Artifacts Summary

North West Genomics Testing Workflow (GTW)
0.0.1 - ci-build flag

DRAFT Implementation Guide

This is for collaboration and discussion purposes and is subject to change.

North West Genomics Testing Workflow (GTW) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Contents:

Requirements: Actor Definitions
Behavior: Capability Statements
Behavior: Operation Definitions
Behavior: Message Definitions
Structures: Questionnaires
Structures: Resource Profiles
Structures: Data Type Profiles
Structures: Extension Definitions
Terminology: Value Sets
Terminology: Code Systems
Example: Example Instances
MFT EPIC Examples

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Requirements: Actor Definitions

The following artifacts define the types of individuals and/or systems that will interact as part of the use cases covered by this implementation guide.

Automation Manager

Manages the Order. This is the function of Genomic Order Management Service and/or GLH LIMS

Clinical Document

From ISO-13606 The set of information committed to one EHR as a result of a clinical encounter or a record documentation session. Examples of COMPOSITION are Progress note, Laboratory test result form, Radiology report, Referral letter, Clinic visit, Clinic letter, Discharge summary, Functional health assessment, Diabetes review.

Intermediary

North West GLH Regional Integration Engine (RIE) This is a Trust Integration Engine (TIE) working at a regional level

Order Filler

Fulfils the Order. The Order Filler Actor is implemented by laboratory information management systems.

Order Placer

Creates the Order. The Order Placer Actor is implemented by the systems used by the clinical practice.

Order Result Tracker

Allows practitioners to view the Genomics Test Report (e.g. Patient Pass or EPR)

Patient Identity Source

Source of the patient demographics change. The Patient Identity Source is implemented by the systems used for patient administration (e.g. PAS or EPR).

Provider Information Source

Source of the provider information change. The Provider Information Source is implemented by the systems used for patient administration (e.g. PAS or EPR) or Organisation Directories (LDAP/X.500).

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

CapabilityStatement for MFT Regional Integration Engine for Genomics

Is based on FHIR Messaging to handle transformation of HL7 FHIR and v2 Messages to FHIR Workflow.

The OpenAPISwagger Definition file below, can be viewed using Swagger Editor

Behavior: Operation Definitions

These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.

Process Message

This is documentation on the version of HL7 FHIR process-message to be used for regional FHIR Messaging, this HL7 FHIR definition SHALL be followed.

Behavior: Message Definitions

These define the types of messages that can be sent and/or received by systems conforming to this implementation guide.

Message Definition - Laboratory Order

DRAFT conversion of HL7 v2.5.1 OML_O21

Message Definition - Laboratory Order Acknowledgement

DRAFT conversion of HL7 v2.5.1 ORL_O22.

At present it is not intended to support Patient and ServiceRequest resources

Message Definition - Unsolicited Observation

DRAFT conversion of HL7 v2.5.1 ORU_R01

Structures: Questionnaires

These define forms used by systems conforming to this implementation guide to capture or expose data to end users.

Example Genomics Test Order Form

Example Genomics Test Order Form (Mock).

Master HL7 genetic variant reporting panel

Master HL7 genetic variant reporting panel Questionnaire Viewer

NW Genomics Test Order Form (Minimal Dataset)

NW Genomics Test Order (Minimal Dataset)

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Composition

DRAFT Extension of EU Lab Composition (and so IPS Composition)

Condition

DRAFT Extension of UKCore-Condition

Diagnostic Report

DRAFT Extension of UK Core DiagnosticReport which includes constraints from:

NHS England Genomics DiagnosticReport use text descriptions only, not the rendered profile.

DocumentReference

Based on UK Definitions from IHE Europe Metadata for exchange medical documents and images

Encounter

DRAFT Extension of UKCore-Encounter which includes constraints from:

HL7 PV1 segment definitions from NHS England HL7 v2 ADT Message Specification

MessageHeader

DRAFT

Observation

DRAFT Extension of UKCore-Observation

Observation Panel

DRAFT For use with Order Entry Forms

OperationOutcome

DRAFT Extension of OperationOutcome

Organization

DRAFT Extension of UKCore Organization which includes elements from:

Patient

DRAFT Extension of UKCore-Patient which includes constraints from:

NHS England Genomics Patient use text descriptions only, not the rendered profile.
HL7 PID segment definitions from NHS England HL7 v2 ADT Message Specification

Practitioner

DRAFT Extension of UKCore Practitioner which includes elements from:

PractitionerRole

DRAFT Extension of UKCore PractitionerRole

Procedure

DRAFT Extension of UKCore-Procedure

QuestionnaireResponse

DRAFT Initial elaboration

RequestGroup

DRAFT To provide grouping of individual ServiceRequests in the Test Order

ServiceRequest

DRAFT Extension of UKCore-ServiceRequest which includes constraints from:

NHS England Genomics ServiceRequest use text descriptions only, not the rendered profile.

Specimen

DRAFT Extension of UKCore-Specimen which includes constraints from:

NHS England Genomics Specimen use text descriptions only, not the rendered profile.

Structures: Data Type Profiles

These define constraints on FHIR data types for systems conforming to this implementation guide.

Accession Number

Usually assigned by the order filler.

Attachment

DRAFT: Additional conformance on FHIR Attachment data type. In HL7 FHIR this is likely to be a Binary resource and in HL7 v2 the OBX segment. When laboratory reports include a url link in DiagnosticReport, the FHIR Bundle should also include a FHIR DocumentReference providing additional document metadata.

CodeableReference

Backport of FHIR R5 CodeableReference. (copied from BE eHealth Platform Federal Core Profiles). Extension able to hold a reference and a concept (Temporary solution until https://jira.hl7.org/browse/FHIR-44661 is solved and see Zulip: https://chat.fhir.org/#narrow/stream/179280-fhir.2Finfrastructure-wg/topic/Backporting.20CodeableReference)

Correlation Identifier

See Enterprise Integration Patterns - Correlation Identifier and Rule 3: Reference Other Aggregates by Identity (Implementing Domain Driven Design)

England Practitioner Identifier

NHS Data Dictionary CONSULTANT CODE and GENERAL MEDICAL PRACTITIONER PPD CODE.

Filler Order Number

HL7 v2 Filler Order Number (ORC-3)

Medical Record Number

Only use in References Data Type if the NHS Number is not known or unverified.

NHS Number

Only traced NHS Number SHOULD be used, un-traced NHS Numbers MUST be clearly indicated.

Organisation Code

NHS Data Dictionary ORGANISATION_CODE

Organisation Site Code

NHS Data Dictionary ORGANISATION SITE IDENTIFIER

Use ODS Site code relevant for organisation. E.g. Use Mid Yorkshire Hospitals NHS Trust (RXF) version of Pinderfields Hospital (RXF05) when referring to Mid Yorks, not others in the director

Placer Group Number

HL7 v2 Placer Group Number (ORC-4)

Placer Order Number

HL7 v2 Placer Order Number (ORC-2)

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

ExtCodeableReference

(copied from BE eHealth Platform Federal Core Profiles) Extension able to hold a reference and a concept (Temporary solution until https://jira.hl7.org/browse/FHIR-44661 is solved and see Zulip: https://chat.fhir.org/#narrow/stream/179280-fhir.2Finfrastructure-wg/topic/Backporting.20CodeableReference )