"baseDefinition": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen",
"derivation": "constraint",
"element": [
{
"id": "Specimen",
"path": "Specimen",
"short": "Sample for analysis",
"definition": "A sample to be used for analysis.",
"min": 0,
"max": "*",
"base": {
"path": "Specimen",
"min": 0,
"max": "*"
},
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "ukcore-spec-001",
"severity": "error",
"human": "There SHALL be only one reference between collection.collector and the extension collectionCollectorR5",
"expression": "collection.collector.reference.empty() or collection.collector.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector').empty()",
"source": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "Role[classCode=SPEC]"
}
]
},
{
"id": "Specimen.id",
"path": "Specimen.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
}
],
"code": "id"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.meta",
"path": "Specimen.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.implicitRules",
"path": "Specimen.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.language",
"path": "Specimen.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.text",
"path": "Specimen.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Specimen.contained",
"path": "Specimen.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.extension",
"path": "Specimen.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.extension:sampleCategory",
"path": "Specimen.extension",
"sliceName": "sampleCategory",
"short": "An extension to record the category of the sample.",
"definition": "Allows the categorisation of a sample into either tumour or germline. Required for WGS Cancer Testing, though not currently part of the Order Management MDS. Additional terms may be added upon review though the valueCodeableConcept.text field MAY be used as a free text representation if needed.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory"
]
}
],
"ele-1"
],
{
"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,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.modifierExtension",
"path": "Specimen.modifierExtension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier",
"path": "Specimen.identifier",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"short": "External Identifier",
"definition": "Multiple identifiers MAY be assigned to a sample as it travels between labs. Each lab SHOULD append their local identifier to the identifier array if needed, ensuring either the system or assigner, is able to disambiguate any identifiers from possibly overlapping numbers from other organizations. Assigner is preferred in this case (see identifier example on the UKCore-Patient page for further guidance)\nNote: accessionIdentifier is unused by the Genomic Medicine Service to facilitate movement of samples across organizational boundaries.",
"min": 1,
"max": "*",
"base": {
"path": "Specimen.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "SPM-2"
},
{
"identity": "rim",
"map": ".id"
}
]
},
{
"id": "Specimen.identifier.id",
"path": "Specimen.identifier.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.identifier.extension",
"path": "Specimen.identifier.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier.use",
"path": "Specimen.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Specimen.identifier.type",
"path": "Specimen.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Specimen.identifier.system",
"path": "Specimen.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "Specimen.identifier.value",
"path": "Specimen.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Specimen.identifier.period",
"path": "Specimen.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"ele-1"
],
{
"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": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Specimen.identifier.assigner",
"path": "Specimen.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen",
"path": "Specimen.identifier",
"sliceName": "identifierGMSSpecimen",
"short": "External Identifier",
"definition": "Id for specimen.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "SPM-2"
},
{
"identity": "rim",
"map": ".id"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.id",
"path": "Specimen.identifier.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.extension",
"path": "Specimen.identifier.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.use",
"path": "Specimen.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.type",
"path": "Specimen.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.system",
"path": "Specimen.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/Id/GMSSpecimen",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.value",
"path": "Specimen.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.period",
"path": "Specimen.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"ele-1"
],
{
"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": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.assigner",
"path": "Specimen.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Specimen.identifier:localIdentifier",
"path": "Specimen.identifier",
"sliceName": "localIdentifier",
"short": "External Identifier",
"definition": "Id for specimen.",
"min": 0,
"max": "*",
"base": {
"path": "Specimen.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "SPM-2"
},
{
"identity": "rim",
"map": ".id"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.id",
"path": "Specimen.identifier.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.extension",
"path": "Specimen.identifier.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.use",
"path": "Specimen.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.type",
"path": "Specimen.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.system",
"path": "Specimen.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/local-identifier/specimen",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.value",
"path": "Specimen.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.period",
"path": "Specimen.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"ele-1"
],
{
"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": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner",
"path": "Specimen.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner.id",
"path": "Specimen.identifier.assigner.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner.extension",
"path": "Specimen.identifier.assigner.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner.reference",
"path": "Specimen.identifier.assigner.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "0",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1",
"ref-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner.type",
"path": "Specimen.identifier.assigner.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"comment": "This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner.identifier",
"path": "Specimen.identifier.assigner.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"min": 1,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"system": "https://fhir.nhs.uk/Id/ods-organization-code"
},
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "Specimen.identifier:localIdentifier.assigner.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Specimen.identifier.assigner.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.accessionIdentifier",
"path": "Specimen.accessionIdentifier",
"short": "Identifier assigned by the lab",
"definition": "The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.",
"min": 0,
"max": "0",
"base": {
"path": "Specimen.accessionIdentifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "SPM-30 (v2.7+)"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id"
}
]
},
{
"id": "Specimen.status",
"path": "Specimen.status",
"short": "available | unavailable | unsatisfactory | entered-in-error",
"definition": "If a Specimen has not been collected, the status SHOULD be marked as 'unavailable'. If the quality of the Specimen is such that it cannot be processed, the status SHOULD be 'unsatisfactory' (this is equivalent to a QC status of Failed). If the Specimen passes quality control, the status SHOULD be set as 'available'",
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"min": 1,
"max": "1",
"base": {
"path": "Specimen.status",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"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"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenStatus"
}
],
"strength": "required",
"description": "Codes providing the status/availability of a specimen.",
"valueSet": "http://hl7.org/fhir/ValueSet/specimen-status|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "v2",
"map": "SPM-20"
},
{
"identity": "rim",
"map": "status"
}
]
},
{
"id": "Specimen.type",
"path": "Specimen.type",
"short": "Kind of material that forms the specimen",
"definition": "The sample type, SNOMED CT preferred. Used to differentiate between raw and extracted (DNA) samples.\nConceptMaps for the allowed values for primary (raw) and final (extracted DNA) samples upon release of MDSv1.04, to aid identification of whether a sample is primary vs. final",
"comment": "The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.",
"min": 1,
"max": "1",
"base": {
"path": "Specimen.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenType"
}
],
