Notice: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
Extensions
The UK Core extensions that are particularly relevant to pathology are listed below.
For a detailed description of all of the UK Core extensions (including examples) refer to UK Core Implementation Guide (STU3 Sequence) - Profiles and Extensions - Extensions Index.
It should be noted most of the pathology related extensions are linked to pre-adopted FHIR R5/R6 elements. For further information refer to UK Core Implementation Guide (STU3 Sequence) - Profiles and Extensions - Extensions Index - Pre-adopted R5/R6 Elements.
Extension-UKCore-DiagnosticReportComposition
This extension allows a Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.
JSON View
{
{
]
}
],
"description": "This extension allows a Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport.",
"purpose": "This is a use case from Genomics to backport R5 functionality and align with HL7 EU laboratory IG.",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
],
{
"definition": "A Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport."
},
{
},
{
"definition": "The Composition provides structure to the content of the DiagnosticReport (and only contains contents referenced in the DiagnosticReport) - e.g., to order the sections of an anatomic pathology structured report.",
]
}
]
}
}
Extension-UKCore-DiagnosticReportNote
An extension to support adding comments about the DiagnosticReport.
JSON View
{
{
]
}
],
"purpose": "This is a Genomics use case to support the backporting of R5 functionality to support adding general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation.",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
],
{
"definition": "May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation."
},
{
},
{
]
}
]
}
}
Extension-UKCore-DiagnosticReportSupportingInfo
An extension to support adding additional information relating to the DiagnosticReport.
Table View
| Extension | .. | |
| Extension.extension | 1.. | |
| Extension.extension:type | 1..1 | |
| Extension.extension:type.url | .. | |
| Extension.extension:type.value[x] | CodeableConcept | 1.. |
| Extension.extension:reference | 1..1 | |
| Extension.extension:reference.url | .. | |
| Extension.extension:reference.value[x] | Reference(DiagnosticReport | Observation | Procedure) | 1..1 |
| Extension.url | .. | |
| Extension.value[x] | ..0 |
JSON View
{
{
]
}
],
"purpose": "This is a Pathology use case to support the backporting of R5 functionality to support adding additional supporting information that was used in the creation of the diagnostic report.",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
],
{
"definition": "This backbone element contains supporting information that was used in the creation of the report not included in the results already included in the report."
},
{
},
},
{
"definition": "The code value for the role of the supporting information in the diagnostic report.",
}
},
{
},
{
]
},
{
},
{
},
{
{
"http://hl7.org/fhir/StructureDefinition/Procedure",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
]
}
]
},
{
},
{
}
]
}
}
Extension-UKCore-ObservationBodyStructure
An extension to support adding a BodyStructure on an Observation.
JSON View
{
{
]
}
],
"purpose": "This is a Pathology use case to support the backporting of R5 functionality to support adding a BodyStructure to an Observation.",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
],
{
"definition": "Indicates the body structure on the subject's body where the observation was made (i.e. the target site).",
},
{
},
{
{
}
]
}
]
}
}
Backport - DO NOT USE
This backport extension SHALL NOT be used due to an issue with PDM server that will cause a "FHIR resource in payload could not be parsed." error. This should be fixed shortly.Extension-UKCore-ObservationOrganizer
This extension indicates that an Observation is functioning as an organizer or grouper, referencing one or more subordinate Observations through hasMember element links. Within this implementation guide, the extension signifies that the Observation represents a test group — for example, a test battery, panel, or profile.
The extension is based on the organizer data element introduced in FHIR R6. Refer to the description of Observation.organizer in the base FHIR R6 Specification (Ballot - 3rd Draft) for more details.
JSON View
{
{
]
}
],
"description": "An extension to replicate the changes within R6 to support adding the organizer element to denote if the Observation instance is an organizer (other names are grouper / panel).",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
],
{
},
{
},
{
]
}
]
}
}
Example Usage
"extension": [ { "url": "http://hl7.org/fhir/6.0/StructureDefinition/extension-Observation.organizer", "valueBoolean": true } ],
Extension-UKCore-ObservationTriggeredBy
This extension supports the sharing of the Observation(s) that triggered the performance of the main observation.
