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 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.


path-data-model-GTT-unstructured-report

{
"resourceType": "Bundle",
"id": "ee9f668a-020b-480f-9e52-8f4ec29f97bf",
"meta": {
"profile": [
"http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab"
]
},
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:ee9f668a-020b-480f-9e52-8f4ec29f97bf"
},
"type": "document",
"timestamp": "2022-03-08T12:09:00+00:00",
"entry": [
{
"fullUrl": "urn:uuid:ce2073cd-7f19-4fd8-9956-f30ef7b4bd44",
"resource": {
"resourceType": "Composition",
"id": "ce2073cd-7f19-4fd8-9956-f30ef7b4bd44",
"meta": {
"profile": [
"http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab"
]
},
"extension": [
{
"url": "http://hl7.eu/fhir/StructureDefinition/composition-basedOn-order-or-requisition",
"valueReference": {
"reference": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac"
}
},
{
"url": "http://hl7.eu/fhir/laboratory/StructureDefinition/composition-diagnosticReportReference",
"valueReference": {
"reference": "urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20"
}
}
],
"identifier": {
"system": "http://Y8J7D-pathlab001.com/report",
"value": "REP-20220210-000218"
},
"status": "final",
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"
}
]
},
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "394915009",
"display": "General pathology (specialty)"
}
]
}
],
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710859"
}
},
"date": "2022-03-08T12:09:00+00:00",
"author": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338"
}
],
"title": "Laboratory Report",
"section": [
{
"title": "Glucose tolerance test",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "1005711000000106",
"display": "Glucose tolerance test"
}
]
},
"entry": [
{
"reference": "urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31"
}
]
}
]
}
},
{
"fullUrl": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338",
"resource": {
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"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": {
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"id": "3c43b5b3-06d6-445f-ae9a-48d5f05df434",
"meta": {
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"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": {
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},
"identifier": [
{
"system": "https://fhir.hl7.org.uk/Id/gmc-number",
"value": "C1008215"
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],
"name": [
{
"use": "official",
"family": "GASKELL",
"given": [
"Gale"
],
"prefix": [
"Dr"
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]
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},
{
"fullUrl": "urn:uuid:d4f5e6a1-2b3c-4d5e-9f6a-7b8c9d0e1f2a",
"resource": {
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"organization": {
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{
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{
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],
"specialty": [
{
"coding": [
{
"system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode",
"code": "600",
"display": "General Medical Practice"
}
]
}
]
}
},
{
"fullUrl": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"resource": {
"resourceType": "Patient",
"id": "ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"meta": {
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"identifier": [
{
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"value": "9727710859"
}
],
"name": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "unsupported"
}
]
}
],
"_birthDate": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "unsupported"
}
]
}
}
},
{
"fullUrl": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac",
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"resourceType": "ServiceRequest",
"id": "1c38d507-9ad7-4b49-ba91-7da204842cac",
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},
"identifier": [
{
"system": "http://B82033-pickeringmedicalpractice.com/labrequest",
"value": "REQ-20220207-000013"
}
],
"status": "active",
"intent": "order",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "108252007",
"display": "Laboratory procedure"
}
]
}
],
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"identifier": {
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"value": "9727710859"
}
},
"authoredOn": "2022-02-07T09:20:00+00:00",
"requester": {
"reference": "urn:uuid:d4f5e6a1-2b3c-4d5e-9f6a-7b8c9d0e1f2a"
},
"performer": [
{
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}
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},
{
"fullUrl": "urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20",
"resource": {
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"id": "35d46ca1-f253-4c97-b7ee-fb5fccdf6c20",
"meta": {
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},
"identifier": [
{
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"basedOn": [
{
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"status": "final",
"category": [
{
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{
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"code": {
"coding": [
{
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"subject": {
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"identifier": {
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"value": "9727710859"
}
},
"issued": "2022-02-10T11:49:00+00:00",
"performer": [
{
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],
"specimen": [
{
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},
{
"reference": "urn:uuid:45f1e625-9af2-4920-9ac4-63b4d9d30bd0"
},
{
"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."
}
},
{
"fullUrl": "urn:uuid:bcee569d-c37d-4901-90b4-c9f27c4dafab",
"resource": {
"resourceType": "Specimen",
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]
},
"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": {
"text": "Venous blood specimen"
},
"subject": {
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},
"receivedTime": "2022-02-09T14:17:06+00:00",
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{
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],
"collection": {
"collectedDateTime": "2022-02-09T10:01:23+00:00",
"fastingStatusCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0916",
"code": "F",
"display": "Patient was fasting prior to the procedure."
