FHIR Genomics Implementation Guide

Notice

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

StructureDefinition Task

The core workflow resource for managing processing of a ServiceRequest from order through to delivery of a DiagnosticReport and completion is Task. Task tracking is a core requirement of the central Genomic Medicine Service.

Each ServiceRequest submitted will instantiate a series of High Level Tasks, which MAY be assigned to different organizations for managing the test request e.g. Sample Processing, Interpretation, Reporting etc. The full list of possible Task types/codes, their associated business statuses, and status reasons is pending internal review.

Tasks will be automatically created by the central broker but updates to statuses and attachment of input/output resources is the responsibility of the assigned organizations.

An illustrative diagram of the links between ServiceRequests and Tasks are provided below (for the initial sample processing). Note: not all resource links are represented, to increase legibility of the diagram. In most cases, the full library of 10 tasks, as defined within Genomic-Task-Code, will be 'spun-up', on submission of a Test order. Tasks related to Samples may be duplicated per Sample to allow tracking of work related to individual Samples as part of the same test request, or equally, may be omitted as in the case of Re-Analysis or Re-Interpretation where data from an existing sample is used, eliminating the need for additional wet-work. For the full cardinality breakdown see further guidance for the Task.code element.

Profile url	FHIR Module	Normative Status
http://hl7.org/fhir/StructureDefinition/Task	HL7 International	trial-use

