PATH-R4-04: Bundle Example - C-Reactive Protein Report

path-mockup-CRP-report

  • This is an example of a report that contains a single test result.
  • The test result is defined as an Observation and is referenced from DiagnosticReport using DiagnosticReport.result.
  • The test result type is numeric and is specified using Observation.valueQuantity.
  • The test result value is high (200 mg/L, compared to the standard reference range of 0-5 mg/L). This is indicated by populating Observation.interpretation with a code value of H for High.

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

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path-data-model-CRP-report
<Bundle xmlns="http://hl7.org/fhir">
<id value="Pathology-Bundle-CRP-Report-Example" />
<meta>
<lastUpdated value="2022-03-08T12:09:00+00:00" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle" />
</meta>
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="1f859037-2942-4117-884a-f51b62db5a52" />
</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.hl7.org.uk/Id/gmc-number" />
<value value="C1008215" />
</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" />
<city value="WHITBY" />
<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-20220307-000142" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<!-- From PaLM procedure reference set -->
<system value="http://snomed.info/sct" />
<code value="135842001" />
<display value="Serum C reactive protein level" />
</coding>
</code>
<subject>
<reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
<display value="WELSH, Joel" />
</subject>
<authoredOn value="2022-01-29T10:24:00+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>
<specimen>
<reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
</specimen>
</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-20220308-004205" />
</identifier>
<basedOn>
<reference value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
</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="2022-03-08T12:09:00+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>
<reference value="urn:uuid:8697e1ea-a15d-4cab-95d9-7335f4b57e22" />
</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-20220307-000105" />
</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="2022-03-07T14:58:00+00:00" />
<collection>
<collectedDateTime value="2022-03-07T11:42:00+00:00" />
</collection>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:8697e1ea-a15d-4cab-95d9-7335f4b57e22" />
<resource>
<Observation>
<id value="8697e1ea-a15d-4cab-95d9-7335f4b57e22" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab" />
</meta>
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="09fd65ba-4bbb-49dd-9d16-ca74f885db6c" />
</identifier>
<status value="final" />
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/observation-category" />
<code value="laboratory" />
<display value="Laboratory" />
</coding>
</category>
<code>
<!-- Equivalent codes from the PBCL and PaLM SNOMED CT reference sets are used in this example. -->
<!-- In practice, it is likely that only a code from one reference set will be carried. -->
<coding>
<!-- From PBCL observable entity reference set -->
<system value="http://snomed.info/sct" />
<code value="1001371000000100" />
<display value="Serum CRP (C reactive protein) level" />
</coding>
<coding>
<!-- From PaLM observable entity reference set -->
<system value="http://snomed.info/sct" />
<code value="1106741000000105" />
<display value="CRP (C reactive protein) mass concentration in serum" />
</coding>
</code>
<subject>
<reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
<display value="WELSH, Joel" />
</subject>
<issued value="2022-03-08T12:09:00+00:00" />
<performer>
<reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
<display value="TD008362 PATH LAB 001" />
</performer>
<valueQuantity>
<value value="200" />
<unit value="mg/L" />
<system value="http://unitsofmeasure.org" />
<code value="mg/L" />
</valueQuantity>
<interpretation>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation" />
<code value="H" />
<display value="High" />
</coding>
</interpretation>
<specimen>
<reference value="urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d" />
</specimen>
<referenceRange>
<low>
<value value="0" />
<unit value="mg/L" />
<system value="http://unitsofmeasure.org" />
<code value="mg/L" />
</low>
<high>
<value value="5" />
<unit value="mg/L" />
<system value="http://unitsofmeasure.org" />
<code value="mg/L" />
</high>
</referenceRange>
</Observation>
</resource>
</entry>
</Bundle>
{
"resourceType": "Bundle",
"id": "Pathology-Bundle-CRP-Report-Example",
"meta": {
"lastUpdated": "2022-03-08T12:09:00+00:00",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle"
]
},
"identifier": {
"system": "https://tools.ietf.org/html/rfc4122",
"value": "1f859037-2942-4117-884a-f51b62db5a52"
},
"type": "message",
"entry": [
{
"fullUrl": "urn:uuid:f18a2226-c0ab-480d-b80a-b6561fe8f9c4",
"resource": {
"resourceType": "MessageHeader",
"id": "f18a2226-c0ab-480d-b80a-b6561fe8f9c4",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader"
]
},
"eventCoding": {
"system": "http://snomed.info/sct",
"code": "371528001",
"display": "Pathology report"
},
"destination": [
{
"name": "PICKERING MEDICAL PRACTICE",
"endpoint": "TBC",
"receiver": {
