Pathology FHIR Implementation Guide

WARNING

This guidance is under active development by NHS England and content may be added or updated on a regular basis. The implementation guide is currently in draft and SHOULD NOT be used for development or implementation without consulting the NHS England Pathology Standards and Implementation team.

PATH-R4-12: Bundle Example - Liver Function Tests and Urea and Electrolytes Report

This is an example of a report that contains the results associated with multiple test groups.
The test groups were requested as part of the same “event” (i.e. by the same practitioner at the same time for the same subject).
An instance of ServiceRequest is required for each requested test group.
Each ServiceRequest within a set of related requests uses a common identifier, ServiceRequest.requisition, to link them together. For further information, refer to the description of the UKCore-ServiceRequest-Lab profile.
In this example, the specimen (venous blood) was collected after the request was made. The specimen is linked to the request within the Bundle using Specimen.request.

The following is a simplified logical data model that illustrates the key references between the FHIR profiles in the example message bundle. To aid clarity, not all of the references are shown. For a detailed description of the relationships between the FHIR profiles, and how they may be used, refer to How to Construct a Pathology Test Report Bundle.

<Bundle xmlns="http://hl7.org/fhir">
    <id value="Pathology-Bundle-LFT-UandE-Report-Example" />
    <meta>
        <lastUpdated value="2022-03-08T14:23:00+00:00" />
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle" />
    </meta>
    <identifier>
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="d8d2d20e-8c44-466d-8640-7a516db7cd27" />
    </identifier>
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:f18a2226-c0ab-480d-b80a-b6561fe8f9c4" />
        <resource>
            <MessageHeader>
                <!--  TBC Review content of MessageHeader  -->
                <id value="f18a2226-c0ab-480d-b80a-b6561fe8f9c4" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader" />
                </meta>
                <eventCoding>
                    <system value="http://snomed.info/sct" />
                    <code value="371528001" />
                    <display value="Pathology report" />
                </eventCoding>
                <destination>
                    <name value="PICKERING MEDICAL PRACTICE" />
                    <!--  TBC Update endpoint address  -->
                    <endpoint value="TBC" />
                    <!--  Requesting Organisation  -->
                    <receiver>
                        <reference value="urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434" />
                    </receiver>
                </destination>
                <sender>
                    <!--  Performing Laboratory  -->
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                </sender>
                <source>
                    <!--  TBC Update endpoint address  -->
                    <endpoint value="TBC" />
                </source>
                <focus>
                    <!--  DiagnosticReport  -->
                    <reference value="urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20" />
                </focus>
                <definition value="https://fhir.nhs.uk/England/MessageDefinition/England-Pathology-Report" />
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
        <resource>
            <Organization>
                <!--  Performing Laboratory  -->
                <id value="8a6d85b8-9837-4fed-a257-4cf207988338" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                </meta>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                    <value value="Y8J7D" />
                </identifier>
                <name value="TD008362 PATH LAB 001" />
                <address>
                    <line value="PATHOLOGY LAB" />
                    <line value="7-8 WELLINGTON PLACE" />
                    <city value="LEEDS" />
                    <district value="WEST YORKSHIRE" />
                    <postalCode value="LS1 4AP" />
                </address>
            </Organization>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434" />
        <resource>
            <Organization>
                <!--  Requesting Organisation  -->
                <id value="3c43b5b3-06d6-445f-ae9a-48d5f05df434" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                </meta>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                    <value value="B82033" />
                </identifier>
                <name value="PICKERING MEDICAL PRACTICE" />
                <address>
                    <line value="SOUTHGATE" />
                    <city value="PICKERING" />
                    <district value="NORTH YORKSHIRE" />
                    <postalCode value="YO18 8BL" />
                </address>
            </Organization>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe" />
        <resource>
            <Practitioner>
                <!--  Requesting Practitioner  -->
                <id value="9a835acf-d715-4d84-8dcf-a8435f6417fe" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                </meta>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/sds-user-id" />
                    <!--  Confirm SDS user id  -->
                    <value value="TBC" />
                </identifier>
                <name>
                    <use value="official" />
                    <family value="GASKELL" />
                    <given value="Gale" />
                    <prefix value="Dr" />
                </name>
            </Practitioner>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
        <resource>
            <Patient>
                <id value="ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                </meta>
                <identifier>
                    <extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus">
                        <valueCodeableConcept>
                            <coding>
                                <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland" />
                                <code value="01" />
