PATH-R4-16a: Bundle Example - Glucose Tolerance Test Report (Unstructured)

path-mockup-GTT-report

  • This is an example of a Glucose Tolerance Test (GTT) report, which is a type of dynamic function test.
  • Dynamic function tests measure the outcome of certain stimulants (or suppressants) usually invoked on the endocrine system. A series of specimens is collected at defined time intervals and the results are reported together as a chronological sequence.
  • Each specimen is represented as a separate Specimen instance.
  • In this example, the patient fasted before the first specimen was taken. This is indicated using Specimen.collection.fastingStatus[x].
  • The results are represented using a single Observation and formatted as a blob of text.
  • A clinical interpretation/summary of the test results is carried in DiagnosticReport.conclusion.

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-GTT-unstructured-report
<Bundle xmlns="http://hl7.org/fhir">
<id value="Pathology-Bundle-GTT-Unstructured-Report-Example" />
<meta>
<lastUpdated value="2022-02-10T11:49:00+00:00" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle" />
</meta>
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="ee9f668a-020b-480f-9e52-8f4ec29f97bf" />
</identifier>
<type value="message" />
<entry>
<fullUrl value="urn:uuid:324d9589-21eb-4852-af10-b8a656105b10" />
<resource>
<MessageHeader>
<!-- TBC Review content of MessageHeader -->
<id value="324d9589-21eb-4852-af10-b8a656105b10" />
<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="9727710859" />
</identifier>
<name>
<use value="official" />
<family value="MOXEY" />
<given value="Judy" />
</name>
<gender value="female" />
<birthDate value="2004-05-06" />
<address>
<line value="1 CASTLEGATE" />
<city value="PICKERING" />
<district value="NORTH YORKSHIRE" />
<postalCode value="YO18 7AY" />
</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-20220207-000013" />
</identifier>
<status value="active" />
<intent value="order" />
<code>
<coding>
<!-- From PaLM procedure reference set -->
<system value="http://snomed.info/sct" />
<code value="113076002" />
<display value="Glucose tolerance test" />
</coding>
</code>
<subject>
<reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
<display value="MOXEY, Judy" />
</subject>
<authoredOn value="2022-02-07T09:20:00+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: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-20220210-000218" />
</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="MOXEY, Judy" />
</subject>
<issued value="2022-02-10T11:49:00+00:00" />
<performer>
<reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
<display value="TD008362 PATH LAB 001" />
</performer>
<specimen>
<reference value="urn:uuid:bcee569d-c37d-4901-90b4-c9f27c4dafab" />
</specimen>
<specimen>
<reference value="urn:uuid:45f1e625-9af2-4920-9ac4-63b4d9d30bd0" />
</specimen>
<specimen>
<reference value="urn:uuid:ad717ae8-cb35-4d66-ba51-e22a76b1d158" />
</specimen>
<result>
<reference value="urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31" />
</result>
<conclusion value="Fasting glucose below 5.1, 1hr below 10.0 and 2hr below 8.5 mmol/L. Normal response to glucose load, no further action required." />
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:bcee569d-c37d-4901-90b4-c9f27c4dafab" />
<resource>
<Specimen>
<id value="bcee569d-c37d-4901-90b4-c9f27c4dafab" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
</meta>
<identifier>
<system value="http://B82033-pickeringmedicalpractice.com/specimen" />
<value value="SPC-REQ-20220209-000082" />
</identifier>
<accessionIdentifier>
<system value="http://Y8J7D-pathlab001.com/specimen" />
<value value="SPC-Lab-20220209-001531" />
</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="MOXEY, Judy" />
</subject>
<receivedTime value="2022-02-09T14:17:06+00:00" />
<request>
<reference value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
</request>
<collection>
<collectedDateTime value="2022-02-09T10:01:23+00:00" />
<fastingStatusCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0916" />
<code value="F" />
<display value="Patient was fasting prior to the procedure." />
</coding>
</fastingStatusCodeableConcept>
</collection>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:45f1e625-9af2-4920-9ac4-63b4d9d30bd0" />
<resource>
<Specimen>
<id value="45f1e625-9af2-4920-9ac4-63b4d9d30bd0" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
</meta>
<identifier>
<system value="http://B82033-pickeringmedicalpractice.com/specimen" />
<value value="SPC-REQ-20220209-000083" />
</identifier>
<accessionIdentifier>
<system value="http://Y8J7D-pathlab001.com/specimen" />
<value value="SPC-Lab-20220209-001549" />
</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="MOXEY, Judy" />
</subject>
<receivedTime value="2022-02-09T14:17:06+00:00" />
