DRAFT Implementation Guide

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

NHS England North West GMSA - IHE Laboratory Testing Workflow (LTW) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Official URL: https://fhir.north-west.england.nhs.uk/ImplementationGuide/north-west.england.nhs.uk				Version: 0.0.1
Draft as of 2025-04-18				Computable Name: NWEngland_IHELTW

Introduction

This guide is to support Genomic Testing Workflow at a regional level and is designed to be compatible with:

• NHS England - FHIR Genomics Implementation Guide which defines the conformance requirements for Genomics in England
• NHS England - Genomic Order Management Service FHIR API a FHIR Workflow based service for managing orders and results at a national level.

Regional Integration Engine Scope

This guide follows IHE Laboratory Testing Workflow, which describes how to use HL7 v2 orders and reports at an enterprise level. It will contain several modifications in order to support HL7 FHIR Messasging, these messages will be closely related to HL7 v2 Messages to help with adoption. For documentation purposes, HL7 v2 version used will be 2.5.1 (this also matches NHS England FHIR Genomics, HL7 International v2 standards around structured Genomic reporting and Digital Health and Care Wales standards around ORU_R01)

GLH Regional Integration Engine (GLH RIE)

This implementation guide will be supported by a Genomics Regional Integration Engine (RIE) which will:

• Message Routing to deliver orders and reports to the regional GLH (and in the future national GLH’s).
• Message Translation to
  • LAB-1 convert HL7 FHIR based orders to HL7 v2 Messages (for Order Placer (local GLH))
  • LAB-3 convert HL7 v2 based results (from Order Placer (local GLH)) to HL7 FHIR Messages
• Message Bridge between regional Trust Integration Engines (TIE)/GLH Laboratory Information System (LIMS) and the national Genomic Order Management Service (LAB-4 and LAB-5)
• May contain a Structured Reporting Message Translation to convert HL7 v2 ORU_R01 structured reports to a HL7 Europe Laboratory Report to replace the use of PDF reports.

Testing

This implementation guide will also enable use of FHIR Testing tools such as Command Line FHIR Validation and Online FHIR Validation

SNOMED CT

UK edition of SNOMED (83821000000107)

Dependencies

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package fhir.r4.ukcore.stu3.currentbuild#0.0.19-pre-release UK Core FHIR profiles and Assets

Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. This includes two components: * Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains. *Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Credits

Role(s)	Contributor(s)
Enterprise Architect	Kevin Mayfield (Aire Logic/Mayfield IS)