                                <display value="Number present and verified" />
                            </coding>
                        </valueCodeableConcept>
                    </extension>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="9727710638" />
                </identifier>
                <name>
                    <use value="official" />
                    <family value="WELSH" />
                    <given value="Joel" />
                </name>
                <gender value="male" />
                <birthDate value="1972-08-23" />
                <address>
                    <line value="ACONBURY" />
                    <line value="LARPOOL DRIVE" />
                    <district value="NORTH YORKSHIRE" />
                    <postalCode value="YO22 4ND" />
                </address>
            </Patient>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
        <resource>
            <ServiceRequest>
                <id value="1c38d507-9ad7-4b49-ba91-7da204842cac" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Lab" />
                </meta>
                <identifier>
                    <system value="http://B82033-pickeringmedicalpractice.com/labrequest" />
                    <value value="REQ-20220307-000046-001" />
                </identifier>
                <requisition>
                    <system value="http://B82033-pickeringmedicalpractice.com/labrequest" />
                    <value value="REQ-20220307-000046" />
                </requisition>
                <status value="active" />
                <intent value="order" />
                <code>
                    <coding>
                        <!--  From PaLM procedure reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="26958001" />
                        <display value="Hepatic function panel" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <authoredOn value="2022-03-07T09:48:00+00:00" />
                <requester>
                    <reference value="urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe" />
                    <display value="GASKELL, Dr Gale" />
                </requester>
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
            </ServiceRequest>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:8660ef6a-65ef-408f-92ce-b4d6d03d783c" />
        <resource>
            <ServiceRequest>
                <id value="8660ef6a-65ef-408f-92ce-b4d6d03d783c" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Lab" />
                </meta>
                <identifier>
                    <system value="http://B82033-pickeringmedicalpractice.com/labrequest" />
                    <value value="REQ-20220307-000046-002" />
                </identifier>
                <requisition>
                    <system value="http://B82033-pickeringmedicalpractice.com/labrequest" />
                    <value value="REQ-20220307-000046" />
                </requisition>
                <status value="active" />
                <intent value="order" />
                <code>
                    <coding>
                        <!--  From PaLM procedure reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="252167001" />
                        <display value="Urea and electrolytes" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <authoredOn value="2022-03-07T09:48:00+00:00" />
                <requester>
                    <reference value="urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe" />
                    <display value="GASKELL, Gale" />
                </requester>
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
            </ServiceRequest>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20" />
        <resource>
            <DiagnosticReport>
                <id value="35d46ca1-f253-4c97-b7ee-fb5fccdf6c20" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport-Lab" />
                </meta>
                <identifier>
                    <system value="http://Y8J7D-pathlab001.com/report" />
                    <value value="REP-20220308-008902" />
                </identifier>
                <basedOn>
                    <!--  Hepatic function panel request  -->
                    <reference value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
                </basedOn>
                <basedOn>
                    <!--  Urea and electrolytes request  -->
                    <reference value="urn:uuid:8660ef6a-65ef-408f-92ce-b4d6d03d783c" />
                </basedOn>
                <status value="final" />
                <category>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/v2-0074" />
                        <code value="LAB" />
                        <display value="Laboratory" />
                    </coding>
                </category>
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="721981007" />
                        <display value="Diagnostic studies report" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <issued value="2022-03-08T14:23:00+00:00" />
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
                <specimen>
                    <reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
                </specimen>
                <result>
                    <!--  Test group Observation for Hepatic function panel  -->
                    <reference value="urn:uuid:33a88119-6dbc-4bdf-809a-c1d822b74e90" />
                </result>
                <result>
                    <!--  Test group Observation for Urea and electrolytes  -->
                    <reference value="urn:uuid:a5c7f5e2-eb95-469b-b588-f7861c260ccb" />
                </result>
            </DiagnosticReport>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
        <resource>
            <Specimen>
                <id value="bab0eaec-1ec5-4598-b660-90bb38a1030d" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
                </meta>
                <identifier>
                    <system value="http://B82033-pickeringmedicalpractice.com/specimen" />
                    <value value="SPC-REQ-20220307-000014" />
                </identifier>
                <accessionIdentifier>
                    <system value="http://Y8J7D-pathlab001.com/specimen" />
                    <value value="SPC-LAB-20220307-007856" />