Task	I		DomainResource	Element id Task Short description A task to be performed Definition A task to be performed. Data type DomainResource 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()` inv-1: Last modified date must be greater than or equal to authored-on date. `lastModified.exists().not() or authoredOn.exists().not() or lastModified >= authoredOn` Mappings rim: Entity. Role, or Act workflow: Request, Event rim: ControlAct[moodCode=INT]
id	Σ	0..1	string	There are no (further) constraints on this element Element id Task.id Short description 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. 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. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Task.meta Short description 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. Data type Meta 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
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Task.implicitRules Short description 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Task.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id Task.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display 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. 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. Data type Narrative 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?
contained		0..*	Resource	There are no (further) constraints on this element Element id Task.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained 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. 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Task.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Task.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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). 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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
identifier		0..*	Identifier	Element id Task.identifier Short description Task Instance Identifier Definition The business identifier for this task. Data type Identifier 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 workflow: Request.identifier, Event.identifier w5: FiveWs.identifier rim: .id
instantiatesCanonical	Σ	0..1	canonical(ActivityDefinition)	Element id Task.instantiatesCanonical Short description Formal definition of task Definition The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Task. Requirements Enables a formal definition of how he task is to be performed, enabling automation. Comments see Canonical References Data type canonical(ActivityDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.instantiatesCanonical, Event.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..1	uri	Element id Task.instantiatesUri Short description Formal definition of task Definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Task. Requirements Enables a formal definition of how he task is to be performed (e.g. using BPMN, BPEL, XPDL or other formal notation to be associated with a task), enabling automation. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.instantiatesUrl rim: .outboundRelationship[typeCode=DEFN].target
basedOn	Σ I	0..*	Reference(Resource)	Element id Task.basedOn Short description Request fulfilled by this task Definition BasedOn refers to a higher-level authorization that triggered the creation of the task. It references a "request" resource such as a ServiceRequest, MedicationRequest, ServiceRequest, CarePlan, etc. which is distinct from the "request" resource the task is seeking to fulfill. This latter resource is referenced by FocusOn. For example, based on a ServiceRequest (= BasedOn), a task is created to fulfill a procedureRequest ( = FocusOn ) to collect a specimen from a patient. 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. Data type Reference(Resource) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn, Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[moodCode=INT]
groupIdentifier	Σ	0..1	Identifier	Element id Task.groupIdentifier Short description Requisition or grouper id Definition An identifier that links together multiple tasks and other requests that were created in the same context. Requirements Billing and/or reporting can be linked to whether multiple requests were created as a single unit. Data type Identifier 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 workflow: Request.groupIdentifier rim: .inboundRelationship[typeCode=COMP].source[moodCode=INT].id
partOf	Σ I	0..*	Reference(Task)	Element id Task.partOf Short description Composite task Definition Task that this particular task is part of. Requirements Allows tasks to be broken down into sub-steps (and this division can occur independent of the original task). Comments This should usually be 0..1. Data type Reference(Task) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.partOf rim: .inboundRelationship[typeCode=COMP].source[moodCode=INT]
status	Σ ?!	1..1	codeBinding	Element id Task.status Short description draft \| requested \| received \| accepted \| + Definition The current status of the task. Requirements These states enable coordination of task status with off-the-shelf workflow solutions that support automation of tasks. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The current status of the task. TaskStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status, Event.status w5: FiveWs.status rim: .statusCode
statusReason	Σ	0..1	CodeableConcept	Element id Task.statusReason Short description Reason for current status Definition An explanation as to why this task is held, failed, was refused, etc. Comments This applies to the current status. Look at the history of the task to see reasons for past statuses. Data type CodeableConcept Binding Codes to identify the reason for current status. These will typically be specific to a particular workflow. (unbound) (example) 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: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN, code="status change"].reasonCode
businessStatus	Σ	0..1	CodeableConcept	Element id Task.businessStatus Short description E.g. "Specimen collected", "IV prepped" Definition Contains business-specific nuances of the business state. Requirements There's often a need to track substates of a task - this is often variable by specific workflow implementation. 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. Data type CodeableConcept Binding The domain-specific business-contextual sub-state of the task. For example: "Blood drawn", "IV inserted", "Awaiting physician signature", etc. (unbound) (example) 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: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="business status"]
intent	Σ	1..1	codeBinding	Element id Task.intent Short description unknown \| proposal \| plan \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Definition Indicates the "level" of actionability associated with the Task, i.e. i+R[9]Cs this a proposed task, a planned task, an actionable task, etc. Comments This element is immutable. Proposed tasks, planned tasks, etc. must be distinct instances. In most cases, Tasks will have an intent of "order". Data type code Binding Distinguishes whether the task is a proposal, plan or full order. TaskIntent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.intent w5: FiveWs.class rim: .moodCode
priority		0..1	codeBinding	Element id Task.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the Task should be addressed with respect to other requests. Requirements Used to identify the service level expected while performing a task. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If missing, this task should be performed with normal priority Data type code Binding The task's priority. RequestPriority (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.priority w5: FiveWs.grade rim: .priorityCode
code	Σ	0..1	CodeableConcept	Element id Task.code Short description Task Type Definition A name or code (or both) briefly describing what the task involves. Comments The title (eg "My Tasks", "Outstanding Tasks for Patient X") should go into the code. Data type CodeableConcept Binding Codes to identify what the task involves. These will typically be specific to a particular workflow. TaskCode (example) 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 workflow: Request.code, Event.code w5: FiveWs.what[x] rim: .code
description	Σ	0..1	string	Element id Task.description Short description Human-readable explanation of task Definition A free-text description of what is to be performed. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .text
focus	Σ I	0..1	Reference(Resource)	Element id Task.focus Short description What task is acting on Definition The request being actioned or the resource being manipulated by this task. Requirements Used to identify the thing to be done. Comments If multiple resources need to be manipulated, use sub-tasks. (This ensures that status can be tracked independently for each referenced resource.). Data type Reference(Resource) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.what[x] rim: .outboundRelationship[typeCode=SUBJ].target
