Use case 1: send LaboratoryTestResults
Introduction
This page describes the technical representation of the selected information in: Use case 1: send LaboratoryTestResults
No workflow and interactions are specified yet. This page proposes a full FHIR conformant exchange specification.
Provider: LaboratoryTestResults request
Because LaboratoryTestResults data consists of several building blocks along with supporting resources, a Bundle resource is used for sending a set of resources in a single interaction. This allows to include referenced secondary resources too.
The Bundle has Bundle.type = collection ande each Bundle.entry carries a FHIR resource. At least Patient information and one or more LaboratoryTestResult resources are expected. The LaboratoryTestResult-Bundle profile shows the Bundle structure.
The Provider SHALL guarantee consistency of all FHIR resource elements with the requirements specified in the #FHIR profiles.
FHIR profiles
| FHIR profile | FHIR Resource | Cardinality | Based on CBB |
|---|---|---|---|
| LaboratoryTestResult-Bundle | Bundle | 1..1 | - |
| LaboratoryTestResult | Observation | 1..* | LaboratoryTestResult |
| LaboratoryTestResult.Specimen | Specimen | 0..* | ^ |
| LaboratoryTestResult.Specimen.Source | Specimen | 0..* | ^ |
| LaboratoryTestResult.Requester | ServiceRequest | 0..* | ^ |
| Patient | Patient | 1..1 | Patient |
| HealthProfessional-Practitioner | Practitioner | 0..* | HealthProfessional |
| HealthProfessional-PractitionerRole | PractitionerRole | 0..* | ^ |
| HealthcareOrganization | Location | 0..* | HealthcareOrganization |
| HealthcareOrganization-Organization | Organization | 0..* | ^ |
Grouping of observations using Observation resources
The CBB LaboratoryTestResult captures both singular laboratory tests and panels/clusters of multiple related tests requested together (e.g., blood gases and EBV serology). The LaboratoryTestResult profile provide guidance on how to populate the Observation resource. All Observation resources of panels/clusters SHALL be included in the LaboratoryTestResult Bundle.
Resource references
The Provider system SHALL produce a complete Bundle containing not only the resources listed directly in the LaboratoryTestResult resources, but all the indirectly referenced resources as well. This should prevent the receiving system to resolve references at the sending system. The CBB implementation guide provides additional guidance on the use of reference datatype.
Identification
Resources SHALL have a stable identifier in the .identifier element for all resources if such an identifier exists in the underlying data. Not all data, like individual results, are currently known to have identifiers in all source systems, but when they exist they are essential and where they do not exist yet they SHOULD be considered. Having stable identification is essential in detection of duplicates and potential clinical decision making issues deriving from duplicates. For more information on dealing with identifiers, see the CBB implementation guide.
Examples
LaboratoryTestResult Bundle examples that contain a single and fictive LaboratoryTestResult. The second and third examples have the same information but demonstrate two different approaches to populating .fullUrl, resource.id and references.
Examples from HL7 BE Laboratory Implementation Guide that are adjusted to align with the CBBs profiles by, for example, removing not defined resources such as the DiagnosticReport. More information can be found in the Boundaries and Relationships page. Below are LaboratoryTestResult Bundle examples of:
Consumer: LaboratoryTestResults response
The Consumer response shall be sent when a success or error condition needs to be communicated. Success is only indicated once the Bundle and accompanying resources are received and completely processed and persisted as appropriate to the Consumer configuration. The Consumer returns an HTTP Status code appropriate to the processing outcome.