Notice: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
PATH-R4-16a: Bundle Example - Glucose Tolerance Test Report (Unstructured)
- 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
Specimeninstance. - 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
Observationand 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 How to Construct Bundles.
</meta>
</identifier>
<MessageHeader>
<!-- TBC Review content of MessageHeader -->
</eventCoding>
<!-- TBC Update endpoint address -->
<!-- Requesting Organisation -->
</receiver>
</destination>
<!-- Performing Laboratory -->
</sender>
<!-- TBC Update endpoint address -->
</source>
<!-- DiagnosticReport -->
</focus>
</MessageHeader>
</resource>
</entry>
<Organization>
<!-- Performing Laboratory -->
</meta>
</identifier>
</address>
</Organization>
</resource>
</entry>
<Organization>
<!-- Requesting Organisation -->
</meta>
</identifier>
</address>
</Organization>
</resource>
</entry>
<Practitioner>
<!-- Requesting Practitioner -->
</meta>
</identifier>
</name>
</Practitioner>
</resource>
</entry>
<Patient>
</meta>
<extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus">
</coding>
</valueCodeableConcept>
</extension>
</identifier>
</name>
</address>
</Patient>
</resource>
</entry>
<ServiceRequest>
</meta>
</identifier>
<!-- From PaLM procedure reference set -->
</coding>
</code>
</subject>
</requester>
</performer>
</ServiceRequest>
</resource>
</entry>
<DiagnosticReport>
</meta>
</identifier>
</basedOn>
</coding>
</category>
</coding>
</code>
</subject>
</performer>
</specimen>
</specimen>
</specimen>
</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>
<Specimen>
</meta>
</identifier>
</accessionIdentifier>
</coding>
</type>
</subject>
</request>
</coding>
</fastingStatusCodeableConcept>
</collection>
</Specimen>
</resource>
</entry>
<Specimen>
</meta>
</identifier>
</accessionIdentifier>
</coding>
</type>
</subject>
</request>
</collection>
</Specimen>
</resource>
</entry>
<Specimen>
</meta>
</identifier>
</accessionIdentifier>
</coding>
</type>
</subject>
</request>
</collection>
</Specimen>
</resource>
</entry>
<Observation>
</meta>
</identifier>
</coding>
</category>
<!-- From PBCL observable entity reference set -->
</coding>
</code>
</subject>
</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>
{
},
},
{
},
{
}
}
],
},
},
],
}
},
{
},
],
{
"PATHOLOGY LAB",
"7-8 WELLINGTON PLACE"
],
}
]
}
},
{
},
],
{
"SOUTHGATE"
],
}
]
}
},
{
},
],
]
}
},
{
},
{
{
{
}
]
}
}
],
}
],
],
{
"1 CASTLEGATE"
],
}
]
}
},
{
},
{
}
],
]
},
},
},
{
}
]
}
},
{
},
],
],
{
{
}
]
}
],
]
},
},
{
}
],
{
},
{
},
{
}
],
],
"conclusion": "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."
}
},
{
},
{
}
],
},
]
},
},
],
{
}
]
}
}
}
},
{
},
{
}
],
},
]
},
},
],
}
}
},
{
},
{
}
],
},
]
},
},
],
}
}
},
{
},
{
}
],
{
{
}
]
}
],
{
}
]
},
},
{
}
],
"valueString": "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"
}
}
]
}
| Bundle |
| id : Pathology-Bundle-GTT-Unstructured-Report-Example |
| meta |
| lastUpdated : 2022-02-10T11:49:00+00:00 |
| 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 |
| id : 324d9589-21eb-4852-af10-b8a656105b10 |
| event |
| 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 |
| entry |
| fullUrl : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| resource |
| 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 |
| line : 7-8 WELLINGTON PLACE |
| city : LEEDS |
| district : WEST YORKSHIRE |
| postalCode : LS1 4AP |
| entry |
| fullUrl : urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434 |
| resource |
| 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 |
| entry |
| fullUrl : urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe |
| resource |
| 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 |
| entry |
| fullUrl : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| resource |
| 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 |
| value |
| 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 |
| entry |
| fullUrl : urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
| resource |
| 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 |
| entry |
| fullUrl : urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20 |
| resource |
| 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 |
| 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 : MOXEY, Judy |