for	Σ I	0..1	Reference(Resource)	Element id Task.for Short description Beneficiary of the Task Alternate names Patient Definition The entity who benefits from the performance of the service specified in the task (e.g., the patient). Requirements Used to track tasks outstanding for a beneficiary. Do not use to track the task owner or creator (see owner and creator respectively). This can also affect access control. 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. Data type Reference(Resource) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.subject, Event.subject w5: FiveWs.subject[x] rim: .participation[typeCode=RCT].role w5: FiveWs.subject
encounter	Σ I	0..1	Reference(Encounter)	Element id Task.encounter Short description Healthcare event during which this task originated Definition The healthcare event (e.g. a patient and healthcare provider interaction) during which this task was created. Requirements For some tasks it may be important to know the link between the encounter the task originated within. 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. Data type Reference(Encounter) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.context, Event.context w5: FiveWs.context rim: .inboundRelationship[typeCode=COMP].source[classCode=PCPR, moodCode=EVN]
executionPeriod	Σ I	0..1	Period	Element id Task.executionPeriod Short description Start and end time of execution Definition Identifies the time action was first taken against the task (start) and/or the time final action was taken against the task prior to marking it as completed (end). 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. Data type Period 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"] workflow: Event.occurrence[x] w5: FiveWs.done[x] rim: .effectiveTime
authoredOn	I	0..1	dateTime	Element id Task.authoredOn Short description Task Creation Date Alternate names Created Date Definition The date and time this task was created. Requirements Most often used along with lastUpdated to track duration of task to supporting monitoring and management. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.authoredOn w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
lastModified	Σ I	0..1	dateTime	Element id Task.lastModified Short description Task Last Modified Date Alternate names Update Date Definition The date and time of last modification to this task. Requirements Used along with history to track task activity and time in a particular task state. This enables monitoring and management. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .inboundRelationship[typeCode=SUBJ, ].source[classCode=CACT, moodCode=EVN].effectiveTime
requester	Σ I	0..1	Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole \| RelatedPerson)	Element id Task.requester Short description Who is asking for task to be done Definition The creator of the task. Requirements Identifies who created this task. May be used by access control mechanisms (e.g., to ensure that only the creator can cancel a task). 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. Data type Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole \| RelatedPerson) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.requester w5: FiveWs.author rim: .participation[typeCode=AUT].role
performerType		0..*	CodeableConceptBinding	Element id Task.performerType Short description Requested performer Definition The kind of participant that should perform the task. Requirements Use to distinguish tasks on different activity queues. 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. Data type CodeableConcept Binding The type(s) of task performers allowed. ProcedurePerformerRoleCodes (preferred) 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 workflow: Event.performer.role, Request.performerType w5: FiveWs.actor rim: .participation[typeCode=PRF].role.code
owner	Σ I	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam \| HealthcareService \| Patient \| Device \| RelatedPerson)	Element id Task.owner Short description Responsible individual Alternate names Performer, Executer Definition Individual organization or Device currently responsible for task execution. Requirements Identifies who is expected to perform this task. Comments Tasks may be created with an owner not yet identified. Data type Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam \| HealthcareService \| Patient \| Device \| RelatedPerson) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor, Request.performer w5: FiveWs.actor rim: .participation[typeCode=PRF].role
location	Σ I	0..1	Reference(Location)	Element id Task.location Short description Where task occurs Definition Principal physical location where the this task is performed. Requirements Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting). 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. Data type Reference(Location) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonCode, Event.reasonCode w5: FiveWs.where[x] rim: .participation[typeCode=LOC].role
reasonCode		0..1	CodeableConcept	Element id Task.reasonCode Short description Why task is needed Definition A description or code indicating why this task needs to be performed. Comments This should only be included if there is no focus or if it differs from the reason indicated on the focus. Data type CodeableConcept Binding Indicates why the task is needed. E.g. Suspended because patient admitted to hospital. (unbound) (example) 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 workflow: Event.location w5: FiveWs.why[x] v2: EVN.7 rim: .reasonCode
reasonReference	I	0..1	Reference(Resource)	Element id Task.reasonReference Short description Why task is needed Definition A resource reference indicating why this task needs to be performed. Comments Tasks might be justified based on an Observation, a Condition, a past or planned procedure, etc. This should only be included if there is no focus or if it differs from the reason indicated on the focus. Use the CodeableConcept text element in `Task.reasonCode` if the data is free (uncoded) text. Data type Reference(Resource) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference, Event.reasonReference w5: FiveWs.why[x] rim: .outboundRelationship[typeCode=RSON].target
insurance	I	0..*	Reference(Coverage \| ClaimResponse)	Element id Task.insurance Short description Associated insurance coverage Definition Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be relevant to the Task. 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. Data type Reference(Coverage \| ClaimResponse) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.insurance v2: IN1/IN2 rim: .outboundRelationship[typeCode=COVBY].target
note		0..*	Annotation	Element id Task.note Short description Comments made about the task Definition Free-text information captured about the task as it progresses. 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). Data type Annotation 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 workflow: Request.note, Event.note rim: .inboundRelationship[typeCode=SUBJ, ].source[classCode=OBS, moodCode=EVN, code="annotation"].value(string)
relevantHistory	I	0..*	Reference(Provenance)	Element id Task.relevantHistory Short description Key events in history of the Task Alternate names Status History Definition Links to Provenance records for past versions of this Task that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the task. Comments This element does not point to the Provenance associated with the current version of the resource - as it would be created after this version existed. The Provenance for the current version can be retrieved with a _revinclude. Data type Reference(Provenance) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.relevantHistory rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
restriction		0..1	BackboneElement	Element id Task.restriction Short description Constraints on fulfillment tasks Definition If the Task.focus is a request resource and the task is seeking fulfillment (i.e. is asking for the request to be actioned), this element identifies any limitations on what parts of the referenced request should be actioned. Requirements Sometimes when fulfillment is sought, you don't want full fulfillment. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: Instead of pointing to request, would point to component of request, having these characteristics
id		0..1	string	There are no (further) constraints on this element Element id Task.restriction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Task.restriction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Task.restriction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension 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
