Profiles and Extensions

Extensions Index

This extension library contains all the extensions Clinically and Technically Assured for use with UK Core. The profiles are found in the Profiles Index. The table below lists all the current extensions and the context of use.

The context of use column indicates the profile and /or element where the extension may be applied. The modifier extension column indicates whether the extension is a modifier extension or not.

The general rule is extensions can be ignored by receivers*. When a modifier extension is received it SHALL NOT be ignored as it modifies the meaning of the element or elements that contains it. Typically, this means information that qualifies or negates the primary meaning of the element that contains it.

For more information from HL7 about FHIR extensions

For more information from HL7 about FHIR Modifier extensions

*There may be specific use cases where this is not the case and the Domain Implementation Guidance associated with the use case SHOULD be consulted.

UK Core Extensions

The Extensions listed below have been defined as UK Core extensions. Also included in this library are some HL7 core-defined extensions which have been added to the UK Core profiles because they have been deemed to be "core" to UK FHIR data exchanges. These will have a page with guidance on usage in the UK and examples to illustrate usage.

Note: implementers of UK Core MAY use any HL7 core-defined extension from the HL7 standard regardless of whether the extension is included in this implementation guide. The list of core-defined extensions in FHIR R4 is available in the HL7 Core-defined Extension Registry.

Implementers of the UK Core profiles MAY also create their own Extensions where required, but are encouraged to engage with the UK Core development process to ensure that there is not an existing suitable extension available, and to assist in guidance around the use of an extension with the UK Core, and with wider use by the UK FHIR Community.

Narrative Listing

Extensions Status Context of Use Related Profile Modifier Extension C&TA Sprint
Extension UKCore-AdditionalContact active ServiceRequest Profile UKCore-ServiceRequest NO 6
Extension UKCore-AddressKey active Address Profile UKCore-Patient NO 1
Extension UKCore-AdmissionMethod active Encounter.hospitalization Profile UKCore-Encounter NO 4
Extension UKCore-AllergyIntoleranceEnd active AllergyIntolerance.
clinicalStatus		 Profile UKCore-AllergyIntolerance NO 2
Extension UKCore-AssociatedEncounter active FamilyMemberHistory Profile UKCore-FamilyMemberHistory NO 6
Extension UKCore-BirthSex active Patient Profile UKCore-Patient NO 1
Extension UKCore-BodySiteReference active Specimen.collection.bodySite Profile UKCore-Specimen NO 6
Extension UKCore-BookingOrganization active Appointment Profile UKCore-Appointment NO 5
Extension UKCore-CareSettingType active Composition
List 		Profile UKCore-Composition
Profile UKCore-List		 NO 4
Extension UKCore-CodingSCTDescDisplay active Coding All clinical profiles that can use SNOMED CT. See the extension page for information about how this is used in profiles. NO 2
Extension UKCore-ConditionEpisode active Condition Profile UKCore-Condition NO 4
Extension UKCore-ContactPreference active Patient,
RelatedPerson		 Profile UKCore-Patient
Profile UKCore-RelatedPerson		 NO 1
Extension UKCore-ContactRank active Patient.contact Profile UKCore-Patient NO 1
Extension UKCore-Coverage active ServiceRequest Profile UKCore-ServiceRequest NO 6
Extension UKCore-CopyCorrespondenceIndicator active Patient.contact,
RelatedPerson		 Profile UKCore-Patient
Profile UKCore-RelatedPerson		 NO 1
Extension UKCore-CuffSize draft Device Profile UKCore-Device-BloodPressure NO 7
Extension UKCore-DeathNotificationStatus active Patient Profile UKCore-Patient NO 1
Extension UKCore-DeliveryChannel active Appointment, Slot Profile UKCore-Appointment
Profile UKCore-Slot		 NO 5
Extension UKCore-DeviceReference active DiagnosticReport.performer,
DiagnosticReport.
resultsInterpreter		 Profile UKCore-DiagnosticReport NO 6
Extension UKCore-DischargeMethod active Encounter Profile UKCore-Encounter NO 4
Extension UKCore-EmergencyCareDischargeStatus active Encounter Profile UKCore-Encounter NO 4
Extension UKCore-EthnicCategory active Patient Profile UKCore-Patient NO 1
Extension UKCore-Evidence active AllergyIntolerance Profile UKCore-AllergyIntolerance NO 2
Extension UKCore-LegalStatus active Encounter Profile UKCore-Encounter NO 4
Extension UKCore-ListWarningCode active List Profile UKCore-List NO 4
Extension UKCore-MainLocation active Organization Profile UKCore-Organization NO 1
Extension UKCore-MedicationPrescribingOrganizationType active MedicationStatement Profile UKCore-MedicationStatement NO 3
Extension UKCore-MedicationRepeatInformation active MedicationRequest Profile UKCore-MedicationRequest NO 3
Extension UKCore-MedicationStatementLastIssueDate active MedicationStatement Profile UKCore-MedicationStatement NO 3
Extension UKCore-MedicationTradeFamily active Medication Profile UKCore-Medication NO 3
Extension UKCore-NHSNumberUnavailableReason active Patient Profile UKCore-Patient NO 6
Extension UKCore-NHSNumberVerificationStatus active Patient.identifier Profile UKCore-Patient NO 1
Extension UKCore-OtherContactSystem active ContactPoint.system,
Patient.telecom.system,
RelatedPerson.telecom.system		 Profile UKCore-Patient
Profile UKCore-RelatedPerson		 NO 1
Extension UKCore-OutcomeOfAttendance active Encounter Profile UKCore-Encounter NO 4
Extension UKCore-ParentPresent active Immunization Profile UKCore-Immunization NO 3
Extension UKCore-PharmacistVerifiedIndicator active MedicationStatement Profile UKCore-MedicationStatement NO 3
Extension UKCore-PriorityReason active ServiceRequest.priority Profile UKCore-ServiceRequest NO 6
Extension UKCore-RecordingSetting draft Observation Profile UKCore-Observation-VitalSigns NO 7
Extension UKCore-ResidentialStatus active Patient Profile UKCore-Patient NO 1
Extension UKCore-SampleCategory active Specimen Profile UKCore-Specimen NO 6
Extension UKCore-SourceOfServiceRequest active ServiceRequest Profile UKCore-ServiceRequest NO 5
Extension UKCore-VaccinationProcedure active Immunization Profile UKCore-Immunization NO 3