"strength": "preferred",
"description": "A code from the SNOMED CT UK Clinical Terminology coding system",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenType"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "SPM-4 and possibly SPM-5"
},
{
"identity": "rim",
"map": ".code"
}
]
},
{
"id": "Specimen.subject",
"path": "Specimen.subject",
"short": "Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device",
"definition": "SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient.\nSamples collected from a Fetus SHOULD reference a Patient resource for the Fetus. This should then be linked to relevant maternal/paternal resources through the RelatedPerson resource. Further information can be found on the Fetus Management clinical scenario. It is not envisaged that samples would need to be linked to more than one person e.g. both fetus and mother, though this assumption will be tested within the Alpha phase of the Genomic Medicine Service.",
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"requirements": "Must know the subject context.",
"min": 1,
"max": "1",
"base": {
"path": "Specimen.subject",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "rim",
"map": ".scoper or .scoper.playsRole"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "Specimen.receivedTime",
"path": "Specimen.receivedTime",
"short": "The time when specimen was received for processing",
"definition": "SHOULD be updated upon receipt at a destination lab",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.receivedTime",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"ele-1"
],
{
"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"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "v2",
"map": "SPM-18"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime"
}
]
},
{
"id": "Specimen.parent",
"path": "Specimen.parent",
"short": "Specimen from which this specimen originated",
"definition": "If a sample has been split into multiple parts, such as DNA being extracted from a primary sample, each SHOULD be represented using an additional Specimen resource, referencing the parent sample through the parent element.\nThe central Order Management broker will only create Tasks for Specimen resources which do not have a parent element, i.e. primary samples. If required, clients can create Tasks for processing of derivative samples manually.\n\nMAY also be used to record the Block identifier for FFPE/Tissue samples, using the reference.identifier element, where a reference to a Specimen resource is not required.",
"comment": "The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.parent",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)"
}
]
},
{
"id": "Specimen.request",
"path": "Specimen.request",
"short": "Why the specimen was collected",
"definition": "SHALL be provided. This SHOULD be a reference to the request which initiated collection of the sample. SHALL NOT be updated if the sample is used for another test e.g. for re-analysis. In the case that a Specimen needs to be processed as part of a new request, e.g. using a sample in storage, the ServiceRequest SHALL reference the pre-existing sample via ServiceRequest.specimen.",
"comment": "The request may be explicit or implied such with a ServiceRequest that requires a blood draw.",
"min": 1,
"max": "1",
"base": {
"path": "Specimen.request",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "v2",
"map": "ORC? OBR-2/3?"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=FLFS].target"
}
]
},
{
"id": "Specimen.collection",
"path": "Specimen.collection",
"short": "Collection details",
"definition": "Additional information which can be collected about the circumstances under which as sample was collected, if relevant. This include extensions for specialHandling of the sample, e.g. due to high risk of infection, as well as an extension to bodySite to extend the coding to a BodyStructure reference, for more detailed collection of structural information e.g. where tumour morphology and topography need to be collected (only required where morphology and topography are required.\nWhere the collector is an Organization, or where the individual is not known, ODS codes MAY be used as identifiers in place of SDS-User-IDs. However, if referencing a resource, the PractitionerRole resource SHOULD still be referenced. In this case the PractitionerRole.identifier and PractitionerRole.practitioner reference would not be filled, leaving only the reference to an Organization from PractitionerRole.organization.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection",
"min": 0,
"max": "1"
},
"type": [
{
"code": "BackboneElement"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SPM-14"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]"
}
]
},
{
"id": "Specimen.collection.id",
"path": "Specimen.collection.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.collection.extension",
"path": "Specimen.collection.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.extension:specialHandling",
"path": "Specimen.collection.extension",
"sliceName": "specialHandling",
"short": "Special handling of the specimen",
"definition": "Special handling during the collection, transport, or storage of the specimen.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/specimen-specialHandling"
]
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-specimen-collection-specialhandling"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.modifierExtension",
"path": "Specimen.collection.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector",
"path": "Specimen.collection.collector",
"short": "Who collected the specimen",
"definition": "Person who collected the specimen.",
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection.collector",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "PRT"
},
{
"identity": "rim",
"map": ".participation[typeCode=PFM].role"
}
]
},
{
"id": "Specimen.collection.collector.id",
"path": "Specimen.collection.collector.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.collection.collector.extension",
"path": "Specimen.collection.collector.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.extension:collectionCollectorR5",
"path": "Specimen.collection.collector.extension",
"sliceName": "collectionCollectorR5",
"short": "Person who collected the specimen",
"definition": "Person who collected the specimen. This is an R5 backport",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector"
]
}
],
"ele-1"
],
{
"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,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.extension:collectionCollectorR5.id",
"path": "Specimen.collection.collector.extension.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.collection.collector.extension:collectionCollectorR5.extension",
"path": "Specimen.collection.collector.extension.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.extension:collectionCollectorR5.url",
"path": "Specimen.collection.collector.extension.url",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.collection.collector",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.extension:collectionCollectorR5.value[x]",
"path": "Specimen.collection.collector.extension.value[x]",
"short": "Person who collected the specimen",
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.reference",
"path": "Specimen.collection.collector.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1",
"ref-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.type",
"path": "Specimen.collection.collector.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"comment": "This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collector.identifier",
"path": "Specimen.collection.collector.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "Specimen.collection.collector.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Specimen.collection.collector.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.collected[x]",
"path": "Specimen.collection.collected[x]",
"short": "Collection time",
"definition": "Time when specimen was collected from subject - the physiologically relevant time.",
"min": 1,
"max": "1",
"base": {
"path": "Specimen.collection.collected[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.init"
},
{
"identity": "v2",
"map": "SPM-17"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "Specimen.collection.duration",
"path": "Specimen.collection.duration",
"short": "How long it took to collect specimen",
"definition": "The span of time over which the collection of a specimen occurred.",
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection.duration",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Duration"
}
],
"ele-1"
],
{
"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": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "drt-1",
"severity": "error",
"human": "There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.",
"expression": "code.exists() implies ((system = %ucum) and value.exists())",
"xpath": "(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value='http://unitsofmeasure.org')",
"source": "http://hl7.org/fhir/StructureDefinition/Duration"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ> depending on the values"
},
{
"identity": "w5",
"map": "FiveWs.init"
}
]
},
{
"id": "Specimen.collection.quantity",
"path": "Specimen.collection.quantity",