repetitions		0..1	positiveInt	Element id Task.restriction.repetitions Short description How many times to repeat Definition Indicates the number of times the requested action should occur. Requirements E.g. order that requests monthly lab tests, fulfillment is sought for 1. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .repeatNumber
period	I	0..1	Period	Element id Task.restriction.period Short description When fulfillment sought Definition Over what time-period is fulfillment sought. Requirements E.g. order that authorizes 1 year's services. Fulfillment is sought for next 3 months. Comments Note that period.high is the due date representing the time by which the task should be completed. Data type Period 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"] rim: .effectiveTime(IVL<TS>)
recipient	I	0..*	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Group \| Organization)	Element id Task.restriction.recipient Short description For whom is fulfillment sought? Definition For requests that are targeted to more than on potential recipient/target, for whom is fulfillment sought? 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. Data type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Group \| Organization) 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .participation[typeCode=SBJ].role
input		0..*	BackboneElement	Element id Task.input Short description Information used to perform task Alternate names Supporting Information Definition Additional information that may be needed in the execution of the task. Requirements Resources and data used to perform the task. This data is used in the business logic of task execution, and is stored separately because it varies between workflows. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: ???
id		0..1	string	There are no (further) constraints on this element Element id Task.input.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Task.input.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Task.input.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension 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
type		1..1	CodeableConcept	Element id Task.input.type Short description Label for the input Alternate names Name Definition A code or description indicating how the input is intended to be used as part of the task execution. Requirements Inputs are named to enable task automation to bind data and pass it from one task to the next. Comments If referencing a BPMN workflow or Protocol, the "system" is the URL for the workflow definition and the code is the "name" of the required input. Data type CodeableConcept Binding Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc. (unbound) (example) 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: ???
value[x]		1..1		Element id Task.input.value[x] Short description Content to use in performing the task Definition The value of the input parameter as a basic type. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: ???
valueBase64Binary			base64Binary	Data type base64Binary
valueBoolean			boolean	Data type boolean
valueCanonical			canonical()	Data type canonical()
valueCode			code	Data type code
valueDate			date	Data type date
valueDateTime			dateTime	Data type dateTime
valueDecimal			decimal	Data type decimal
valueId			id	Data type id
valueInstant			instant	Data type instant
valueInteger			integer	Data type integer
valueMarkdown			markdown	Data type markdown
valueOid			oid	Data type oid
valuePositiveInt			positiveInt	Data type positiveInt
valueString			string	Data type string
valueTime			time	Data type time
valueUnsignedInt			unsignedInt	Data type unsignedInt
valueUri			uri	Data type uri
valueUrl			url	Data type url
valueUuid			uuid	Data type uuid
valueAddress			Address	Data type Address
valueAge			Age	Data type Age
valueAnnotation			Annotation	Data type Annotation
valueAttachment			Attachment	Data type Attachment
valueCodeableConcept			CodeableConcept	Data type CodeableConcept
valueCoding			Coding	Data type Coding
valueContactPoint			ContactPoint	Data type ContactPoint
valueCount			Count	Data type Count
valueDistance			Distance	Data type Distance
valueDuration			Duration	Data type Duration
valueHumanName			HumanName	Data type HumanName
valueIdentifier			Identifier	Data type Identifier
valueMoney			Money	Data type Money
valuePeriod			Period	Data type Period
valueQuantity			Quantity	Data type Quantity
valueRange			Range	Data type Range
valueRatio			Ratio	Data type Ratio
valueSampledData			SampledData	Data type SampledData
valueSignature			Signature	Data type Signature
valueTiming			Timing	Data type Timing
valueContactDetail			ContactDetail	Data type ContactDetail
valueContributor			Contributor	Data type Contributor
valueDataRequirement			DataRequirement	Data type DataRequirement
valueExpression			Expression	Data type Expression
valueParameterDefinition			ParameterDefinition	Data type ParameterDefinition
valueRelatedArtifact			RelatedArtifact	Data type RelatedArtifact
valueTriggerDefinition			TriggerDefinition	Data type TriggerDefinition
valueUsageContext			UsageContext	Data type UsageContext
valueDosage			Dosage	Data type Dosage
valueMeta			Meta	Data type Meta
valueReference			Reference()	Data type Reference()
output		0..*	BackboneElement	Element id Task.output Short description Information produced as part of task Definition Outputs produced by the Task. Requirements Resources and data produced during the execution the task. This data is generated by the business logic of task execution, and is stored separately because it varies between workflows. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: ???
id		0..1	string	There are no (further) constraints on this element Element id Task.output.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Task.output.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Task.output.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. Data type Extension 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
type		1..1	CodeableConcept	Element id Task.output.type Short description Label for output Alternate names Name Definition The name of the Output parameter. Requirements Outputs are named to enable task automation to bind data and pass it from one task to the next. 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. Data type CodeableConcept Binding Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc. (unbound) (example) 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: ???
value[x]		1..1		Element id Task.output.value[x] Short description Result of output Definition The value of the Output parameter as a basic type. Requirements Task outputs can take any form. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: ???
valueBase64Binary			base64Binary	Data type base64Binary
valueBoolean			boolean	Data type boolean
valueCanonical			canonical()	Data type canonical()
valueCode			code	Data type code
valueDate			date	Data type date
valueDateTime			dateTime	Data type dateTime
valueDecimal			decimal	Data type decimal
valueId			id	Data type id
valueInstant			instant	Data type instant
valueInteger			integer	Data type integer
valueMarkdown			markdown	Data type markdown
valueOid			oid	Data type oid
valuePositiveInt			positiveInt	Data type positiveInt
valueString			string	Data type string
valueTime			time	Data type time
valueUnsignedInt			unsignedInt	Data type unsignedInt
valueUri			uri	Data type uri
valueUrl			url	Data type url
valueUuid			uuid	Data type uuid
valueAddress			Address	Data type Address
valueAge			Age	Data type Age
valueAnnotation			Annotation	Data type Annotation
valueAttachment			Attachment	Data type Attachment
valueCodeableConcept			CodeableConcept	Data type CodeableConcept
valueCoding			Coding	Data type Coding
valueContactPoint			ContactPoint	Data type ContactPoint
valueCount			Count	Data type Count
valueDistance			Distance	Data type Distance
valueDuration			Duration	Data type Duration
valueHumanName			HumanName	Data type HumanName
valueIdentifier			Identifier	Data type Identifier
valueMoney			Money	Data type Money
valuePeriod			Period	Data type Period
valueQuantity			Quantity	Data type Quantity
valueRange			Range	Data type Range
valueRatio			Ratio	Data type Ratio
valueSampledData			SampledData	Data type SampledData
valueSignature			Signature	Data type Signature
valueTiming			Timing	Data type Timing
valueContactDetail			ContactDetail	Data type ContactDetail
valueContributor			Contributor	Data type Contributor
valueDataRequirement			DataRequirement	Data type DataRequirement
valueExpression			Expression	Data type Expression
valueParameterDefinition			ParameterDefinition	Data type ParameterDefinition
valueRelatedArtifact			RelatedArtifact	Data type RelatedArtifact
valueTriggerDefinition			TriggerDefinition	Data type TriggerDefinition
valueUsageContext			UsageContext	Data type UsageContext
valueDosage			Dosage	Data type Dosage
valueMeta			Meta	Data type Meta
valueReference			Reference()	Data type Reference()