HL7 Core-defined Extensions

The following HL7 Core-defined Extensions have been agreed as suitable to be included for use with the UK Core Profiles because the use case for an Extension is fully met by a pre-existing HL7 Core-defined Extension.

Implementers of the UK Core profiles MAY also use other HL7 core-defined extensions to extend the UK Core if required by the local implementation, but are encouraged to engage with the UK Core development process to add guidance into the UK Core for wider use by the UK FHIR Community.

HL7 Core-defined Extension Context of Use Related Profile Modifier Extension
Extension coding-sctdescid Coding Use on Element ID Coding NO
Extension observation-bodyPosition Observation Profile UKCore-Observation-VitalSigns NO
Extension organization-period Organization Profile UKCore-Organization NO
Extension patient-birthPlace Patient Profile UKCore-Patient NO
Extension patient-birthTime Patient.birthDate Profile UKCore-Patient NO
Extension patient-cadavericDonor Patient Profile UKCore-Patient NO
Extension patient-interpreterRequired Patient Profile UKCore-Patient NO
Core-defined Extension patient-proficiency Patient Profile UKCore-Patient NO
Extension specimen-specialHandling Specimen.collection Profile UKCore-Specimen NO

Pre-adopted R5 Elements

The following R5 elements have been agreed as suitable to be included for use with the UK Core Profiles because the use case for pre-adopting an R5 element as an Extension, rather than creating a UK Core specific extension is fully met.

As of 19/05/2023, the package to enable pre-adopted elements to function as per the guidance, is not available. To enable rendering and validation of these pre-adopted elements, we have provided UK Core proxy extensions, as per the current threads on chat.fhir.org, with the R5 canonical urls. These proxy extensions will be retired once the HL7 package is released.

R5 Element Related Profile Proxy Extension Modifier Extension
DiagnosticReport.composition Profile UKCore-DiagnosticReport
Profile UKCore-DiagnosticReport-Lab		 Extension UKCore-DiagnosticReportComposition NO
DiagnosticReport.note Profile UKCore-DiagnosticReport
Profile UKCore-DiagnosticReport-Lab		 Extension UKCore-DiagnosticReportNote NO
DiagnosticReport.supportingInfo Profile UKCore-DiagnosticReport
Profile UKCore-DiagnosticReport-Lab		 Extension UKCore-DiagnosticReportSupportingInfo NO
FamilyMemberHistory.participant Profile UKCore-FamilyMemberHistory Extension UKCore-FamilyMemberHistoryParticipant NO
Observation.bodyStructure Profile UKCore-Observation
Profile UKCore-Observation-Lab
Profile UKCore-Observation-Group-Lab		 Extension UKCore-ObservationBodyStructure NO
Observation.triggeredBy Profile UKCore-Observation
Profile UKCore-Observation-Lab
Profile UKCore-Observation-Group-Lab		 Extension UKCore-ObservationTriggeredBy NO
Specimen.collection.collector Profile UKCore-Specimen Extension UKCore-SpecimenCollectionCollector NO