"reference": "urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434"
}
}
],
"sender": {
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338"
},
"source": {
"endpoint": "TBC"
},
"focus": [
{
"reference": "urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20"
}
],
"definition": "https://fhir.nhs.uk/England/MessageDefinition/England-Pathology-Report"
}
},
{
"fullUrl": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338",
"resource": {
"resourceType": "Organization",
"id": "8a6d85b8-9837-4fed-a257-4cf207988338",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
]
},
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "Y8J7D"
}
],
"name": "TD008362 PATH LAB 001",
"address": [
{
"line": [
"PATHOLOGY LAB",
"7-8 WELLINGTON PLACE"
],
"city": "LEEDS",
"district": "WEST YORKSHIRE",
"postalCode": "LS1 4AP"
}
]
}
},
{
"fullUrl": "urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434",
"resource": {
"resourceType": "Organization",
"id": "3c43b5b3-06d6-445f-ae9a-48d5f05df434",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
]
},
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/ods-organization-code",
"value": "B82033"
}
],
"name": "PICKERING MEDICAL PRACTICE",
"address": [
{
"line": [
"SOUTHGATE"
],
"city": "PICKERING",
"district": "NORTH YORKSHIRE",
"postalCode": "YO18 8BL"
}
]
}
},
{
"fullUrl": "urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe",
"resource": {
"resourceType": "Practitioner",
"id": "9a835acf-d715-4d84-8dcf-a8435f6417fe",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner"
]
},
"identifier": [
{
"system": "https://fhir.hl7.org.uk/Id/gmc-number",
"value": "C1008215"
}
],
"name": [
{
"use": "official",
"family": "GASKELL",
"given": [
"Gale"
],
"prefix": [
"Dr"
]
}
]
}
},
{
"fullUrl": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"resource": {
"resourceType": "Patient",
"id": "ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
]
},
"identifier": [
{
"extension": [
{
"url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland",
"code": "01",
"display": "Number present and verified"
}
]
}
}
],
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710638"
}
],
"name": [
{
"use": "official",
"family": "WELSH",
"given": [
"Joel"
]
}
],
"gender": "male",
"birthDate": "1972-08-23",
"address": [
{
"line": [
"ACONBURY",
"LARPOOL DRIVE"
],
"city": "WHITBY",
"postalCode": "YO22 4ND"
}
]
}
},
{
"fullUrl": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac",
"resource": {
"resourceType": "ServiceRequest",
"id": "1c38d507-9ad7-4b49-ba91-7da204842cac",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Lab"
]
},
"identifier": [
{
"system": "http://B82033-pickeringmedicalpractice.com/labrequest",
"value": "REQ-20220307-000142"
}
],
"status": "active",
"intent": "order",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "135842001",
"display": "Serum C reactive protein level"
}
]
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"display": "WELSH, Joel"
},
"authoredOn": "2022-01-29T10:24:00+00:00",
"requester": {
"reference": "urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe",
"display": "GASKELL, Dr Gale"
},
"performer": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338",
"display": "TD008362 PATH LAB 001"
}
],
"specimen": [
{
"reference": "urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d"
}
]
}
},
{
"fullUrl": "urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20",
"resource": {
"resourceType": "DiagnosticReport",
"id": "35d46ca1-f253-4c97-b7ee-fb5fccdf6c20",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-DiagnosticReport-Lab"
]
},
"identifier": [
{
"system": "http://Y8J7D-pathlab001.com/report",
"value": "REP-20220308-004205"
}
],
"basedOn": [
{
"reference": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac"
}
],
"status": "final",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0074",
"code": "LAB",
"display": "Laboratory"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"
}
]
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"display": "WELSH, Joel"
},
"issued": "2022-03-08T12:09:00+00:00",
"performer": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338",
"display": "TD008362 PATH LAB 001"
}
],
"specimen": [
{
"reference": "urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d"
}
],
"result": [
{
"reference": "urn:uuid:8697e1ea-a15d-4cab-95d9-7335f4b57e22"
}
]
}
},
{
"fullUrl": "urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d",
"resource": {
"resourceType": "Specimen",
"id": "bab0eaec-1ec5-4598-b660-90bb38a1030d",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen"
]
},
"identifier": [
{
"system": "http://B82033-pickeringmedicalpractice.com/specimen",
"value": "SPC-REQ-20220307-000105"
}
],
"accessionIdentifier": {
"system": "http://Y8J7D-pathlab001.com/specimen",
"value": "SPC-Lab-20220307-007856"
},
"status": "available",
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "122555007",
"display": "Venous blood specimen"
}
]
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"display": "WELSH, Joel"
},
"receivedTime": "2022-03-07T14:58:00+00:00",
"collection": {
"collectedDateTime": "2022-03-07T11:42:00+00:00"
}
}
},
{
"fullUrl": "urn:uuid:8697e1ea-a15d-4cab-95d9-7335f4b57e22",
"resource": {
"resourceType": "Observation",
"id": "8697e1ea-a15d-4cab-95d9-7335f4b57e22",
"meta": {
"profile": [
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