Task-NonWGSRareDiseaseTestOrder-Cancellation-Example

Task-NonWGSRareDiseaseTestOrder-Example

Task-NonWGSRareDiseaseTestOrderAccepted-Example

Task-NonWGSRareDiseaseTestOrderAccepted-FetalScenario-Example

Task-NonWGSRareDiseaseTestOrderAccepted-FollowupTest-Example

Task-NonWGSRareDiseaseTestOrderAccepted-HaemOncology-Example

Task-NonWGSRareDiseaseTestOrderAccepted-Reanalysis-Example

Task-NonWGSRareDiseaseTestOrderAccepted-SufficientSample-Example

Task-NonWGSRareDiseaseTestOrderCancelled-FollowupTest-Example

Task-NonWGSRareDiseaseTestOrderCompleted-CascadeTesting-Example

Task-NonWGSRareDiseaseTestOrderCompleted-FollowupTest-Example

Task-NonWGSRareDiseaseTestOrderForwarded-OutOfCountry-Example

Task-NonWGSRareDiseaseTestOrderForwarded-SolidTumor-Example

Task-NonWGSRareDiseaseTestOrderRejected-Example

Task-NonWGSRareDiseaseTestOrderHold-Example

Task-NonWGSRareDiseaseTestOrderRejected-CancerSolidTumor-Example

Task-NonWGSRareDiseaseTestOrderRejected-FetalScenario-Example

Task-NonWGSRareDiseaseTestOrder-InsufficientSample-Example

Task-NonWGSTestOrderAccepted-VariantReinterpretation-Example

Task-NonWGSTestOrderFormAccepted-UsingStoredSample-Example

Task-TestOrderFormAccepted-StorageOfMaterial-Example

Task-WGSRareDiseaseTestOrder-Example

Task-WGSRareDiseaseTestOrderAccepted-Example

Task-WGSRareDiseaseTestOrderAccepted-DirectToLab-Example

Task-WGSRareDiseaseTestOrderAccepted-TrioTestingProband-Example

Task-WGSRareDiseaseTestOrderCompleted-DirectToLab-Example

Task-WGSRareDiseaseTestOrderCompleted-TrioTestingProband-Example

Task-WGSRareDiseaseTestOrderForwarded-Example

Task-WGSRareDiseaseTestOrderHold-DirectToLab-Example

Task-WGSRareDiseaseTestOrderHold-TrioTestingProband-Example

Task-WGSRareDiseaseTestOrderRequested-DirectToLab-Example

Task-NonWGSTestOrderFormRequested-UsingStoredSample-Example

Task-WGSRareDiseaseTestOrderAccepted-TrioTestingFather-Example

Task-WGSRareDiseaseTestOrderAccepted-TrioTestingMother-Example

FHIR	MDS	HL7v2
Task.executionPeriod.start	PLCM activity - Activity start date and time	Derived from TQ1-7 in the ORL response message for the activity based on the OML request
Task.executionPeriod.end	PLCM activity - Activity end date and time	Derived from TQ1-8 in the ORL response message for the activity based on the OML request
Task.owner	PLCM activity - ODS code of organisation submitting to PLCM, PLCM activity - ODS code of organisation delivering requested test, PLCM activity - ODS code of the laboratory site delivering requested test	OBR-32.7 if sourced from principle results interpreter, OBX-32.10, AFF-2.10 associated with performing organization
Task.status	PLCM activity - Sample plating quality control	Implied through status recorded in ORC-25 indicating plating quality control had passed
Task.statusReason	PLCM activity - Sample plating quality control fail code	ORC-25
Task.output	Extracted specimen - Location details	SAC-15

basedOn

This element will not be used within the Genomic Medicine Service. The ServiceRequest a Task is seeking to fulfill SHALL be referenced through the `focus` element. Specimen resources being acted upon by tasks related to specimen prep/processing SHOULD be referenced through the `Task.input` element.

status

Initially, automatically populated by the central service upon instantiation. Tasks will be first marked as 'draft' until their prerequisites have been satisfied, after which they will be marked as 'requested' until accepted/claimed by an organization. Upon acceptance, the owning organization is responsible for updating the status up until completion (or if the owning organization is not integrated into the GMS, the organization who has referred the task to the unintegrated org).