"short": "The quantity of specimen collected",
"definition": "The Specimen.collection.quantity is the amount of the sample collected at collection time. This quantity does not change as the sample is processed.\n\nThe Specimen.container.specimenQuantity is the amount of sample remaining in a container, this is equivalent to GEL 1001 banked volume. This value should be updated as the specimen is used.\n\nIf a specimen is split, additional specimen resources SHOULD be created (referencing the parent specimen), with individual container.specimenQuantity values.",
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection.quantity",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"ele-1"
],
{
"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": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity": "v2",
"map": "SPM-12"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].role[classCode=SPEC].player.quantity"
}
]
},
{
"id": "Specimen.collection.method",
"path": "Specimen.collection.method",
"short": "Technique used to perform collection",
"definition": "A coded value specifying the technique that is used to perform the procedure.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection.method",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenCollectionMethod"
}
],
"strength": "example",
"description": "The technique that is used to perform the procedure.",
"valueSet": "http://hl7.org/fhir/ValueSet/specimen-collection-method"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "SPM-7"
},
{
"identity": "rim",
"map": ".methodCode"
}
]
},
{
"id": "Specimen.collection.bodySite",
"path": "Specimen.collection.bodySite",
"short": "Anatomical collection site",
"definition": "Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.",
"comment": "If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html).",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection.bodySite",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
}
],
"strength": "preferred",
"description": "Codes describing anatomical locations. May include laterality.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SpecimenBodySite"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "SPM-8 and SPM-9"
},
{
"identity": "rim",
"map": ".targetSiteCode"
}
]
},
{
"id": "Specimen.collection.bodySite.id",
"path": "Specimen.collection.bodySite.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.collection.bodySite.extension",
"path": "Specimen.collection.bodySite.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.bodySite.extension:bodySiteReference",
"path": "Specimen.collection.bodySite.extension",
"sliceName": "bodySiteReference",
"short": "An extension to allow referencing to a BodyStructure",
"definition": "An extension to replicate the changes within R5 altering the data type of Specimen.collection.bodySite from CodeableConcept to CodeableReference (bodyStructure).",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference"
]
}
],
"ele-1"
],
{
"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,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.bodySite.extension:bodySiteReference.id",
"path": "Specimen.collection.bodySite.extension.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.collection.bodySite.extension:bodySiteReference.extension",
"path": "Specimen.collection.bodySite.extension.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.bodySite.extension:bodySiteReference.url",
"path": "Specimen.collection.bodySite.extension.url",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BodySiteReference",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.bodySite.extension:bodySiteReference.value[x]",
"path": "Specimen.collection.bodySite.extension.value[x]",
"short": "A reference to a BodyStructure",
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/BodyStructure"
]
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.bodySite.extension:bodyStructureReference",
"path": "Specimen.collection.bodySite.extension",
"sliceName": "bodyStructureReference",
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/bodySite"
]
}
],
"ele-1"
],
{
"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,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.collection.bodySite.coding",
"path": "Specimen.collection.bodySite.coding",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Specimen.collection.bodySite.text",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Specimen.collection.bodySite.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "Specimen.collection.fastingStatus[x]",
"path": "Specimen.collection.fastingStatus[x]",
"short": "Whether or how long patient abstained from food and/or drink",
"definition": "Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection.",
"comment": "Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/​time] in 2 hour Urine --12 hours fasting), or using a component observation ` such as `Observation.component code` = LOINC 49541-6 (Fasting status - Reported).",
"requirements": "Many diagnostic tests require fasting to facilitate accurate interpretation.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.collection.fastingStatus[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
},
{
"code": "Duration"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FastingStatus"
}
],
"strength": "extensible",
"description": "Codes describing the fasting status of the patient.",
"valueSet": "http://terminology.hl7.org/ValueSet/v2-0916"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "OBR-"
}
]
},
{
"id": "Specimen.processing",
"path": "Specimen.processing",
"short": "Processing and processing step details",
"definition": "SHOULD be updated if processing occurs on the sample which affects later use, e.g. additives added",
"min": 0,
"max": "*",
"base": {
"path": "Specimen.processing",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]"
}
]
},
{
"id": "Specimen.processing.id",
"path": "Specimen.processing.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.processing.extension",
"path": "Specimen.processing.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.processing.modifierExtension",
"path": "Specimen.processing.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.processing.description",
"path": "Specimen.processing.description",
"short": "Textual description of procedure",
"definition": "Textual description of procedure.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.processing.description",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".text"
}
]
},
{
"id": "Specimen.processing.procedure",
"path": "Specimen.processing.procedure",
"short": "Indicates the treatment step applied to the specimen",
"definition": "A coded value specifying the procedure used to process the specimen.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.processing.procedure",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenProcessingProcedure"
}
],
"strength": "example",
"description": "Type indicating the technique used to process the specimen.",
"valueSet": "http://hl7.org/fhir/ValueSet/specimen-processing-procedure"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "rim",
"map": ".code"
}
]
},
{
"id": "Specimen.processing.procedure.id",
"path": "Specimen.processing.procedure.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.processing.procedure.extension",
"path": "Specimen.processing.procedure.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.processing.procedure.coding",
"path": "Specimen.processing.procedure.coding",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT",
"path": "Specimen.processing.procedure.coding",
"sliceName": "codingSnomedCT",
"short": "Code defined by a terminology system",
"definition": "codes from https://fhir.nhs.uk/ConceptMap/genomics-samplepreparation",
"comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.id",
"path": "Specimen.processing.procedure.coding.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.extension",
"path": "Specimen.processing.procedure.coding.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.system",
"path": "Specimen.processing.procedure.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "http://snomed.info/sct",
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.version",
"path": "Specimen.processing.procedure.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.code",
"path": "Specimen.processing.procedure.coding.code",
"short": "Symbol in syntax defined by the system",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Specimen.processing.procedure.coding.display",
"short": "Representation defined by the system",
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.userSelected",
"path": "Specimen.processing.procedure.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
"id": "Specimen.processing.procedure.text",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "Specimen.processing.procedure.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "Specimen.processing.additive",
"path": "Specimen.processing.additive",
"short": "Material used in the processing step",
"definition": "Material used in the processing step.",
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"min": 0,
"max": "*",
"base": {
"path": "Specimen.processing.additive",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Substance"
]
}
],
"ele-1"
],
{
"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": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "SPM-6"