                </accessionIdentifier>
                <status value="available" />
                <type>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="122555007" />
                        <display value="Venous blood specimen" />
                    </coding>
                </type>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <receivedTime value="2022-03-07T14:54:00+00:00" />
                <request>
                    <reference value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
                </request>
                <collection>
                    <collectedDateTime value="2022-03-07T10:02:00+00:00" />
                </collection>
            </Specimen>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:33a88119-6dbc-4bdf-809a-c1d822b74e90" />
        <resource>
            <Observation>
                <!--  Test group Observation for Hepatic function panel  -->
                <id value="33a88119-6dbc-4bdf-809a-c1d822b74e90" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Group-Lab" />
                </meta>
                <identifier>
                    <system value="https://tools.ietf.org/html/rfc4122" />
                    <value value="9920b5d3-9f19-41df-8d5a-fd2d4288e305" />
                </identifier>
                <status value="final" />
                <category>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/observation-category" />
                        <code value="laboratory" />
                        <display value="Laboratory" />
                    </coding>
                </category>
                <code>
                    <coding>
                        <!--  From PaLM procedure reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="26958001" />
                        <display value="Hepatic function panel" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <issued value="2022-03-08T14:23:00+00:00" />
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
                <hasMember>
                    <!--  Total bilirubin substance concentration in serum  -->
                    <reference value="urn:uuid:47faffbf-34c0-45b2-9c65-285f89fd1521" />
                </hasMember>
                <hasMember>
                    <!--  Albumin mass concentration in serum  -->
                    <reference value="urn:uuid:a0a65e1f-8aba-47a7-ab20-014f2943e7dd" />
                </hasMember>
                <hasMember>
                    <!--  Alkaline phosphatase enzyme activity in serum  -->
                    <reference value="urn:uuid:aa8aa37b-3a69-478f-a2be-947af624d7cb" />
                </hasMember>
                <hasMember>
                    <!--  Alanine aminotransferase enzyme activity in serum  -->
                    <reference value="urn:uuid:3f98327b-f215-4bc5-bd52-ed6477a3da4a" />
                </hasMember>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:47faffbf-34c0-45b2-9c65-285f89fd1521" />
        <resource>
            <Observation>
                <!--  Total bilirubin substance concentration in serum  -->
                <id value="47faffbf-34c0-45b2-9c65-285f89fd1521" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab" />
                </meta>
                <identifier>
                    <system value="https://tools.ietf.org/html/rfc4122" />
                    <value value="a26ada79-ac32-4ff8-a3e4-fb5950462271" />
                </identifier>
                <status value="final" />
                <category>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/observation-category" />
                        <code value="laboratory" />
                        <display value="Laboratory" />
                    </coding>
                </category>
                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="1107221000000109" />
                        <display value="Total bilirubin substance concentration in serum" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <issued value="2022-03-08T14:23:00+00:00" />
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
                <valueQuantity>
                    <value value="6" />
                    <unit value="umol/L" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="umol/L" />
                </valueQuantity>
                <specimen>
                    <reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
                </specimen>
                <referenceRange>
                    <high>
                        <value value="21" />
                        <unit value="umol/L" />
                        <system value="http://unitsofmeasure.org" />
                        <code value="umol/L" />
                    </high>
                </referenceRange>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:a0a65e1f-8aba-47a7-ab20-014f2943e7dd" />
        <resource>
            <Observation>
                <!--  Albumin mass concentration in serum  -->
                <id value="a0a65e1f-8aba-47a7-ab20-014f2943e7dd" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab" />
                </meta>
                <identifier>
                    <system value="https://tools.ietf.org/html/rfc4122" />
                    <value value="78443cb9-f248-44ef-9e6b-37fc4a592c1b" />
                </identifier>
                <status value="final" />
                <category>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/observation-category" />
                        <code value="laboratory" />
                        <display value="Laboratory" />
                    </coding>
                </category>
                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="1105861000000106" />
                        <display value="Albumin mass concentration in serum" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <issued value="2022-03-08T14:23:00+00:00" />
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
                <valueQuantity>
                    <value value="47" />
                    <unit value="g/L" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="g/L" />
                </valueQuantity>
                <specimen>
                    <reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
                </specimen>
                <referenceRange>
