Bundle Example - Urine Microscopy, Culture and Sensitivity Report (Unstructured)

path-mockup-MCS-01-report

  • This is an example of a complex report.
  • The results are represented using a single Observation and formatted as text.
  • The report includes a range of numeric, semi-quantitative and qualitative results.
  • In this example, the specimen (urine) was collected after the request was made. The specimen is linked to the request within the Bundle using Specimen.request.
  • 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-MCS-01-unstructured-report
{
"resourceType": "Bundle",
"id": "7f15fd51-8df4-4793-b74f-fb3ce029f96d",
"meta": {
"profile": [
"http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab"
]
},
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:7f15fd51-8df4-4793-b74f-fb3ce029f96d"
},
"type": "document",
"timestamp": "2022-03-08T12:09:00+00:00",
"entry": [
{
"fullUrl": "urn:uuid:f9b37ab6-a74b-414e-aa4f-af9667f3447c",
"resource": {
"resourceType": "Composition",
"id": "f9b37ab6-a74b-414e-aa4f-af9667f3447c",
"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-20220225-006301"
},
"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": "Urinary microscopy, culture and sensitivities",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "995581000000104",
"display": "Urinary microscopy, culture and sensitivities"
}
]
},
"entry": [
{
"reference": "urn:uuid:bd867909-49ca-4a4b-b02f-162790b6800f"
}
]
}
]
}
},
{
"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": [
"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": {
"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:d4f5e6a1-2b3c-4d5e-9f6a-7b8c9d0e1f2a",
"resource": {
"resourceType": "PractitionerRole",
"id": "d4f5e6a1-2b3c-4d5e-9f6a-7b8c9d0e1f2a",
"practitioner": {
"reference": "urn:uuid:9a835acf-d715-4d84-8dcf-a8435f6417fe"
},
"organization": {
"reference": "urn:uuid:3c43b5b3-06d6-445f-ae9a-48d5f05df434"
},
"code": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "62247001",
"display": "General practitioner"
}
]
}
],
"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": {
"profile": [
"http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core"
]
},
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"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",
"resource": {
"resourceType": "ServiceRequest",
"id": "1c38d507-9ad7-4b49-ba91-7da204842cac",
"meta": {
"profile": [
"http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"
]
},
"identifier": [
{
"system": "http://B82033-pickeringmedicalpractice.com/labrequest",
"value": "REQ-20220221-000018"
}
],
"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": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710859"
}
},
"authoredOn": "2022-02-21T10:29:00+00:00",
"requester": {
"reference": "urn:uuid:d4f5e6a1-2b3c-4d5e-9f6a-7b8c9d0e1f2a"
},
"performer": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338"
}
]
}
},
{
"fullUrl": "urn:uuid:bde5b0a5-4fb3-4655-acf0-215b93aee006",
"resource": {
"resourceType": "Specimen",
"id": "bde5b0a5-4fb3-4655-acf0-215b93aee006",
"meta": {
"profile": [
"http://hl7.eu/fhir/laboratory/StructureDefinition/Specimen-eu-lab"
]
},
"identifier": [
{
"system": "http://B82033-pickeringmedicalpractice.com/specimen",
"value": "SPC-REQ-20220221-000024"
}
],
"accessionIdentifier": {
"system": "http://Y8J7D-pathlab001.com/specimen",
"value": "SPC-Lab-20220221-004306"
},
"status": "available",
"type": {
"text": "Urine specimen"
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710859"
}
},
"receivedTime": "2022-02-21T14:58:00+00:00",
"request": [
{
"reference": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac"
}
],
"collection": {
"collectedDateTime": "2022-02-21T11:07:00+00:00"
}
}
},
{
"fullUrl": "urn:uuid:35d46ca1-f253-4c97-b7ee-fb5fccdf6c20",
"resource": {
"resourceType": "DiagnosticReport",
"id": "35d46ca1-f253-4c97-b7ee-fb5fccdf6c20",
"meta": {
"profile": [
"http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab"
]
},
"identifier": [
{
"system": "http://Y8J7D-pathlab001.com/report",
"value": "REP-20220225-006301"
}
],
"basedOn": [
{
"reference": "urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac"
}
],
"status": "final",
"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 (specialty)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "721981007",
"display": "Diagnostic studies report"
}
]
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710859"
}
},
"issued": "2022-02-25T13:47:00+00:00",
"performer": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338"
}
],
"specimen": [
{
"reference": "urn:uuid:bde5b0a5-4fb3-4655-acf0-215b93aee006"
}
],
"result": [
{
"reference": "urn:uuid:bd867909-49ca-4a4b-b02f-162790b6800f"
}
],
"conclusion": "Likely to be clinically significant."
