This section documents proposed changes to be applied to the UK Core for the next release. These are highlighted to allow reviewers to comment on the proposed changes. Solutions for the issues which lead to these proposed changes may have been discussed on the Clinical and Technical Assurance Sprint 6 calls but can still be challenged by any reviewer.
| Number | Context | Type | Source | Issue | Proposal |
|---|---|---|---|---|---|
| Issue 1 | Specimen.type | Slice, Binding | UK Core development team | Open slice snomedCT from CareConnect | Remove slice, bind element to ValueSet UKCore-SpecimenType (preferred) |
| Issue 2 | Specimen.collection.bodySite | Slice, Binding | UK Core development team | Open slice snomedCT from CareConnect | Remove slice, bind element to ValueSet UKCore-SpecimenBodySite (preferred) |
| Issue 3 | Specimen.collection.bodySite | Extension, Backport | Genomic Medicine Service | R5 Functionality Change - CodeableConcept is now CodeableReference (BodyStructure) | Backport the R5 functionality as a new extension: Extension-UKCore-BodySiteReference |
| Issue 4 | Specimen | Extension | Genomic Medicine Service | Genomics use case to record the state of a sample, whether it is a Solid Tumour Sample, Liquid Tumour Sample, Normal Sample, or Germline Sample | Add a new extension: Extension-UKCore-SampleState |
| Issue 5 | Specimen.container.type | Binding | Genomic Medicine Service | Current binding is base and (example) strength | Review and assure the current bound ValueSet for UK suitability, extend / replace as needed, bind at element level with (preferred) strength |
| Issue 6 | Specimen.collection.collector | Backport | Genomic Medicine Service, Pathology | R5 functionality Change - now includes reference to Patient and RelatedPerson | Backport the R5 functionality by adding a reference the UKCore-Patient and UKCore-RelatedPerson profiles |
| Issue 7 | DiagnosticReport.category | Slice | UK Core development team | Open slice snomedCT from CareConnect | Remove slice |
| Issue 8 | DiagnosticReport.code | Slice, Binding | UK Core development team | Open slice snomedCT from CareConnect | Remove slice, bind element to ValueSet UKCore-ReportCodeSnCT (preferred) |
| Issue 9 | DiagnosticReport.conclusionCode | Slice, Binding | UK Core development team | Open slice snomedCT from CareConnect | Remove slice, bind element to ValueSet UKCore-FindingCode (preferred) |
| Issue 10 | DiagnosticReport | Profiles | UK Core development team | Current Profiles may not be optimal for implementers to use. | Create a draft UKCore-DiagnosticReport-Lab profile that can be reviewed. This work is underway and is being done in collaboration between England and Wales. |
| Issue 11 | Observation.code | Slice, Binding | UK Core development team | Open slice snomedCT from CareConnect | Proposal to remove slice, but this requires investigation to determine if technically possible to remove without impacting derived profiles. Remove slice, bind element to ValueSet UKCore-ObservationType (preferred) |
| Issue 12 | Observation.bodySite | Slice, Binding | UK Core development team | Open slice snomedCT from CareConnect | Remove slice, bind element to ValueSet UKCore-BodySite (preferred) |
| Issue 13 | Observation | Extension, Backport | Genomic Medicine Service, Pathology | R5 Functionality Change - New BackboneElement TriggeredBy, reference to triggering Observation | Backport the R5 functionality as a new extension: Extension-UKCore-TriggeredBy |
| Issue 14 | Observation | Profiles | UK Core development team | Current Profiles may not be optimal for implementers to use. | Proposal to create a specific derived Observation profile(s) to cover use cases, such as Lab observations, or a Header / Group to aid implementation. This work is underway and is being done in collaboration between England and Wales. |
| Issue 15 | Consent.policyRule | Binding | Genomic Medicine Service | Current bound (extensible) ValueSet is US centric | Review suggested sources of UK policies, create UK CodeSystem and ValueSet and bind at element level as needed |
| Issue 16 | ImagingStudy | Proposal | UK Core development team | As there no current use case(s) have been put forward for profiling ImagingStudy | There are Options: Remove draft profile, leave draft profile, review draft profile as is, current proposal is to review draft profile as is to allow it to be submitted for Ballot. |
| Issue 17 | FamilyMemberHistory.dataAbsentReason | Binding | Genomic Medicine Service | For Genomics use case, current (example) binding is not suitable | Genomics to review ValueSet, and expand / extend / replace as needed |