Table View
| Extension | .. | |
| Extension.extension | 2.. | |
| Extension.extension:observation | 1..1 | |
| Extension.extension:observation.extension | ..0 | |
| Extension.extension:observation.url | .. | |
| Extension.extension:observation.value[x] | Reference(Observation) | 1.. |
| Extension.extension:type | 1..1 | |
| Extension.extension:type.extension | ..0 | |
| Extension.extension:type.url | .. | |
| Extension.extension:type.value[x] | code | 1.. |
| Extension.extension:reason | ..1 | |
| Extension.extension:reason.extension | ..0 | |
| Extension.extension:reason.url | .. | |
| Extension.extension:reason.value[x] | string | 1.. |
| Extension.url | .. | |
| Extension.value[x] | ..0 |
JSON View
{
{
]
}
],
"description": "This extension supports the sharing of the observation(s) that triggered the performance of the main observation.",
"purpose": "This is a Pathology use case to backport R5 functionality to identify the observation(s) that triggered the performance of this observation.",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
],
{
},
{
},
{
},
{
},
{
},
{
]
},
{
}
},
{
},
{
},
{
]
},
{
"definition": "Provides the reason why this observation was performed as a result of the observation(s) referenced.",
},
{
},
{
},
{
]
},
{
},
{
}
]
}
}
Extension-UKCore-SpecimenCollectionCollector
This extension allows the referencing of Patient and RelatedPerson within Specimen.collection.
JSON View
{
{
]
}
],
"purpose": "This is a use case from Genomics to backport R5 functionality extending the referencing of Specimen.collection.collector to include Patient and RelatedPerson",
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
],
{
},
{
},
{
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
]
}
]
}
}
Extension-valueset-reference
This extension allows the referencing of codes to a specific valueset. Within this implementation guide it is used to differentiate the SNOMED CT refsets in the UKCore-Observation-Lab.code element slicing.
Table View
| Extension | 0..1 | |
| Extension.id | string | 0..1 |
| Extension.extension | Extension | 0..0 |
| Extension.url | uri | 1..1 |
| Extension.value[x] | uri | 1..1 |
JSON View
{
{
},
{
}
],
"description": "A logical reference (e.g. a reference to ValueSet.url) that identifies the value set/version that identifies the set of possible coded values this coding was chosen from or constrained by.",
{
},
{
}
],
],
{
"definition": "A logical reference (e.g. a reference to ValueSet.url) that identifies the value set/version that identifies the set of possible coded values this coding was chosen from or constrained by.",
"comment": "If this extension is used with an [extensible binding](terminologies.html#extensible), and the concept comes from outside the bound valueset, the value set SHALL be different from the bound valueset.",
},
"ele-1"
],
{
},
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
},
],
{
},
{
}
],
},
{
"xmlAttr"
],
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
},
{
{
}
],
}
],
]
},
{
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/extensibility.html) for a list).",
},
],
{
}
],
]
}
]
},
{
"definition": "A logical reference (e.g. a reference to ValueSet.url) that identifies the value set/version that identifies the set of possible coded values this coding was chosen from or constrained by.",
"comment": "If this extension is used with an [extensible binding](terminologies.html#extensible), and the concept comes from outside the bound valueset, the value set SHALL be different from the bound valueset.",
]
},
{
},
{
},
{
}
]
}
}
Example Usage
The following shows the code 1000821000000103 | Serum albumin level | which is from the SNOMED CT PBCL Observables reference set. This code is equivalent to 1105861000000106 | Albumin mass concentration in serum | from the SNOMED CT PaLM Observables reference set.
"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": "1000821000000103", "display": "Serum albumin level" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/valueset-reference", "valueUri": "https://fhir.hl7.org.uk/ValueSet/UKCore-PathologyAndLaboratoryMedicineObservables" } ], "system": "http://snomed.info/sct", "code": "1105861000000106", "display": "Albumin mass concentration in serum" } ] }