<request>
<reference value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
</request>
<collection>
<collectedDateTime value="2022-02-09T11:03:07+00:00" />
</collection>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:ad717ae8-cb35-4d66-ba51-e22a76b1d158" />
<resource>
<Specimen>
<id value="ad717ae8-cb35-4d66-ba51-e22a76b1d158" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen" />
</meta>
<identifier>
<system value="http://B82033-pickeringmedicalpractice.com/specimen" />
<value value="SPC-REQ-20220209-000084" />
</identifier>
<accessionIdentifier>
<system value="http://Y8J7D-pathlab001.com/specimen" />
<value value="SPC-Lab-20220209-001587" />
</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="MOXEY, Judy" />
</subject>
<receivedTime value="2022-02-09T14:17:06+00:00" />
<request>
<reference value="urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac" />
</request>
<collection>
<collectedDateTime value="2022-02-09T12:02:17+00:00" />
</collection>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31" />
<resource>
<Observation>
<id value="6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab" />
</meta>
<identifier>
<system value="https://tools.ietf.org/html/rfc4122" />
<value value="ba7fa6e0-2170-4905-ac9f-e53970b17aed" />
</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 PBCL observable entity reference set -->
<system value="http://snomed.info/sct" />
<code value="1005711000000106" />
<display value="Glucose tolerance test" />
</coding>
</code>
<subject>
<reference value="urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4" />
<display value="MOXEY, Judy" />
</subject>
<effectiveDateTime value="2022-02-09T10:01:23+00:00" />
<issued value="2022-02-10T11:49:00+00:00" />
<performer>
<reference value="urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338" />
<display value="TD008362 PATH LAB 001" />
</performer>
<valueString value="GTT Fasting Glucose 4.8 mmol/L \n GTT Glucose 60 min 8.8 mmol/L\n GTT Glucose 120 min 6.4 mmol/L" />
</Observation>
</resource>
</entry>
</Bundle>
{
"resourceType": "Bundle",
"id": "Pathology-Bundle-GTT-Unstructured-Report-Example",
"meta": {
"lastUpdated": "2022-02-10T11:49:00+00:00",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle"
]
},
"identifier": {
"system": "https://tools.ietf.org/html/rfc4122",
"value": "ee9f668a-020b-480f-9e52-8f4ec29f97bf"
},
"type": "message",
"entry": [
{
"fullUrl": "urn:uuid:324d9589-21eb-4852-af10-b8a656105b10",
"resource": {
"resourceType": "MessageHeader",
"id": "324d9589-21eb-4852-af10-b8a656105b10",
"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"
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}
],
"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": [
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},
"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": "9727710859"
}
],
"name": [
{
"use": "official",
"family": "MOXEY",
"given": [
"Judy"
]
}
],
"gender": "female",
"birthDate": "2004-05-06",
"address": [
{
"line": [
"1 CASTLEGATE"
],
"city": "PICKERING",
"district": "NORTH YORKSHIRE",
"postalCode": "YO18 7AY"
}
]
}
},
{
"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-20220207-000013"
}
],
"status": "active",
"intent": "order",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "113076002",
"display": "Glucose tolerance test"
}
]
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"display": "MOXEY, Judy"
},
"authoredOn": "2022-02-07T09:20:00+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"
}
]
}
},
{
"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-20220210-000218"
}
],
"basedOn": [
{
"reference": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac"
}
],
"status": "final",
"category": [
{
"coding": [
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Bundle.entry[10].resource[0].category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/observation-category
Bundle.entry[10].resource[0].category[0].coding[0].code[0]laboratory
Bundle.entry[10].resource[0].category[0].coding[0].display[0]Laboratory
Bundle.entry[10].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[10].resource[0].code[0].coding[0].code[0]1005711000000106
Bundle.entry[10].resource[0].code[0].coding[0].display[0]Glucose tolerance test
Bundle.entry[10].resource[0].subject[0].reference[0]urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4
Bundle.entry[10].resource[0].subject[0].display[0]MOXEY, Judy
Bundle.entry[10].resource[0].effective[0]2022-02-09T10:01:23+00:00
Bundle.entry[10].resource[0].issued[0]2022-02-10T11:49:00+00:00
Bundle.entry[10].resource[0].performer[0].reference[0]urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338
Bundle.entry[10].resource[0].performer[0].display[0]TD008362 PATH LAB 001
Bundle.entry[10].resource[0].value[0]GTT Fasting Glucose 4.8 mmol/L \n GTT Glucose 60 min 8.8 mmol/L\n GTT Glucose 120 min 6.4 mmol/L