If a ServiceRequest is cancelled, any Tasks which have not already moved into in-progress SHALL be moved into the cancelled state, any in-progress Tasks will require lab processes to manage closure of the Task and appropriate reimbursement.

For the full list of expected Task statuses in use by the GMS, please refer to the table below. For the allowed Task status transitions, please see the FHIR R4 Task state machine model.

Status	Description	Genomic workflow usage
Draft	The task is not yet ready to be acted upon.	Initial state for Tasks. Used for tasks which require prerequisite tasks to be completed first.
Requested	The task is ready to be acted upon and action is sought.	Status indicating a task can be worked on/claimed, all prerequisites have been satisfied.
Received	A potential performer has claimed ownership of the task and is evaluating whether to perform it.	NOT USED within Genomics as Tasks will be polled for rather than being sent out to assigned organizations. Most likely not used unless tasks are automatically assigned and organizations are notified by the central service, e.g. to GLH.
Accepted	The potential performer has agreed to execute the task but has not yet started work.	Used when an assigned owner has accepted the task after being assigned.
Rejected	The potential performer who claimed ownership of the task has decided not to execute it prior to performing any action.	Used if an organization was assigned to a task but is unable to perform work against it. It is expected if an alternative organization can be assigned, this is done as an owner update rather than marking the task as rejected. If subsequent work does occur, a duplicate task will need to be created as the 'rejected' state is a terminal one.
Ready	The task is ready to be performed, but no action has yet been taken. Used in place of requested/received/accepted/rejected when request assignment and acceptance is a given.	NOT USED within Genomics as it is not assumed that Tasks will be automatically accepted when prerequisites are satisfied.
Cancelled	The task was not completed.	Used when a task has been created but later identified as unneeded, e.g. due to modifications to test order such as the ServiceRequest being cancelled. Automatically set by the central broker.
In Progress	The task has been started but is not yet complete.	When work has commenced.
On Hold	The task has been started but work has been paused.	A holding state where work is expected to continue but is being blocked through some external issue. Suppliers will need to state reason why work is on hold through the statusReason field e.g. Awaiting Sample.
Failed	The task was attempted but could not be completed due to some error.	Indicates the task cannot continue and is unrcoverable without external intervention. If modifications to the test order allow the task to be resumed, a new task should be created e.g. a new sample is provided to replace a previous sample which has failed quality control. If the Task results in an unrecoverable error, the ServiceRequest may need to be revoked.
Completed	The task has been completed.	Marked once all actions against a task are complete, and follow on Tasks can commence.
Entered in Error	The task should never have existed and is retained only because of the possibility it may have used.	May be used if user created Tasks are created in error, e.g. duplicate Tasks, or Tasks have been created by the central broker and the ServiceRequest has subsequently been marked as entered-in-error.

"status": "rejected",

statusReason

Reasons why a Task has been marked as on-hold, cancelled etc. SHOULD use the Genomic-Task-StatusReason CodeSystem. NOTE: The list of appropriate statusReasons is pending finalization.

"statusReason": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/task-status-reason-genomics",
                "code": "further-information-needed",
                "display": "Further Information Needed"
            }
        ]
    },

businessStatus

Genomic specific business statuses for capturing more granular information as part of processing the task. SHOULD use the Genomic-Business-Status CodeSystem. NOTE: The list of appropriate buinessStatuses is pending finalization. Mapping business statuses to the high level container Tasks and statuses is still ongoing.

"businessStatus": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/business-status-genomics",
                "code": "sample-sent",
                "display": "Sample Sent"
            }
        ]
    },

code

High level coding for the Task, matches the NGTP stages for genomic test processing. Clients SHOULD use the Genomic-Task-Code CodeSystem. NOTE: The list of appropriate codes is pending finalization.

The currently allowed code list and their definition is provided in the table below. The table also provides the cardinality of each Task per ServiceRequest or Sample attached to the request as generated by the central broker on submission of a test request. Note: the cardinalities listed reflect the number of concurrent active tasks per service request at any one time, there may be cases where additional Tasks need to be spun up manually, e.g. on failure such as when a new sample needs to be processed after a previous sample fails Quality Control, or when further preparation is required. This cardinality supports the use cases for both requests with multiple participants, e.g. Duo/Trio, and multiple samples per participant e.g. Cancer testing.