| Issue 18 | FamilyMemberHistory.relationship | Binding | Genomic Medicine Service | For Genomics use case, current (example) binding is not suitable | Genomics to review ValueSet, and expand / extend / replace as needed |
| Issue 19 | FamilyMemberHistory.reasonCode | Binding | Genomic Medicine Service | For Genomics use case, current (example) binding is not suitable | Genomics to review ValueSet, and expand / extend / replace as needed |
| Issue 20 | FamilyMemberHistory.condition.code | Binding | Genomic Medicine Service | For Genomics use case, current (example) binding is not suitable | Genomics to review ValueSet, and expand / extend / replace as needed |
| Issue 21 | FamilyMemberHistory.condition.outcome | Binding | Genomic Medicine Service | For Genomics use case, current (example) binding is not suitable | Genomics to review ValueSet, and expand / extend / replace as needed |
| Issue 22 | FamilyMemberHistory | Extension, CareConnect | Genomic Medicine Service | Genomics use case to record the the associated encounter for which Family Member History was recorded. This functionality already exists in an FHIR STU3 CareConnect Extension on the CareConnect FamilyMemberHistory profile. | Replicate STU3 extension in R4, as a new extension: Extension UKCore-AssociatedEncounter |
| Issue 23 | FamilyMemberHistory | Extension, CareConnect, Backport | Genomic Medicine Service | Genomics use case to record the practitioner that recorded the event. This functionality already exists in an FHIR STU3 CareConnect Extension on the CareConnect FamilyMemberHistory profile. R5 Functionality change - new BackboneElement, FamilyMemberHistory.participant, which has a reference to Practitioner | PractitionerRole | Patient | RelatedPerson | Device | Organization | CareTeam, and a code for the participants role.
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Options: Replicate STU3 extension in R4, as a new extension: Extension UKCore-Recorder, or backport the R5 functionality as a new extension: Extension-UKCore-Participant |
| Issue 24 | ServiceRequest.category | Binding | Genomic Medicine Service | Genomics use case to record, if the ServiceRequest.category is Whole Genome Sequencing (WGS)/non-WGS Rare Disease/Cancer |
Create a UK Core ValueSet, with base filtering, and filtering to WGS/non-WGS concepts provided by Genomics, bind to element as (preferred) strength |
| Issue 25 | ServiceRequest.orderDetail | Binding | Genomic Medicine Service | Genomics use case to expand this binding to all SNOMED CT procedure codes, in order to support panel testing. | Bind element to ValueSet UKCore-ProcedureCode (preferred) |
| Issue 26 | ServiceRequest | Extension | Genomic Medicine Service | Genomics use case to record who should be contacted regarding questions arising from a Genomics Test Order, along with their contact details. This differs from requester and responsibleClinician. | Add a new extension: Extension-UKCore-AdditionalContact, referencing Organization | Practitioner | PractitionerRole |
| Issue 27 | ServiceRequest | Extension | Genomic Medicine Service | Genomics use case to record the reason why an urgent test has been requested. This differs from supportingInfo in that it does not necessarily indicate why the test is being requested. | Add a new extension: Extension-UKCore-PriorityReason, with a binding to ValueSet UKCore-ServiceRequestReasonCode |
| Issue 28 | ServiceRequest | Extension | Genomic Medicine Service | Genomics use case to record the funding category for a ServiceRequest. It is expected this would be populated with a code indicating whether the service request is part of NHS coverage or private, and would be used for reimbursement purposes by receiving labs. | Add a new extension: Extension-UKCore-Coverage |
| Issue 29 | Patient | Extension | Genomic Medicine Service | Genomics use case to record why an NHS Number for the patient has not been provided within a test request. This differs from NHS Number trace status as this indicates reason. | Add a new extension: Extension-UKCore-NHSNumberUnavailableReason |
| Issue 30 | Organization.type | Binding | Genomic Medicine Service | Genomics use case to extend the codes available within Organization.type to record the org type as GLH (Genomic Lab Hub), GEL (Genomics England), or LAB (Other Genomics Laboratory), to aid in automated routing of request. |
Add CodeSystem, add ValueSet including base CodeSystem and UKCore code system, bind to element as (extensible) |