},
{
"identity": "rim",
"map": ".participation[typeCode=CSM].role[classCode=ADTV].code"
}
]
},
{
"id": "Specimen.processing.time[x]",
"path": "Specimen.processing.time[x]",
"short": "Date and time of specimen processing",
"definition": "A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.processing.time[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "Specimen.container",
"path": "Specimen.container",
"short": "Direct container of specimen (tube/slide, etc.)",
"definition": "The UK Core STU3 version of Specimen backports the R5 changes to the container BackboneElement to support capturing of storage location for a sample (through `container.location`) and recursive capture of device identifiers (e.g. tube, well, rack, freezer through `container.device`).\nThe container.identifier should match the identifier associated with the barcode for the tube/collection device. This can be searched using the container-id SearchParameter.\n\nAdditional examples/guidance will be provided within this IG once use of the fields has been appropriately tested.\n\nSample tracking information SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing, on either the output or input elements. This information MAY include consignment number, destination, date sent etc.\n\nIf known, the container type SHOULD be populated, using the example bound ValueSet, in SNOMED CT. If an appropraite code cannot be found, the specimen container type should be populated using free text, in Specimen.container.type.text. Additional container elements, such as capacity or specimenQuantity MAY be populated if known.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.container",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".player.scopingRole[classCode=CONT].scoper"
}
]
},
{
"id": "Specimen.container.id",
"path": "Specimen.container.id",
"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": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Specimen.container.extension",
"path": "Specimen.container.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.container.extension:specimenContainerLocationR5",
"path": "Specimen.container.extension",
"sliceName": "specimenContainerLocationR5",
"short": "R5: Where the container is (new)",
"definition": "R5: `Specimen.container.location` (new:Reference(Location))",
"comment": "Element `Specimen.container.location` has a context of Specimen.container based on following the parent source element upwards and mapping to `Specimen`.\nElement `Specimen.container.location` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location"
]
}
],
"ele-1"
],
{
"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,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.container.modifierExtension",
"path": "Specimen.container.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"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": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Specimen.container.identifier",
"path": "Specimen.container.identifier",
"short": "Id for the container",
"definition": "Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.",
"min": 0,
"max": "*",
"base": {
"path": "Specimen.container.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "v2",
"map": "SAC-3"
},
{
"identity": "rim",
"map": ".id"
}
]
},
{
"id": "Specimen.container.description",
"path": "Specimen.container.description",
"short": "Textual description of the container",
"definition": "Textual description of the container.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.container.description",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".desc"
}
]
},
{
"id": "Specimen.container.type",
"path": "Specimen.container.type",
"short": "Kind of container directly associated with specimen",
"definition": "The type of container associated with the specimen (e.g. slide, aliquot, etc.).",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.container.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenContainerType"
}
],
"strength": "preferred",
"description": "Type of specimen container.",
"valueSet": "http://hl7.org/fhir/ValueSet/specimen-container-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "SPM-27"
},
{
"identity": "rim",
"map": ".code"
}
]
},
{
"id": "Specimen.container.capacity",
"path": "Specimen.container.capacity",
"short": "Container volume or size",
"definition": "The capacity (volume or other measure) the container may contain.",
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.container.capacity",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"ele-1"
],
{
"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": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity": "v2",
"map": "one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20"
},
{
"identity": "rim",
"map": ".quantity"
}
]
},
{
"id": "Specimen.container.specimenQuantity",
"path": "Specimen.container.specimenQuantity",
"short": "Quantity of specimen within container",
"definition": "The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.",
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.container.specimenQuantity",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity",
"profile": [
"http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
]
}
],
"ele-1"
],
{
"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": "qty-3",
"severity": "error",
"human": "If a code for the unit is present, the system SHALL also be present",
"expression": "code.empty() or system.exists()",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity"
},
{
"key": "sqty-1",
"severity": "error",
"human": "The comparator is not used on a SimpleQuantity",
"expression": "comparator.empty()",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SN (see also Range) or CQ"
},
{
"identity": "rim",
"map": "PQ, IVL<PQ>, MO, CO, depending on the values"
},
{
"identity": "v2",
"map": "SAC-23 (value) SAC-24 (units"
},
{
"identity": "rim",
"map": ".playedRole[classCode=CONT].quantity"
}
]
},
{
"id": "Specimen.container.additive[x]",
"path": "Specimen.container.additive[x]",
"short": "Additive associated with container",
"definition": "Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.container.additive[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
},
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Substance"
]
}
],
"ele-1"
],
{
"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"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenContainerAdditive"
}
],
"strength": "example",
"description": "Substance added to specimen container.",
"valueSet": "http://terminology.hl7.org/ValueSet/v2-0371"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "SAC-27"
},
{
"identity": "rim",
"map": ".scopesRole[classCode=ADTV].player"
}
]
},
{
"id": "Specimen.condition",
"path": "Specimen.condition",
"short": "State of the specimen",
"definition": "Used to record the condition of a specimen. Within Genomics, SHOULD be used to record the fixed/frozen state, using the UK Core bound ValueSet.",
"comment": "Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.",
"requirements": "The specimen condition can be used to assess its quality or appropriateness for a specific test.",
"min": 0,
"max": "1",
"base": {
"path": "Specimen.condition",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"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"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SpecimenCondition"
}
],
"strength": "extensible",
"description": "Codes describing the state of the specimen.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BiopsyState"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "SPM-24"
}
]
},
{
"id": "Specimen.note",
"path": "Specimen.note",
"short": "Comments",
"definition": "To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).",
"comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
"min": 0,
"max": "*",
"base": {
"path": "Specimen.note",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Annotation"
}
],
"ele-1"
],
{
"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"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act"
},
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
}
]
},
"element": [
{
"id": "Specimen.extension:sampleCategory",
"path": "Specimen.extension",
"sliceName": "sampleCategory",
"definition": "Allows the categorisation of a sample into either tumour or germline. Required for WGS Cancer Testing, though not currently part of the Order Management MDS. Additional terms may be added upon review though the valueCodeableConcept.text field MAY be used as a free text representation if needed."
},
{
"id": "Specimen.identifier",
"path": "Specimen.identifier",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"definition": "Multiple identifiers MAY be assigned to a sample as it travels between labs. Each lab SHOULD append their local identifier to the identifier array if needed, ensuring either the system or assigner, is able to disambiguate any identifiers from possibly overlapping numbers from other organizations. Assigner is preferred in this case (see identifier example on the UKCore-Patient page for further guidance)\nNote: accessionIdentifier is unused by the Genomic Medicine Service to facilitate movement of samples across organizational boundaries.",
"min": 1
},
{
"id": "Specimen.identifier.assigner",