                    <low>
                        <value value="35" />
                        <unit value="g/L" />
                        <system value="http://unitsofmeasure.org" />
                        <code value="g/L" />
                    </low>
                    <high>
                        <value value="50" />
                        <unit value="g/L" />
                        <system value="http://unitsofmeasure.org" />
                        <code value="g/L" />
                    </high>
                </referenceRange>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:aa8aa37b-3a69-478f-a2be-947af624d7cb" />
        <resource>
            <Observation>
                <!--  Alkaline phosphatase enzyme activity in serum  -->
                <id value="aa8aa37b-3a69-478f-a2be-947af624d7cb" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab" />
                </meta>
                <identifier>
                    <system value="https://tools.ietf.org/html/rfc4122" />
                    <value value="b9c64863-06b5-4e98-b226-8ef28059f238" />
                </identifier>
                <status value="final" />
                <category>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/observation-category" />
                        <code value="laboratory" />
                        <display value="Laboratory" />
                    </coding>
                </category>
                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="1106051000000106" />
                        <display value="Alkaline phosphatase enzyme activity in serum" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
                    <display value="WELSH, Joel" />
                </subject>
                <issued value="2022-03-08T14:23:00+00:00" />
                <performer>
                    <reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
                    <display value="TD008362 PATH LAB 001" />
                </performer>
                <valueQuantity>
                    <value value="96" />
                    <unit value="iu/L" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="[iU]/L" />
                </valueQuantity>
                <specimen>
                    <reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
                </specimen>
                <referenceRange>
                    <low>
                        <value value="30" />
                        <unit value="iu/L" />
                        <system value="http://unitsofmeasure.org" />
                        <code value="[iU]/L" />
                    </low>
                    <high>
                        <value value="130" />
                        <unit value="iu/L" />
                        <system value="http://unitsofmeasure.org" />
                        <code value="[iU]/L" />
                    </high>
                </referenceRange>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:3f98327b-f215-4bc5-bd52-ed6477a3da4a" />
        <resource>
            <Observation>
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                <code>
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                        <!--  From PaLM observable entity reference set  -->
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                        <display value="Alanine aminotransferase enzyme activity in serum" />
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                </referenceRange>
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    </entry>
    <entry>
        <fullUrl value="urn:uuid:a5c7f5e2-eb95-469b-b588-f7861c260ccb" />
        <resource>
            <Observation>
                <!--  Test group Observation for Urea and electrolytes  -->
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                </category>
                <code>
                    <coding>
                        <!--  From PaLM procedure reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="26958001" />
                        <display value="Hepatic function panel" />
                    </coding>
                </code>
                <subject>
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                </performer>
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                    <!--  Urea substance concentration in serum  -->
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                    <!--  Sodium substance concentration in serum  -->
                    <reference value="urn:uuid:f5a0e88f-a76a-4526-8927-579771471c58" />
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                <hasMember>
                    <!--  Potassium substance concentration in plasma  -->
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                    <!--  Creatinine substance concentration in serum  -->
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                    <!--  eGFR (estimated glomerular filtration rate) using CKD-Epi  -->
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        </resource>
    </entry>
    <entry>
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        <resource>
            <Observation>
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                </category>
                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
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                        <display value="Urea substance concentration in serum" />
                    </coding>
                </code>
                <subject>
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    <entry>
        <fullUrl value="urn:uuid:f5a0e88f-a76a-4526-8927-579771471c58" />
        <resource>
            <Observation>
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                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
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    <entry>
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            <Observation>
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                <code>
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                        <display value="Potassium substance concentration in plasma" />
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                <subject>
