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 Implementation team.PATH-R4-12: Bundle Example - Lipids Profile and Haemoglobin A1c (HbA1c) Report
- This is an example of a report that contains the results associated with a single test group and a single test.
- The tests 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
ServiceRequestis required for the test group and a separate instance ofServiceRequestis required for the single test. - Each
ServiceRequestwithin 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
BundleusingSpecimen.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
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.
</meta>
</identifier>
<MessageHeader>
<!-- TBC Review content of MessageHeader -->
</meta>
</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>
</requisition>
<!-- From PaLM procedure reference set -->
</coding>
</code>
</subject>
</requester>
</performer>
</ServiceRequest>
</resource>
</entry>
<ServiceRequest>
</meta>
</identifier>
</requisition>
<!-- From PaLM procedure reference set -->
</coding>
</code>
</subject>
</requester>
</performer>
</ServiceRequest>
</resource>
</entry>
<DiagnosticReport>
</meta>
</identifier>
<!-- Serum lipid levels request -->
</basedOn>
<!-- HbA1c request -->
</basedOn>
</coding>
</category>
</coding>
</code>
</subject>
</performer>
</specimen>
<!-- Test group Observation for Serum lipid levels -->
</result>
<!-- Test result Observation for HbA1c level -->
</result>
</DiagnosticReport>
</resource>
</entry>
<Specimen>
</meta>
</identifier>
</accessionIdentifier>
</coding>
</type>
</subject>
</request>
</collection>
</Specimen>
</resource>
</entry>
<Observation>
<!-- Test group Observation for Serum lipid levels -->
</meta>
</identifier>
</coding>
</category>
<!-- From PaLM procedure reference set -->
</coding>
</code>
</subject>
</performer>
<!-- Cholesterol substance concentration in serum -->
</hasMember>
<!-- HDL (high density lipoprotein) cholesterol substance concentration in serum -->
</hasMember>
<!-- Serum cholesterol/high density lipoprotein ratio -->
</hasMember>
<!-- Non-HDL (high density lipoprotein) cholesterol molar concentration in serum -->
</hasMember>
</Observation>
</resource>
</entry>
<Observation>
<!-- Cholesterol substance concentration in serum -->
</meta>
</identifier>
</coding>
</category>
<!-- 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. -->
<!-- From PBCL observable entity reference set -->
</coding>
<!-- From PaLM observable entity reference set -->
</coding>
</code>
</subject>
</performer>
</valueQuantity>
</specimen>
</Observation>
</resource>
</entry>
<Observation>
<!-- HDL (high density lipoprotein) cholesterol substance concentration in serum -->
</meta>
</identifier>
</coding>
</category>
<!-- 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. -->
<!-- From PBCL observable entity reference set -->
</coding>
<!-- From PaLM observable entity reference set -->
</coding>
</code>
</subject>
</performer>
</valueQuantity>
</specimen>
</Observation>
</resource>
</entry>
<Observation>
<!-- Serum cholesterol/high density lipoprotein ratio -->
</meta>
</identifier>
</coding>
</category>
<!-- From PBCL observable entity reference set (an equivalent PaLM code does not currently exist) -->
</coding>
</code>
</subject>
</performer>
</valueQuantity>
</specimen>
</Observation>
</resource>
</entry>
<Observation>
<!-- Non-HDL (high density lipoprotein) cholesterol molar concentration in serum -->
</meta>
</identifier>
</coding>
</category>
<!-- 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. -->
<!-- From PBCL observable entity reference set -->
</coding>
<!-- From PaLM observable entity reference set -->
</coding>
</code>
</subject>
</performer>
</valueQuantity>
</specimen>
</Observation>
</resource>
</entry>
<Observation>
<!-- Haemoglobin A1c level - International Federation of Clinical Chemistry and Laboratory Medicine standardised -->
</meta>
</identifier>
</coding>
</category>
<!-- From PBCL and PaLM observable entity reference sets -->
<display value="Haemoglobin A1c level - International Federation of Clinical Chemistry and Laboratory Medicine standardised" />
</coding>
</code>
</subject>
</performer>
</valueQuantity>
</specimen>
</Observation>
</resource>
</entry>
</Bundle>
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}
| Bundle |
| id : Pathology-Bundle-Lipids-HbA1c-Report-Example |
| meta |
| lastUpdated : 2022-07-06T10:49:00+00:00 |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Bundle |
| identifier |
| system : https://tools.ietf.org/html/rfc4122 |
| value : d8d2d20e-8c44-466d-8640-7a516db7cd27 |
| type : message |
| entry |
| fullUrl : urn:uuid:f18a2226-c0ab-480d-b80a-b6561fe8f9c4 |
| resource |
| id : f18a2226-c0ab-480d-b80a-b6561fe8f9c4 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MessageHeader |
| 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 : 9727710638 |
| name |
| use : official |
| family : WELSH |
| given : Joel |
| gender : male |
| birthDate : 1972-08-23 |
| address |
| line : ACONBURY |
| line : LARPOOL DRIVE |
| district : NORTH YORKSHIRE |
| postalCode : YO22 4ND |
| 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-20220704-000027-001 |
| requisition |
| system : http://B82033-pickeringmedicalpractice.com/labrequest |
| value : REQ-20220704-000027 |
| status : active |
| intent : order |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 271244005 |
| display : Measurement of serum lipid level |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : WELSH, Joel |
| authoredOn : 2022-07-04T11:05:00+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:8660ef6a-65ef-408f-92ce-b4d6d03d783c |
| resource |
| id : 8660ef6a-65ef-408f-92ce-b4d6d03d783c |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Lab |
| identifier |
