England-Observation-Lab-Pathology (Test Group)

Summary

A Pathology specific profile derived from the UK Core and EU-Lab Observation profiles to allow for the use of Pathology Bounded Coded List (PBCL) and Pathology and Laboratory Medicine (PaLM) SNOMED reference sets.

This page details how the profile is used to represent a test group. Within this implementation guide, the term 'test group' is used to denote a set of related tests that are reported together, for example a Full Blood Count. Test groups are more widely referred to as batteries, panels or profiles.

For a description of how the profile is used to represent test results, refer to England-Observation-Lab-Pathology (Test Result).

Profile Views

Refer to Profile Descriptions for a definition of the different profile view formats.

ObservationOrganizerR6Extension(boolean)
value[x]Fixed Value
value[x]Fixed Value
value[x]Fixed Value
interpretationBinding
ObservationOrganizerR6Extension(boolean)
value[x]Fixed Value
value[x]Fixed Value
value[x]Fixed Value
interpretationBinding
ObservationOrganizerR6Extension(boolean)
value[x]Fixed Value
value[x]Fixed Value
value[x]Fixed Value
interpretationBinding

Additional Guidance

meta.profile

This element SHALL be populated using the appropriate value from the table on the Profiles page.

extension:ObservationOrganizerR6

This extension SHALL be populated to indicate that, in this context, the Observation represents a test group i.e. a battery, panel, or profile.

Refer to Extension UKCore-ObservationOrganizer for further information.

status

This element SHALL be populated with a value taken from the ObservationStatus ValueSet.

The status of the test group Observation SHOULD be consistent with the status of the test result Observations it references. For example, if one or more test results have a status of preliminary, the test group SHOULD also have a status of preliminary.

category

This element SHOULD be populated with the following values, taken from the ObservationCategoryCodes and LabSpecialtyEuVs ValueSets respectively:

"category": [
    {
        "coding": [
            {
                "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                "code": "laboratory",
                "display": "Laboratory"
            }
        ]
    },
    {
        "coding": [
            {
                "system": "http://snomed.info/sct",
                "code": "394915009",
                "display": "General pathology (speciality)"
            }
        ]
    }
]

code

The clinical code and name of the test group, for example:

"code": {
    "coding": [
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/valueset-reference",
                    "valueUri": "https://fhir.hl7.org.uk/ValueSet/UKCore-PathologyBoundedCodeListObservables"
                }
            ],        
            "system": "http://snomed.info/sct",
            "code": "1022441000000101",
            "display": "FBC - full blood count"
        }
    ]
}

This element has an open slice and SHALL be populated using one of the following:

  • A SNOMED CT code that is a member of the 999002881000000100 | PBCL (Pathology Bounded Code List) observables simple reference set.
  • If a SNOMED CT code from the SNOMED PBCL reference set cannot be identified, a local code MAY be used.

The standard FHIR Extension valueset-reference SHALL be used to indicate that the SNOMED CT code is a member of the SNOMED PBCL reference set. The relevant URI value for the SNOMED PBCL reference set is as follows:

  • SNOMED PBCL: https://fhir.nhs.uk/England/ValueSet/England-PathologyBoundedCodeListObservables

The valueset-reference extension SHALL only be used for SNOMED CT codes that are members of a reference set and SHALL NOT be used for local codes.

subject

Reference to the Patient.

effective[x]

The clinically relevant date and time, or time-period, for the test group. In the context of laboratory reporting, this is typically the date and time, or time-period, that the associated specimen was collected.

The presence of [x] in an element name is used to indicate a choice of data type. The [x] part of the element name is replaced with an appropriate data type, in title-case format e.g. effectiveDateTime.

This element SHALL be populated using one of the following, in order of preference:

  • Specimen.collection.collected[x]
  • Specimen.receivedTime
  • Specimen.processing.time[x]
  • the Specimen resource creation date and time i.e. the initial value of `Specimen.meta.lastUpdate

issued

The date and time the test group results were issued.

performer

Reference to the performing Organization.

value[x]

This element SHOULD NOT be populated because a test group does not carry a test result.

Where an Observation is used to represent a test result, then England-Observation-Lab-Pathology (Test Result) SHALL be used instead.

note

Comments relating to the test group.

specimen

Reference to the Specimen used during testing.

hasMember

References to the Observations that make up the test group. The references may be to single test results, test groups or a mixture of both.

Multiple levels of test group Observations and test result Observations may be nested to support complex report structures, such as those used in Microscopy, Culture and Sensitivity (MC&S) reports. Refer to the Design Overview section for further information.