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    </entry>
    <entry>
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            <Observation>
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                        <display value="Laboratory" />
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                </category>
                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="1107001000000108" />
                        <display value="Creatinine substance concentration in serum" />
                    </coding>
                </code>
                <subject>
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                <performer>
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                <specimen>
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                </referenceRange>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:e6127f03-4a96-45d3-abd8-1adcf0189be4" />
        <resource>
            <Observation>
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                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab" />
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                <category>
                    <coding>
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                        <code value="laboratory" />
                        <display value="Laboratory" />
                    </coding>
                </category>
                <code>
                    <coding>
                        <!--  From PaLM observable entity reference set  -->
                        <system value="http://snomed.info/sct" />
                        <code value="1011481000000105" />
                        <display value="eGFR (estimated glomerular filtration rate) using creatinine Chronic Kidney Disease Epidemiology Collaboration equation per 1.73 square metres" />
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                <subject>
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                    <system value="http://unitsofmeasure.org" />
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                </note>
                <specimen>
                    <reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
                </specimen>
            </Observation>
        </resource>
    </entry>
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Bundle.entry[18].resource[0].category[0].coding[0].code[0]	laboratory
Bundle.entry[18].resource[0].category[0].coding[0].display[0]	Laboratory
Bundle.entry[18].resource[0].code[0].coding[0].system[0]	http://snomed.info/sct
Bundle.entry[18].resource[0].code[0].coding[0].code[0]	1107001000000108
Bundle.entry[18].resource[0].code[0].coding[0].display[0]	Creatinine substance concentration in serum
Bundle.entry[18].resource[0].subject[0].reference[0]	urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4
Bundle.entry[18].resource[0].subject[0].display[0]	WELSH, Joel
Bundle.entry[18].resource[0].issued[0]	2022-03-08T14:23:00+00:00
Bundle.entry[18].resource[0].performer[0].reference[0]	urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338
Bundle.entry[18].resource[0].performer[0].display[0]	TD008362 PATH LAB 001
Bundle.entry[18].resource[0].value[0].value[0]	73
Bundle.entry[18].resource[0].value[0].unit[0]	umol/L
Bundle.entry[18].resource[0].value[0].system[0]	http://unitsofmeasure.org
Bundle.entry[18].resource[0].value[0].code[0]	umol/L
Bundle.entry[18].resource[0].specimen[0].reference[0]	urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d
Bundle.entry[18].resource[0].referenceRange[0].low[0].value[0]	59
Bundle.entry[18].resource[0].referenceRange[0].low[0].unit[0]	umol/L
Bundle.entry[18].resource[0].referenceRange[0].low[0].system[0]	http://unitsofmeasure.org
Bundle.entry[18].resource[0].referenceRange[0].low[0].code[0]	umol/L
Bundle.entry[18].resource[0].referenceRange[0].high[0].value[0]	104
Bundle.entry[18].resource[0].referenceRange[0].high[0].unit[0]	umol/L
Bundle.entry[18].resource[0].referenceRange[0].high[0].system[0]	http://unitsofmeasure.org
Bundle.entry[18].resource[0].referenceRange[0].high[0].code[0]	umol/L
Bundle.entry[19].fullUrl[0]	urn:uuid:e6127f03-4a96-45d3-abd8-1adcf0189be4
Bundle.entry[19].resource[0].id[0]	e6127f03-4a96-45d3-abd8-1adcf0189be4
Bundle.entry[19].resource[0].meta[0].profile[0]	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab
Bundle.entry[19].resource[0].identifier[0].system[0]	https://tools.ietf.org/html/rfc4122
Bundle.entry[19].resource[0].identifier[0].value[0]	c6d25926-fb74-400b-98b8-47ae7393f127
Bundle.entry[19].resource[0].status[0]	final
Bundle.entry[19].resource[0].category[0].coding[0].system[0]	http://terminology.hl7.org/CodeSystem/observation-category
Bundle.entry[19].resource[0].category[0].coding[0].code[0]	laboratory
Bundle.entry[19].resource[0].category[0].coding[0].display[0]	Laboratory
Bundle.entry[19].resource[0].code[0].coding[0].system[0]	http://snomed.info/sct
Bundle.entry[19].resource[0].code[0].coding[0].code[0]	1011481000000105
Bundle.entry[19].resource[0].code[0].coding[0].display[0]	eGFR (estimated glomerular filtration rate) using creatinine Chronic Kidney Disease Epidemiology Collaboration equation per 1.73 square metres
Bundle.entry[19].resource[0].subject[0].reference[0]	urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4
Bundle.entry[19].resource[0].subject[0].display[0]	WELSH, Joel
Bundle.entry[19].resource[0].issued[0]	2022-03-08T14:23:00+00:00
Bundle.entry[19].resource[0].performer[0].reference[0]	urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338
Bundle.entry[19].resource[0].performer[0].display[0]	TD008362 PATH LAB 001
Bundle.entry[19].resource[0].value[0].value[0]	100
Bundle.entry[19].resource[0].value[0].unit[0]	mL/min/1.73m2
Bundle.entry[19].resource[0].value[0].system[0]	http://unitsofmeasure.org
Bundle.entry[19].resource[0].value[0].code[0]	mL/min/((173/100).m2)
Bundle.entry[19].resource[0].note[0].text[0]	Calculated eGFR is not valid in children or pregnancy. Less accurate with acute change in creatinine (AKI). Caution with high or low muscle mass or amputation. Avoid blood sampling within 12 hours of eating meat. Ethnicity factor comment removed Dec21 NG203.
Bundle.entry[19].resource[0].specimen[0].reference[0]	urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d