| issued : 2022-02-10T11:49:00+00:00 |
| performer |
| reference : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| display : TD008362 PATH LAB 001 |
| specimen |
| reference : urn:uuid:bcee569d-c37d-4901-90b4-c9f27c4dafab |
| specimen |
| reference : urn:uuid:45f1e625-9af2-4920-9ac4-63b4d9d30bd0 |
| specimen |
| reference : urn:uuid:ad717ae8-cb35-4d66-ba51-e22a76b1d158 |
| result |
| reference : urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31 |
| conclusion : 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. |
| entry |
| fullUrl : urn:uuid:bcee569d-c37d-4901-90b4-c9f27c4dafab |
| resource |
| id : bcee569d-c37d-4901-90b4-c9f27c4dafab |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen |
| identifier |
| system : http://B82033-pickeringmedicalpractice.com/specimen |
| value : SPC-REQ-20220209-000082 |
| accessionIdentifier |
| system : http://Y8J7D-pathlab001.com/specimen |
| value : SPC-Lab-20220209-001531 |
| 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 : MOXEY, Judy |
| receivedTime : 2022-02-09T14:17:06+00:00 |
| request |
| reference : urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
| collection |
| collected : 2022-02-09T10:01:23+00:00 |
| fastingStatus |
| coding |
| system : http://terminology.hl7.org/CodeSystem/v2-0916 |
| code : F |
| display : Patient was fasting prior to the procedure. |
| entry |
| fullUrl : urn:uuid:45f1e625-9af2-4920-9ac4-63b4d9d30bd0 |
| resource |
| id : 45f1e625-9af2-4920-9ac4-63b4d9d30bd0 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen |
| identifier |
| system : http://B82033-pickeringmedicalpractice.com/specimen |
| value : SPC-REQ-20220209-000083 |
| accessionIdentifier |
| system : http://Y8J7D-pathlab001.com/specimen |
| value : SPC-Lab-20220209-001549 |
| 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 : MOXEY, Judy |
| receivedTime : 2022-02-09T14:17:06+00:00 |
| request |
| reference : urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
| collection |
| collected : 2022-02-09T11:03:07+00:00 |
| entry |
| fullUrl : urn:uuid:ad717ae8-cb35-4d66-ba51-e22a76b1d158 |
| resource |
| id : ad717ae8-cb35-4d66-ba51-e22a76b1d158 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Specimen |
| identifier |
| system : http://B82033-pickeringmedicalpractice.com/specimen |
| value : SPC-REQ-20220209-000084 |
| accessionIdentifier |
| system : http://Y8J7D-pathlab001.com/specimen |
| value : SPC-Lab-20220209-001587 |
| 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 : MOXEY, Judy |
| receivedTime : 2022-02-09T14:17:06+00:00 |
| request |
| reference : urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
| collection |
| collected : 2022-02-09T12:02:17+00:00 |
| entry |
| fullUrl : urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31 |
| resource |
| id : 6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab |
| identifier |
| system : https://tools.ietf.org/html/rfc4122 |
| value : ba7fa6e0-2170-4905-ac9f-e53970b17aed |
| status : final |
| category |
| coding |
| system : http://terminology.hl7.org/CodeSystem/observation-category |
| code : laboratory |
| display : Laboratory |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 1005711000000106 |
| display : Glucose tolerance test |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : MOXEY, Judy |
| effective : 2022-02-09T10:01:23+00:00 |
| issued : 2022-02-10T11:49:00+00:00 |
| performer |
| reference : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| display : TD008362 PATH LAB 001 |
| 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 |
| Bundle.id[0] | Pathology-Bundle-GTT-Unstructured-Report-Example |
| Bundle.meta[0].lastUpdated[0] | 2022-02-10T11:49:00+00:00 |
| Bundle.identifier[0].system[0] | https://tools.ietf.org/html/rfc4122 |
| Bundle.identifier[0].value[0] | ee9f668a-020b-480f-9e52-8f4ec29f97bf |
| Bundle.type[0] | message |
| Bundle.entry[0].fullUrl[0] | urn:uuid:324d9589-21eb-4852-af10-b8a656105b10 |
| Bundle.entry[0].resource[0].id[0] | 324d9589-21eb-4852-af10-b8a656105b10 |
| Bundle.entry[0].resource[0].event[0].system[0] | http://snomed.info/sct |
| Bundle.entry[0].resource[0].event[0].code[0] | 371528001 |
| Bundle.entry[0].resource[0].event[0].display[0] | Pathology report |
| Bundle.entry[0].resource[0].destination[0].name[0] | PICKERING MEDICAL PRACTICE |