}
]
}
}
}
},
{
"fullUrl": "urn:uuid:45f1e625-9af2-4920-9ac4-63b4d9d30bd0",
"resource": {
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},
"identifier": [
{
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"value": "SPC-REQ-20220209-000083"
}
],
"accessionIdentifier": {
"system": "http://Y8J7D-pathlab001.com/specimen",
"value": "SPC-Lab-20220209-001549"
},
"status": "available",
"type": {
"text": "Venous blood specimen"
},
"subject": {
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"identifier": {
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"value": "9727710859"
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},
"receivedTime": "2022-02-09T14:17:06+00:00",
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{
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],
"collection": {
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}
}
},
{
"fullUrl": "urn:uuid:ad717ae8-cb35-4d66-ba51-e22a76b1d158",
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},
"identifier": [
{
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"value": "SPC-REQ-20220209-000084"
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],
"accessionIdentifier": {
"system": "http://Y8J7D-pathlab001.com/specimen",
"value": "SPC-Lab-20220209-001587"
},
"status": "available",
"type": {
"text": "Venous blood specimen"
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710859"
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},
"receivedTime": "2022-02-09T14:17:06+00:00",
"request": [
{
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}
],
"collection": {
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}
}
},
{
"fullUrl": "urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31",
"resource": {
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"id": "6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31",
"meta": {
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},
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"status": "final",
"category": [
{
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{
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"code": "laboratory",
"display": "Laboratory"
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{
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{
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"code": "394915009",
"display": "General pathology (specialty)"
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],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "1005711000000106",
"display": "Glucose tolerance test"
}
]
},
"subject": {
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"identifier": {
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"value": "9727710859"
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},
"effectiveDateTime": "2022-02-09T10:01:23+00:00",
"issued": "2022-02-10T11:49:00+00:00",
"performer": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338"
}
],
"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
Bundle.id[0]ee9f668a-020b-480f-9e52-8f4ec29f97bf
Bundle.meta[0].profile[0]http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab
Bundle.identifier[0].system[0]urn:ietf:rfc:3986
Bundle.identifier[0].value[0]urn:uuid:ee9f668a-020b-480f-9e52-8f4ec29f97bf
Bundle.type[0]document
Bundle.timestamp[0]2022-03-08T12:09:00+00:00
Bundle.entry[0].fullUrl[0]urn:uuid:ce2073cd-7f19-4fd8-9956-f30ef7b4bd44
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Bundle.entry[0].resource[0].meta[0].profile[0]http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab
Bundle.entry[0].resource[0].extension[0].url[0]http://hl7.eu/fhir/StructureDefinition/composition-basedOn-order-or-requisition
Bundle.entry[0].resource[0].extension[0].value[0].reference[0]urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac
Bundle.entry[0].resource[0].extension[1].url[0]http://hl7.eu/fhir/laboratory/StructureDefinition/composition-diagnosticReportReference
Bundle.entry[0].resource[0].extension[1].value[0].reference[0]urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20
Bundle.entry[0].resource[0].identifier[0].system[0]http://Y8J7D-pathlab001.com/report
Bundle.entry[0].resource[0].identifier[0].value[0]REP-20220210-000218
Bundle.entry[0].resource[0].status[0]final
Bundle.entry[0].resource[0].type[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].type[0].coding[0].code[0]721981007
Bundle.entry[0].resource[0].type[0].coding[0].display[0]Diagnostic studies report
Bundle.entry[0].resource[0].category[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].category[0].coding[0].code[0]394915009
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Bundle.entry[0].resource[0].subject[0].reference[0]urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4
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Bundle.entry[0].resource[0].subject[0].identifier[0].value[0]9727710859
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Bundle.entry[0].resource[0].author[0].reference[0]urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338
Bundle.entry[0].resource[0].title[0]Laboratory Report
Bundle.entry[0].resource[0].section[0].title[0]Glucose tolerance test
Bundle.entry[0].resource[0].section[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].section[0].code[0].coding[0].code[0]1005711000000106
Bundle.entry[0].resource[0].section[0].code[0].coding[0].display[0]Glucose tolerance test
Bundle.entry[0].resource[0].section[0].entry[0].reference[0]urn:uuid:6b64af83-2ea2-4b0f-a6a7-17e5a7b27a31
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Bundle.entry[1].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/ods-organization-code
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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
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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
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