"path": "Specimen.identifier.assigner",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Organization-Genomics"
]
}
]
},
{
"id": "Specimen.identifier:identifierGMSSpecimen",
"path": "Specimen.identifier",
"sliceName": "identifierGMSSpecimen",
"max": "1"
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.use",
"path": "Specimen.identifier.use",
"max": "0"
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.type",
"path": "Specimen.identifier.type",
"max": "0"
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.system",
"path": "Specimen.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/Id/GMSSpecimen"
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.value",
"path": "Specimen.identifier.value",
"min": 1
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.period",
"path": "Specimen.identifier.period",
"max": "0"
},
{
"id": "Specimen.identifier:identifierGMSSpecimen.assigner",
"path": "Specimen.identifier.assigner",
"max": "0"
},
{
"id": "Specimen.identifier:localIdentifier",
"path": "Specimen.identifier",
"sliceName": "localIdentifier"
},
{
"id": "Specimen.identifier:localIdentifier.system",
"path": "Specimen.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/local-identifier/specimen"
},
{
"id": "Specimen.identifier:localIdentifier.value",
"path": "Specimen.identifier.value",
"min": 1
},
{
"id": "Specimen.identifier:localIdentifier.assigner",
"path": "Specimen.identifier.assigner",
"min": 1
},
{
"id": "Specimen.identifier:localIdentifier.assigner.reference",
"path": "Specimen.identifier.assigner.reference",
"max": "0"
},
{
"id": "Specimen.identifier:localIdentifier.assigner.identifier",
"path": "Specimen.identifier.assigner.identifier",
"min": 1,
"system": "https://fhir.nhs.uk/Id/ods-organization-code"
}
},
{
"id": "Specimen.accessionIdentifier",
"path": "Specimen.accessionIdentifier",
"max": "0"
},
{
"id": "Specimen.status",
"path": "Specimen.status",
"definition": "If a Specimen has not been collected, the status SHOULD be marked as 'unavailable'. If the quality of the Specimen is such that it cannot be processed, the status SHOULD be 'unsatisfactory' (this is equivalent to a QC status of Failed). If the Specimen passes quality control, the status SHOULD be set as 'available'",
"min": 1
},
{
"id": "Specimen.type",
"path": "Specimen.type",
"definition": "The sample type, SNOMED CT preferred. Used to differentiate between raw and extracted (DNA) samples.\nConceptMaps for the allowed values for primary (raw) and final (extracted DNA) samples upon release of MDSv1.04, to aid identification of whether a sample is primary vs. final",
"min": 1
},
{
"id": "Specimen.subject",
"path": "Specimen.subject",
"definition": "SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient.\nSamples collected from a Fetus SHOULD reference a Patient resource for the Fetus. This should then be linked to relevant maternal/paternal resources through the RelatedPerson resource. Further information can be found on the Fetus Management clinical scenario. It is not envisaged that samples would need to be linked to more than one person e.g. both fetus and mother, though this assumption will be tested within the Alpha phase of the Genomic Medicine Service.",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "Specimen.receivedTime",
"path": "Specimen.receivedTime",
"definition": "SHOULD be updated upon receipt at a destination lab"
},
{
"id": "Specimen.parent",
"path": "Specimen.parent",
"definition": "If a sample has been split into multiple parts, such as DNA being extracted from a primary sample, each SHOULD be represented using an additional Specimen resource, referencing the parent sample through the parent element.\nThe central Order Management broker will only create Tasks for Specimen resources which do not have a parent element, i.e. primary samples. If required, clients can create Tasks for processing of derivative samples manually.\n\nMAY also be used to record the Block identifier for FFPE/Tissue samples, using the reference.identifier element, where a reference to a Specimen resource is not required.",
"max": "1",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Specimen-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "Specimen.request",
"path": "Specimen.request",
"definition": "SHALL be provided. This SHOULD be a reference to the request which initiated collection of the sample. SHALL NOT be updated if the sample is used for another test e.g. for re-analysis. In the case that a Specimen needs to be processed as part of a new request, e.g. using a sample in storage, the ServiceRequest SHALL reference the pre-existing sample via ServiceRequest.specimen.",
"min": 1,
"max": "1",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "Specimen.collection",
"path": "Specimen.collection",
"definition": "Additional information which can be collected about the circumstances under which as sample was collected, if relevant. This include extensions for specialHandling of the sample, e.g. due to high risk of infection, as well as an extension to bodySite to extend the coding to a BodyStructure reference, for more detailed collection of structural information e.g. where tumour morphology and topography need to be collected (only required where morphology and topography are required.\nWhere the collector is an Organization, or where the individual is not known, ODS codes MAY be used as identifiers in place of SDS-User-IDs. However, if referencing a resource, the PractitionerRole resource SHOULD still be referenced. In this case the PractitionerRole.identifier and PractitionerRole.practitioner reference would not be filled, leaving only the reference to an Organization from PractitionerRole.organization."
},
{
"id": "Specimen.collection.extension:specialHandling",
"path": "Specimen.collection.extension",
"sliceName": "specialHandling",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-specimen-collection-specialhandling"
}
},
{
"id": "Specimen.collection.collector",
"path": "Specimen.collection.collector",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "Specimen.collection.collected[x]",
"path": "Specimen.collection.collected[x]",
"min": 1
},
{
"id": "Specimen.collection.quantity",
"path": "Specimen.collection.quantity",
"definition": "The Specimen.collection.quantity is the amount of the sample collected at collection time. This quantity does not change as the sample is processed.\n\nThe Specimen.container.specimenQuantity is the amount of sample remaining in a container, this is equivalent to GEL 1001 banked volume. This value should be updated as the specimen is used.\n\nIf a specimen is split, additional specimen resources SHOULD be created (referencing the parent specimen), with individual container.specimenQuantity values."
},
{
"id": "Specimen.collection.bodySite.extension:bodyStructureReference",
"path": "Specimen.collection.bodySite.extension",
"sliceName": "bodyStructureReference",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/bodySite"
]
}
],
"isModifier": false
},
{
"id": "Specimen.processing",
"path": "Specimen.processing",
"definition": "SHOULD be updated if processing occurs on the sample which affects later use, e.g. additives added"
},
{
"id": "Specimen.processing.procedure.coding",
"path": "Specimen.processing.procedure.coding",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
}
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT",
"path": "Specimen.processing.procedure.coding",
"sliceName": "codingSnomedCT",
"definition": "codes from https://fhir.nhs.uk/ConceptMap/genomics-samplepreparation"
},
{
"id": "Specimen.processing.procedure.coding:codingSnomedCT.system",
"path": "Specimen.processing.procedure.coding.system",
"fixedUri": "http://snomed.info/sct"
},
{
"id": "Specimen.container",
"path": "Specimen.container",
"definition": "The UK Core STU3 version of Specimen backports the R5 changes to the container BackboneElement to support capturing of storage location for a sample (through `container.location`) and recursive capture of device identifiers (e.g. tube, well, rack, freezer through `container.device`).\nThe container.identifier should match the identifier associated with the barcode for the tube/collection device. This can be searched using the container-id SearchParameter.\n\nAdditional examples/guidance will be provided within this IG once use of the fields has been appropriately tested.\n\nSample tracking information SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing, on either the output or input elements. This information MAY include consignment number, destination, date sent etc.\n\nIf known, the container type SHOULD be populated, using the example bound ValueSet, in SNOMED CT. If an appropraite code cannot be found, the specimen container type should be populated using free text, in Specimen.container.type.text. Additional container elements, such as capacity or specimenQuantity MAY be populated if known.",
"max": "1"
},
{
"id": "Specimen.container.extension:specimenContainerLocationR5",
"path": "Specimen.container.extension",
"sliceName": "specimenContainerLocationR5",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location"
]
}
]
},
{
"id": "Specimen.condition",
"path": "Specimen.condition",
"definition": "Used to record the condition of a specimen. Within Genomics, SHOULD be used to record the fixed/frozen state, using the UK Core bound ValueSet.",
"max": "1"
}
]
}
}