Task.code display	Definition of work within Task	Cardinality (general case)	Cardinality (Reanalysis/Reinterpretation)	Cardinality (DNA Storage)
Process Genomic Test Request	Test code requested is ratified by the lab against provided patient information (checking eligibility)	1..1 (per ServiceRequest)	1..1	1..1
Request & Sample Alignment	The lab confirms/validates the data and sample(s) required for given test type are present	1..* (1 per Specimen referenced from or referencing the ServiceRequest)	1..1 (At least 1 will always be required, e.g. for validation of data in the No Sample scenario)	1..* (per Sample)
Sample Preparation	Sample is prepared, as appropriate for the selected test type, and DNA extracted. May have multiples if further preparation is required	1..* (1 per Sample)	0..0 (Not required for Reanalysis/Reinterpretation requests where a sample does not need to be prepared)	1..* (1 per Sample)
Sample Processing	DNA sample(s) are sequenced, generating read/sequence data to feed into analysis	1..* (1 per Sample or extracted DNA sample)	0..0 (Not required for Reanalysis/Reinterpretation requests where a sample does not need to be sequenced)	0..0 (Not required for DNA storage where a sample does not need to be sequenced)
Genetic/Genomic Data Processing	Sequence data is passed through a bio-pipeline, generates variant priorities lists for analysis	1..* (1 per Sample or read data)	0..* (For Reanalysis, should match the number of Samples for the parent request. Not required for Reinterpretation requests)	0..0 (Not required for DNA storage requests)
Interpretation	Results analysis is organised and interpreted by a Clincial Scientist	1..* (1 per Sample or variant priorities list)	1..* (For Reanalysis/Reinterpretation, should match the number of Samples for the parent request	0..0 (Not required for DNA storage requests)
Produce Interim Report	A report is created and deemed interim pending MDT, if necessary	1..* (1 per Sample. TBC whether one interim report would be generated per sample/set of genetic data or 1 per request)	1..* (For Reanalysis/Reinterpretation, should match the number of Samples for the parent request	0..0 (Not required for DNA storage requests)
Genomic MDT	Multi-Diciplinary-Team consults on the interim report	1..1 (max 1 per ServiceRequest, for the purposes of the Alpha an MDT task will always be created, even if not needed)	1..1	0..0 (Not required for DNA storage requests)
Produce Final Report	Interim report is deemed final or is updated following MDT	1..1 (per ServiceRequest)	1..1	1..1
Distribute Report	Final report is distributed or marked as distributable/available	1..1 (per ServiceRequest or Final Report)	1..1	1..1

Rendered within a diagram, the Task cardinalities and their inputs are illustrated in the diagram below:

GenomicOrderManagementTaskModel

"code": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/task-code-genomics",
                "code": "sample-processing",
                "display": "Sample Processing"
            }
        ]
    },

focus

The ServiceRequest the Task is fulfilling. Autopopulated by the central service.

"focus": {
        "reference": "ServiceRequest/ServiceRequest-SavedTestOrder-Example"
    },

for

A reference to the Patient resource or the identifier, NHS number, for the patient for whom the Task is for. Autopopulated by the central service if the Task is automatically generated.

If a Task is created by client system or user interaction, for SHALL be populated with a reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS.

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

executionPeriod

MAY be used to capture start and end DateTimes associated with execution of a Task. It is expected the start time will be populated as a Task is moved to in-progress and the end time will be populated as a Task is marked as completed. Usage of this field will be investigated during the Alpha phase of the Genomic Order Management project as timelines for task execution can also be derived from the AuditEvents recorded as Tasks are updated.

"executionPeriod": {
        "start": "2023-10-31T10:25:05+00:00",
        "end": "2023-11-15T16:45:05+00:00"
    },

authoredOn

Autopopulated by the central service on creation of the Task.

"authoredOn": "2023-09-18T18:30:00Z"

lastModidified

Time at which a change to the task was made, e.g. status updated. SHALL be updated on change.

"lastModified": "2023-09-18T19:11:00Z"

requester

The original requester of the ServiceRequest the Task is fulfilling. Autopopulated by the central service.

"requester": {
        "reference": "PractitionerRole/PractitionerRole-GeneSmithENT-Example"
    },

owner

Autopopulated by the central service if a performer is assigned at Test submission. By default, this will the Home GLH for the submitting organization, unless an alternative is specified. The Home GLH/original performer (managing entity) SHOULD remain the owner for the Process Genomic Test Task, throughout the test order-fulfillment process.

This field can be updated by the organization claiming the task (though this could also be autopopulated if automated per test routing tables are integrated into the central service functionality). Owner SHOULD be populated using organization ODS code references.

The responsibility for routing/reassigning ownership of Tasks lies with the current owner following the transfers of responsibility as per the National Genomic Testing Process (NGTP). The different scenarios for how follow-on routing may be achieved is summarised in the points below:

In most cases, by default the test will be routed to the home GLH (or other lab/GLH as dictated by the initial routing table).
This would mean all Tasks by default would have this organization, e.g. home GLH, as the initial owner, it would then be the responsibility of the GLH to reassign tasks to other organizations, where they 'send away' or commission work.
Once that work is complete, the send-away organization can choose to reassign the current Task (where another organization needs to conduct work against the same Task before it can be marked as complete)/or assign the follow-on Task (where the current task can be marked as complete) to the next organization, if this is known.
If the next organization to send work to is unknown, responsibility should lie with the original/previous owner e.g. Home GLH to reassign the task to the next organization that needs to complete work. This should be captured by having the current owner reassign the task back to the GLH (or organization which assigned the task to them) if further work needs to occur within the current task; or the next task in the NGTP moves from the draft state into the requested state (indicating all its prerequisites have been satisfied). The owner of that task, e.g home GLH, then either starts work or assigns this to the relevant organization.
In further phases, a routing advice service may be provided by NHS England to aid organizations in identifying which organization should be assigned, after completing their work.