}
},
{
"fullUrl": "urn:uuid:bd867909-49ca-4a4b-b02f-162790b6800f",
"resource": {
"resourceType": "Observation",
"id": "bd867909-49ca-4a4b-b02f-162790b6800f",
"meta": {
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/England-Observation-Lab-Pathology"
]
},
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:uuid:02875aea-9815-4d1d-b34e-f9f29b859d02"
}
],
"status": "final",
"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 (specialty)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "995581000000104",
"display": "Urinary microscopy, culture and sensitivities"
}
]
},
"subject": {
"reference": "urn:uuid:ab87a3f8-1d37-44a9-804e-5e962598a6e4",
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9727710859"
}
},
"effectiveDateTime": "2022-02-21T11:07:00+00:00",
"issued": "2022-02-25T13:47:00+00:00",
"performer": [
{
"reference": "urn:uuid:8a6d85b8-9837-4fed-a257-4cf207988338"
}
],
"valueString": "Microscopy\\nCasts None seen\\nWhite cells >35 x10*6/L\\nRed cells 10-35 x10*6/L\\nEpithelial cells +\\n\\nCulture\\n1. Staphylococcus aureus Scanty growth\\n\\nSensitivities 1\\nFlucloxacillin S\\nTrimethoprim S\\nNitrofurantoin R",
"specimen": {
"reference": "urn:uuid:bde5b0a5-4fb3-4655-acf0-215b93aee006"
}
}
}
]
}
Bundle
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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:7f15fd51-8df4-4793-b74f-fb3ce029f96d
Bundle.type[0]document
Bundle.timestamp[0]2022-03-08T12:09:00+00:00
Bundle.entry[0].fullUrl[0]urn:uuid:f9b37ab6-a74b-414e-aa4f-af9667f3447c
Bundle.entry[0].resource[0].id[0]f9b37ab6-a74b-414e-aa4f-af9667f3447c
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
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Bundle.entry[0].resource[0].status[0]final
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Bundle.entry[0].resource[0].type[0].coding[0].display[0]Diagnostic studies report
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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]Urinary microscopy, culture and sensitivities
Bundle.entry[0].resource[0].section[0].code[0].coding[0].system[0]http://snomed.info/sct
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Bundle.entry[1].resource[0].address[0].line[0]PATHOLOGY LAB
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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
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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
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Bundle.entry[4].resource[0].code[0].coding[0].code[0]62247001
Bundle.entry[4].resource[0].code[0].coding[0].display[0]General practitioner
Bundle.entry[4].resource[0].specialty[0].coding[0].system[0]https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode
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Bundle.entry[4].resource[0].specialty[0].coding[0].display[0]General Medical Practice
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Bundle.entry[5].resource[0].meta[0].profile[0]http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core
Bundle.entry[5].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[5].resource[0].identifier[0].value[0]9727710859
Bundle.entry[5].resource[0].name[0].extension[0].url[0]http://hl7.org/fhir/StructureDefinition/data-absent-reason
Bundle.entry[5].resource[0].name[0].extension[0].value[0]unsupported
Bundle.entry[5].resource[0].birthDate[0].extension[0].url[0]http://hl7.org/fhir/StructureDefinition/data-absent-reason
Bundle.entry[5].resource[0].birthDate[0].extension[0].value[0]unsupported
Bundle.entry[6].fullUrl[0]urn:uuid:1c38d507-9ad7-4b49-ba91-7da204842cac
Bundle.entry[6].resource[0].id[0]1c38d507-9ad7-4b49-ba91-7da204842cac
Bundle.entry[6].resource[0].meta[0].profile[0]http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab
Bundle.entry[6].resource[0].identifier[0].system[0]http://B82033-pickeringmedicalpractice.com/labrequest
Bundle.entry[6].resource[0].identifier[0].value[0]REQ-20220221-000018
Bundle.entry[6].resource[0].status[0]active
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