FHIRMDSHL7v2
SpecimenSample/Biopsy inc germline, Extracted SpecimenSPM
Specimen.subjectFetus - Is sample for fetal or unregistered neonate, Raw specimen/biopsy - Family member provided byPID segment attached to SPM
Specimen.collection.quantityPLCM activity - Sample volume, Raw specimen/biopsy - VolumeSPM-12
Specimen.typePLCM activity - Sample category codeSPM-4
Specimen.identifier.assignerRaw specimen/biopsy - Id assigning authority ODS code (many), Raw specimen/biopsy - Is assigning authority a histopathology laboratory (many), Extracted specimen - Id assigning authority ODS code (many)SPM-2.1.2
Specimen.identifier.valueRaw specimen/biopsy - Id (many), Extracted specimen - Id (many)SPM-2
Specimen.container.identifierRaw specimen/biopsy - Sample well identifierSAC-3
Specimen.noteRaw specimen/biopsy - Location details (will use backported R5 container.location once released), Extracted specimen - Location details, Raw specimen/biopsy - Sample to follow reason, Raw specimen/biopsy - Additional specimen/biopsy information, Extracted specimen - Additional specimen informationSAC-15, NTE segment attached to ORC, OBX segments attached to SPM
Specimen.extension:sampleCategoryRaw specimen/biopsy - WGS specimen type categorySPM-5
Specimen.typeRaw specimen/biopsy - Type, Raw specimen/biopsy - Blood component, Extracted specimen - TypeSPM-4
Specimen.conditionRaw specimen/biopsy - StateSPM-24
Specimen.processingRaw specimen/biopsy - Sample preparation (submitted to GLH)Combination of SPM-6/SPM-24 or NTE segments if other processing
Specimen.collection.collectedDateTimeRaw specimen/biopsy - Obtained dateSPM-17
Specimen.receivedTimeRaw specimen/biopsy - Received dateSPM-18
Specimen.collection.extension:specimen-specialHandling.valueCoding.codeRaw specimen/biopsy - High risk reason, Raw specimen/biopsy - Option for products of conceptionSPM-16.2, SPM-15
Specimen.collection.bodySiteRaw specimen/biopsy - Biopsy siteSPM-8/SPM-9
Specimen.statusRaw specimen/biopsy - Sample to followN/A implied through absence of SPM segment in test order
Specimen.conditionExtracted specimen - StateSPM-24
Specimen.processing.timeDateTimeExtracted specimen - Extracted dateOBR-7 attached to processing procedure in SAC-30

