UK Core Clinical and Technical Assurance Sprint 6 Documentation Pack

UK Core Clinical and Technical Assurance Sprint 6 Documentation Pack

Proposed Changes

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 UKCore-Specimen.type Slice, Binding UK Core development team Open slice snomedCT from CareConnect Remove slice, bind element to ValueSet-UKCore-SpecimenType (preferred)
Issue 2 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-DiagnosticReport.category Slice UK Core development team Open slice snomedCT from CareConnect Remove slice
Issue 8 UKCore-DiagnosticReport.code Slice, Binding UK Core development team Open slice snomedCT from CareConnect Remove slice, bind element to ValueSet-UKCore-ReportCode (preferred)
Issue 9 UKCore-DiagnosticReport.conclusionCode Slice, Binding UK Core development team Open slice snomedCT from CareConnect Remove slice, bind element to ValueSet-UKCore-FindingCode (preferred)
Issue 10 UKCore-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 UKCore-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 UKCore-Observation.bodySite Slice, Binding UK Core development team Open slice snomedCT from CareConnect Remove slice, bind element to ValueSet-UKCore-BodySite (preferred)
Issue 13 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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.
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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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 UKCore-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)



The Design and Development Approach used for the UK Core assets is documented online.

See below for specific FHIR R4 guidance on:
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