| Bundle.entry[0].resource[0].destination[0].endpoint[0] | TBC |
| Bundle.entry[0].resource[0].destination[0].receiver[0].reference[0] | urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434 |
| Bundle.entry[0].resource[0].sender[0].reference[0] | urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| Bundle.entry[0].resource[0].source[0].endpoint[0] | TBC |
| Bundle.entry[0].resource[0].focus[0].reference[0] | urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20 |
| Bundle.entry[0].resource[0].definition[0] | https://fhir.nhs.uk/England/MessageDefinition/England-Pathology-Report |
| Bundle.entry[1].fullUrl[0] | urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| Bundle.entry[1].resource[0].id[0] | 8a6d85b8-9837-4fed-a257-4cf207988338 |
| Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization |
| Bundle.entry[1].resource[0].identifier[0].system[0] | https://fhir.nhs.uk/Id/ods-organization-code |
| Bundle.entry[1].resource[0].identifier[0].value[0] | Y8J7D |
| Bundle.entry[1].resource[0].name[0] | TD008362 PATH LAB 001 |
| Bundle.entry[1].resource[0].address[0].line[0] | PATHOLOGY LAB |
| Bundle.entry[1].resource[0].address[0].line[1] | 7-8 WELLINGTON PLACE |
| Bundle.entry[1].resource[0].address[0].city[0] | LEEDS |
| Bundle.entry[1].resource[0].address[0].district[0] | WEST YORKSHIRE |
| Bundle.entry[1].resource[0].address[0].postalCode[0] | LS1 4AP |
| Bundle.entry[2].fullUrl[0] | urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434 |
| Bundle.entry[2].resource[0].id[0] | 3c43b5b3-06d6-445f-ae9a-48d5f05df434 |
| Bundle.entry[2].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization |
| Bundle.entry[2].resource[0].identifier[0].system[0] | https://fhir.nhs.uk/Id/ods-organization-code |
| Bundle.entry[2].resource[0].identifier[0].value[0] | B82033 |
| Bundle.entry[2].resource[0].name[0] | PICKERING MEDICAL PRACTICE |
| Bundle.entry[2].resource[0].address[0].line[0] | SOUTHGATE |
| Bundle.entry[2].resource[0].address[0].city[0] | PICKERING |
| Bundle.entry[2].resource[0].address[0].district[0] | NORTH YORKSHIRE |
| Bundle.entry[2].resource[0].address[0].postalCode[0] | YO18 8BL |
| Bundle.entry[3].fullUrl[0] | urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe |
| Bundle.entry[3].resource[0].id[0] | 9a835acf-d715-4d84-8dcf-a8435f6417fe |
| Bundle.entry[3].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner |
| Bundle.entry[3].resource[0].identifier[0].system[0] | https://fhir.hl7.org.uk/Id/gmc-number |
| Bundle.entry[3].resource[0].identifier[0].value[0] | C1008215 |
| Bundle.entry[3].resource[0].name[0].use[0] | official |
| Bundle.entry[3].resource[0].name[0].family[0] | GASKELL |
| Bundle.entry[3].resource[0].name[0].given[0] | Gale |
| Bundle.entry[3].resource[0].name[0].prefix[0] | Dr |
| Bundle.entry[4].fullUrl[0] | urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| Bundle.entry[4].resource[0].id[0] | ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| Bundle.entry[4].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient |
| Bundle.entry[4].resource[0].identifier[0].extension[0].url[0] | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus |
| Bundle.entry[4].resource[0].identifier[0].extension[0].value[0].coding[0].system[0] | https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland |
| Bundle.entry[4].resource[0].identifier[0].extension[0].value[0].coding[0].code[0] | 01 |
| Bundle.entry[4].resource[0].identifier[0].extension[0].value[0].coding[0].display[0] | Number present and verified |
| Bundle.entry[4].resource[0].identifier[0].system[0] | https://fhir.nhs.uk/Id/nhs-number |
| Bundle.entry[4].resource[0].identifier[0].value[0] | 9727710859 |
| Bundle.entry[4].resource[0].name[0].use[0] | official |
| Bundle.entry[4].resource[0].name[0].family[0] | MOXEY |
| Bundle.entry[4].resource[0].name[0].given[0] | Judy |
| Bundle.entry[4].resource[0].gender[0] | female |
| Bundle.entry[4].resource[0].birthDate[0] | 2004-05-06 |
| Bundle.entry[4].resource[0].address[0].line[0] | 1 CASTLEGATE |
| Bundle.entry[4].resource[0].address[0].city[0] | PICKERING |
| Bundle.entry[4].resource[0].address[0].district[0] | NORTH YORKSHIRE |
| Bundle.entry[4].resource[0].address[0].postalCode[0] | YO18 7AY |
| Bundle.entry[5].fullUrl[0] | urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
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