Additional Guidance

extension:sampleCategory

Allows the categorisation of a sample into either tumour or germline. Required for WGS Cancer Testing, though not currently part of the Order Management MDS. Additional terms may be added upon review though the valueCodeableConcept.text field MAY be used as a free text representation if needed.
"extension": [
        {
            "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SampleCategory",
            "valueCodeableConcept": {
                "coding": [
                    {
                        "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-SampleCategory",
                        "code": "germline",
                        "display": "Germline"
                    }
                ]
            }
        }
    ]

identifier

Multiple identifiers MAY be assigned to a sample as it travels between labs. Each lab SHOULD append their local identifier to the identifier array if needed, ensuring either the system or assigner, is able to disambiguate any identifiers from possibly overlapping numbers from other organizations. Assigner is preferred in this case (see identifier example on the Genomics-Patient page for further guidance)

The identifier SHOULD be the identifier assigned by the system, e.g. LIMS, EPR etc., during accessioning. Identifiers for the containers, e.g. specimen tube barcode, SHOULD instead be recorded in Specimen.container.identifier. There is no requirement that the Specimen and container identifiers match but both SHOULD be present to support identification of a sample.

Note: accessionIdentifier is unused by the Genomic Medicine Service to facilitate movement of samples across organizational boundaries.

"identifier":  [
        {
            "system": "https://fhir.add.nhs.uk/Id/specimenId",
            "value": "RGT03135"
        }
    ],

status

If a Specimen has not been collected, the status SHOULD be marked as 'unavailable'. If the quality of the Specimen is such that it cannot be processed, the status SHOULD be 'unsatisfactory' (this is equivalent to a QC status of Failed). If the Specimen passes quality control, the status SHOULD be set as 'available
"status": "unsatisfactory",

type

The sample type, SNOMED CT preferred. Used to differentiate between raw and extracted (DNA) samples.

ConceptMaps for the allowed values for primary (raw) and final (extracted DNA) samples upon release of MDSv1.04, to aid identification of whether a sample is primary vs. final

"type": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "445295009",
                "display": "Blood specimen with EDTA"
            }
        ]
    },

subject

SHALL be provided. This SHOULD be a reference to the Patient resource or the identifier, NHS number, for the patient.