Tasks assigned to a particular organization SHOULD be searched for using the owner search parameter with the :identifier modifier i.e. [base]/Task?owner:identifier=8J834 or [base]/Task?owner:identifier=https://fhir.nhs.uk/Id/ods-organization-code|8J834

"owner": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "69010"
        },
        "display": "Pathology Lab - ADDENBROOKE'S HOSPITAL LABORATORY"
    },

note

Used for messaging between owner and other orgnizations e.g. during handover of task or requesting information from requesting clinician.

"note":  [
        {
            "text": "Sample has not been received within 4 week window. Task will be closed unless further communication is received"
        }
    ]

input

Used to attach inputs to a Task, if relevant. e.g. references to Specimen's which a Sample Processing task is acting on. No CodeSystem exists for this field as of publication but this will be investigated as future work.

Specimen references SHOULD be added to Tasks acting on Specimen resources, e.g. Tasks marked SamplePreparation or SampleProcessing. This is to clearly disambiguate which specimen a task is acting on, where multiple specimens are necessary for processing the test request.

The table below provides possible inputs that could be provided for certain Tasks as part of fulfillment of a test order. A finalised list is pending business analysis work to identify the operational data generated as fulfilment against a test order progresses and the need for this data to pass between organizations.

Task.code display	Possible Task.input
Process Genomic Test Request	N/A, all information required should be part of or refernced from the ServiceRequest
Request & Sample Alignment	Specimen resource to be aligned and potentially Consent resources where these are captured post submission of a test request
Sample Preparation	Specimen resource to be prepared as part of this Task
Sample Processing	DNA Specimen resource to be sequenced as part of this Task as well as Consignment, Rack and Well identifiers to allow for specimen tracking
Genetic/Genomic Data Processing	Sequence data generated from the previous Task, potentially referenced using DocumentReference resources, these SHOULD reference the Specimen from which the data originated
Interpretation	Variant Priorities lists generated from the previous Task, the representation of these lists is still under investigation
Produce Interim Report	Guidance/Recommendations generated though data interpretation, the representation of these items is still under investigation
Genomic MDT	Interim reports, references to Diagnostic report resources containing either structured Genomic reports or binary representations of the reports
Produce Final Report	Interim reports and potentially recommendations from the MDT, whether these are represented within the DiagnosticReport itself or contained as other resource types is still under investigation
Distribute Report	The final report to be distributed

"input":  [
    {
            "type": {
                "coding":  [
                    {
                        "system": "https://fhir.nhs.uk/CodeSystem/AdditionalInfoTypeGenomics",
                        "code": "Specimen",
                        "display": "Specimen"
                    }
                ]
            },
            "valueReference": {
                "reference": "Specimen/Specimen-CancerSolidTumor-Example"
            }
        }
    ]

output

Used to attach outputs from a Task, if relevant. e.g. VUS files during processing or a DiagnosticReport upon completion of reporting stage. No CodeSystem exists for this field as of publication but this will be investigated as future work.

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. Further modelling of the types/format expected are pending clinical scenarios.

The table below provides possible outputs that could be generated by certain Tasks as part of fulfillment of a test order. A finalised list is pending business analysis work to identify the operational data generated as fulfilment against a test order progresses and the need for this data to pass between organizations.

Task.code display	Possible Task.output
Process Genomic Test Request	N/A, may result in updates to the ServiceRequest if codes or supporting information needs to change
Request & Sample Alignment	Aligned Specimen resource for request (except for Reanalysis/Reinterpretation)
Sample Preparation	DNA Specimen resource as well as Consignment, Rack and Well identifiers to allow for specimen tracking
Sample Processing	Sequence/Read data
Genetic/Genomic Data Processing	Variant information
Interpretation	Potentially structured guidance/recommendations
Produce Interim Report	Interim reports
Genomic MDT	Potentially ammended Interim/combined report or recommendations from MDT
Produce Final Report	Final Report
Distribute Report	N/A, final report will be included as input to Task

"output":  [
       {
          "type": {
            "coding": [
              {
                "system": "https://fhir.nhs.uk/CodeSystem/AdditionalInfoTypeGenomics",
                "code": "DiagnosticReport",
                "display": "DiagnosticReport"
              }
            ]
          },
          "valueReference": {
            "reference": "DiagnosticReport/DiagnosticReport-PhoebeSmithGeneticReport-Example"
          }
        }
    ]