| system : http://B82033-pickeringmedicalpractice.com/labrequest |
| value : REQ-20220704-000027-002 |
| requisition |
| system : http://B82033-pickeringmedicalpractice.com/labrequest |
| value : REQ-20220704-000027 |
| status : active |
| intent : order |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 43396009 |
| display : Haemoglobin A1c measurement |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : WELSH, Joel |
| authoredOn : 2022-07-04T11:05:00+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-20220706-002378 |
| basedOn |
| reference : urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
| basedOn |
| reference : urn:uuid:8660ef6a-65ef-408f-92ce-b4d6d03d783c |
| 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 : 2022-07-06T10:49:00+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:4e4410fd-27d3-413e-901a-380caa78b411 |
| result |
| reference : urn:uuid:efa161d2-5fe4-4c8c-8b0e-cc268c70be4f |
| entry |
| fullUrl : urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d |
| resource |
| 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-20220705-000004 |
| accessionIdentifier |
| system : http://Y8J7D-pathlab001.com/specimen |
| value : SPC-Lab-20220705-006215 |
| 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 : 2022-07-05T15:17:00+00:00 |
| request |
| reference : urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac |
| collection |
| collected : 2022-07-05T08:52:00+00:00 |
| entry |
| fullUrl : urn:uuid:4e4410fd-27d3-413e-901a-380caa78b411 |
| resource |
| id : 4e4410fd-27d3-413e-901a-380caa78b411 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab |
| identifier |
| system : https://tools.ietf.org/html/rfc4122 |
| value : ee1a61c2-9a65-4dcb-ba83-fb25e3df6e72 |
| status : final |
| category |
| coding |
| system : http://terminology.hl7.org/CodeSystem/observation-category |
| code : laboratory |
| display : Laboratory |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 271244005 |
| display : Measurement of serum lipid level |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : WELSH, Joel |
| issued : 2022-07-06T10:49:00+00:00 |
| performer |
| reference : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| display : TD008362 PATH LAB 001 |
| hasMember |
| reference : urn:uuid:7038e91e-ec48-4e5c-9e1b-7d5111599410 |
| hasMember |
| reference : urn:uuid:d1249582-ac45-43a7-8254-dbb10acff635 |
| hasMember |
| reference : urn:uuid:417dd1ff-90ac-4553-9688-4f5a409eee48 |
| hasMember |
| reference : urn:uuid:d6015a3f-2521-40db-b1e0-16ee53a23767 |
| entry |
| fullUrl : urn:uuid:7038e91e-ec48-4e5c-9e1b-7d5111599410 |
| resource |
| id : 7038e91e-ec48-4e5c-9e1b-7d5111599410 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab |
| identifier |
| system : https://tools.ietf.org/html/rfc4122 |
| value : ec266e51-1144-445e-8e24-cb7aad39d52a |
| status : final |
| category |
| coding |
| system : http://terminology.hl7.org/CodeSystem/observation-category |
| code : laboratory |
| display : Laboratory |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 1005671000000105 |
| display : Serum cholesterol level |
| coding |
| system : http://snomed.info/sct |
| code : 1106541000000101 |
| display : Cholesterol substance concentration in serum |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : WELSH, Joel |
| issued : 2022-07-06T10:49:00+00:00 |
| performer |
| reference : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| display : TD008362 PATH LAB 001 |
| value |
| value : 6.1 |
| unit : mmol/L |
| system : http://unitsofmeasure.org |
| code : mmol/L |
| specimen |
| reference : urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d |
| entry |
| fullUrl : urn:uuid:d1249582-ac45-43a7-8254-dbb10acff635 |
| resource |
| id : d1249582-ac45-43a7-8254-dbb10acff635 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab |
| identifier |
| system : https://tools.ietf.org/html/rfc4122 |
| value : 4722ed7d-da71-46c4-88c5-6bea8a442efd |
| status : final |
| category |
| coding |
| system : http://terminology.hl7.org/CodeSystem/observation-category |
| code : laboratory |
| display : Laboratory |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 1005681000000107 |
| display : Serum high density lipoprotein cholesterol level |
| coding |
| system : http://snomed.info/sct |
| code : 1107681000000108 |
| display : HDL (high density lipoprotein) cholesterol substance concentration in serum |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : WELSH, Joel |
| issued : 2022-07-06T10:49:00+00:00 |
| performer |
| reference : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| display : TD008362 PATH LAB 001 |
| value |
| value : 1.44 |
| unit : mmol/L |
| system : http://unitsofmeasure.org |
| code : mmol/L |
| specimen |
| reference : urn:uuid:bab0eaec-1ec5-4598-b660-90bb38a1030d |
| entry |
| fullUrl : urn:uuid:417dd1ff-90ac-4553-9688-4f5a409eee48 |
| resource |
| id : 417dd1ff-90ac-4553-9688-4f5a409eee48 |
| meta |
| profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation-Lab |
| identifier |
| system : https://tools.ietf.org/html/rfc4122 |
| value : 80b5e6d0-8b18-456e-b5a0-d4e986533655 |
| status : final |
| category |
| coding |
| system : http://terminology.hl7.org/CodeSystem/observation-category |
| code : laboratory |
| display : Laboratory |
| code |
| coding |
| system : http://snomed.info/sct |
| code : 1015681000000109 |
| display : Serum cholesterol/high density lipoprotein ratio |
| subject |
| reference : urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4 |
| display : WELSH, Joel |
| issued : 2022-07-06T10:49:00+00:00 |
| performer |
| reference : urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338 |
| display : TD008362 PATH LAB 001 |
| value |
| value : 4.2 |
| unit : 1/1 |
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