Samples collected from a Fetus SHOULD reference a Patient resource for the Fetus. This should then be linked to relevant maternal/paternal resources through the RelatedPerson resource. Further information can be found on the Fetus Management clinical scenario. It is not envisaged that samples would need to be linked to more than one person e.g. both fetus and mother, though this assumption will be tested within the Alpha phase of the Genomic Medicine Service.

"subject": {
        "reference": "Patient/Patient-MeirLieberman-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },

receivedTime

SHOULD be updated upon receipt at a destination lab
"receivedTime": "2023-09-18T18:30:00Z"

parent

If a sample has been split into multiple parts, such as DNA being extracted from a primary sample, each SHOULD be represented using an additional Specimen resource, referencing the parent Specimen resource through the parent element.

The central Order Management broker will only create Tasks for Specimen resources which do not reference parent Specimen resources, i.e. primary samples. If required, clients can create Tasks for processing of derivative samples manually.

MAY also be used to record the Block identifier for FFPE/Tissue samples, using the reference.identifier element, where the reference to a Specimen is outside the scope of Genomics, e.g. an identifier originating from Pathology (e.g. using parent.identifier.type.text = "Block Identifier").

"parent": [
        {
            "reference": "Specimen/Specimen-BloodEDTA-Example"
        }
    ],

request

SHALL be provided. This SHOULD be a reference to the request which initiated collection of the sample. SHALL NOT be updated if the sample is used for another test e.g. for re-analysis. In the case that a Specimen needs to be processed as part of a new request, e.g. using a sample in storage, the ServiceRequest SHALL reference the pre-existing sample via ServiceRequest.specimen.
"request":  [
        {
            "reference": "ServiceRequest/ServiceRequest-NonWGSTestOrderForm-Example"
        }
    ]

collection

Additional information which can be collected about the circumstances under which as sample was collected, if relevant. This include extensions for specialHandling of the sample, e.g. due to high risk of infection, as well as an extension to bodySite to extend the coding to a BodyStructure reference, for more detailed collection of structural information e.g. where tumour morphology and topography need to be collected (only required where morphology and topography are required.

Where the collector is an Organization, or where the individual is not known, ODS codes MAY be used as identifiers in place of SDS-User-IDs. However, if referencing a resource, the PractitionerRole resource SHOULD still be referenced. In this case the PractitionerRole.identifier and PractitionerRole.practitioner reference would not be filled, leaving only the reference to an Organization from PractitionerRole.organization.

Note on quanitities

The Specimen.collection.quantity is the amount of the sample collected at collection time. This quantity does not change as the sample is processed.

The Specimen.container.specimenQuantity is the amount of sample remaining in a container, this is equivalent to GEL 1001 banked volume. This value should be updated as the specimen is used.

If a specimen is split, additional specimen resources SHOULD be created (referencing the parent specimen), with individual container.specimenQuantity values.

"collection": {
        "collector": {
            "identifier": {
                "system": "https://fhir.nhs.uk/Id/sds-user-id",
                "value": "999999"
            }
        },
        "collectedDateTime": "2022-07-11T09:00:00Z",
        "quantity": {
            "system": "http://unitsofmeasure.org",
            "code": "mL",
            "value": 2.5
        },
        "method": {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "129300006",
                    "display": "Puncture - action"
                }
            ]
        },
        "bodySite": {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/bodySite",
                    "valueReference": {
                        "reference": "BodyStructure/BodyStructure-BodySiteLocationForearm-Example"
                    }
                }
            ],
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "14975008",
                    "display": "Forearm structure (body structure)"
                }
            ]
        }
    },

processing

SHOULD be updated if processing occurs on the sample which affects later use, e.g. additives added
"processing": [
    {
      "description": "Acidify to pH < 3.0 with 6 N HCl.",
      "procedure": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0373",
            "code": "ACID"
          }
        ]
      },
      "additive": [
        {
          "display": "6 N HCl"
        }
      ],
      "timeDateTime": "2015-08-18T08:10:00Z"
    }
  ],

container

The UK Core STU3 version of Specimen backports the R5 changes to the container BackboneElement to support capturing of storage location for a sample (through `container.location`) and recursive capture of device identifiers (e.g. tube, well, rack, freezer through `container.device`).

The container.identifier SHALL match the identifier associated with the barcode for the tube/collection device. This can be searched using the container-id SearchParameter.

Additional examples/guidance will be provided within this IG once use of the fields has been appropriately tested.

Sample tracking information SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing, on either the output or input elements. This information MAY include consignment number, destination, date sent etc.

If known, the container type SHOULD be populated, using the example bound ValueSet, in SNOMED CT. If an appropraite code cannot be found, the specimen container type should be populated using free text, in Specimen.container.type.text. Additional container elements, such as capacity or specimenQuantity MAY be populated if known.

"container":  [
        {
            "extension":  [
                {
                    "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.location",
                    "valueReference": {
                            "reference": "Location/Location-NTGLHFridge-Example"
                    }
                }
            ],
            "identifier": [
                {
                    "system": "urn:iso:std:iso:15417:2007",
                    "value": "ABC-abc-1234"
                }
            ],
            "type": {
                "coding": [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "702284002",
                        "display": "Non-evacuated blood collection tube, lithium heparin"
                    }
                ]
            }
        }
    ]

condition

Used to record the condition of a specimen. Within Genomics, SHOULD be used to record the fixed/frozen state, using the UK Core bound ValueSet.
"condition":  [
        {
            "coding":  [
                {
                    "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PrimarySampleState",
                    "code": "fresh",
                    "display": "Fresh"
                }
            ]
        }
    ]