US Core Implementation Guide
7.0.0 - CI Build United States of America flag

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core Specimen Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-specimen Version: 7.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreSpecimenProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.42.56

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

This profile sets minimum expectations for the Specimen resource to record, search, and fetch “substances being sampled or tested. (e.g., nasopharyngeal swab, whole blood, serum, urine, wound swab)” associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases.

Example Usage Scenarios:

The following are example usage scenarios for the US Core Specimen profile:

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Specimen Must Have:

  1. a specimen code

Each Specimen Must Support:

  1. business identifier(s)*
  2. an accession identifier*
  3. a patient

Additional USCDI Requirements:

These Additional USCDI Requirements elements are not Mandatory or Must Support but are required for ONC Health IT certification testing and are included in the formal definition of the profile and the Specimen examples.

  1. specimen collection source site
  2. specimen condition*

* see guidance below

Profile Specific Implementation Guidance:

  • Since the binding is extensible when a code is unavailable, just text is allowed.
  • *Although both Specimen.identifier and Specimen.accessionIdentifier are marked as Must Support, the server system is not required to support both, but SHALL support at least one of these elements.
    • The client application SHALL support both elements.
  • *The specimen condition is used by the laboratory to determine the acceptability of a specimen for the ordered test. An individual specimen condition may be acceptable for one test, and not for another. The specimen condition is typically provided when the specimen does not meet the laboratory’s criteria for acceptability whether the test was performed or not. Examples include but are not limited to hemolyzed, clotted, container leaking, and missing patient name. This element may include information about the contents of the container, the container, and the label.
  • in addition to Specimen search criteria, clients may request Specimen resources be included with Observation or DiagnosticReport resource query. An example query is provided in the Notes section below.

Usage:

Changes since version 7.0.0-ballot:

  • The data elements list has changed
  • One or more text definitions, invariants or bindings have changed
  • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    This structure is derived from Specimen

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Specimen 0..*SpecimenSample for analysis
    ... identifier S0..*IdentifierSpecimen identifier
    ... accessionIdentifier S0..1IdentifierIdentifier assigned by the lab
    ... type S1..1CodeableConceptKind of material that forms the specimen
    Binding: Specimen type . (extensible)
    ... subject S0..1Reference(US Core Patient Profile S | Group | Device | Substance | US Core Location Profile)The patient where the specimen came from.
    ... collection 0..1BackboneElement𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Collection details
    .... bodySite 0..1CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen Source Site
    Binding: SNOMEDCTBodyStructures (extensible)
    ... condition 0..*CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen condition
    Binding: hl7VS-specimenCondition (extensible)

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Specimen.typeextensibleSpecimenType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54
    Specimen.collection.bodySiteextensibleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Specimen.conditionextensibleHl7VSSpecimenCondition
    http://terminology.hl7.org/ValueSet/v2-0493
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Specimen 0..*SpecimenSample for analysis
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier SΣ0..*IdentifierSpecimen identifier
    ... accessionIdentifier SΣ0..1IdentifierIdentifier assigned by the lab
    ... status ?!Σ0..1codeavailable | unavailable | unsatisfactory | entered-in-error
    Binding: SpecimenStatus (required): Codes providing the status/availability of a specimen.

    ... type SΣ1..1CodeableConceptKind of material that forms the specimen
    Binding: Specimen type . (extensible)
    ... subject SΣ0..1Reference(US Core Patient Profile)The patient where the specimen came from.
    ... collection 0..1BackboneElement𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Collection details
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... bodySite 0..1CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen Source Site
    Binding: SNOMEDCTBodyStructures (extensible)
    ... condition Σ0..*CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen condition
    Binding: hl7VS-specimenCondition (extensible)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Specimen.statusrequiredSpecimenStatus
    http://hl7.org/fhir/ValueSet/specimen-status|4.0.1
    from the FHIR Standard
    Specimen.typeextensibleSpecimenType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54
    Specimen.collection.bodySiteextensibleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Specimen.conditionextensibleHl7VSSpecimenCondition
    http://terminology.hl7.org/ValueSet/v2-0493

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorSpecimenIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorSpecimenIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceSpecimenA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Specimen 0..*SpecimenSample for analysis
    ... id Σ0..1idLogical id of this artifact
    ... meta Σ0..1MetaMetadata about the resource
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... language 0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    ... text 0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... extension 0..*ExtensionAdditional content defined by implementations
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier SΣ0..*IdentifierSpecimen identifier
    ... accessionIdentifier SΣ0..1IdentifierIdentifier assigned by the lab
    ... status ?!Σ0..1codeavailable | unavailable | unsatisfactory | entered-in-error
    Binding: SpecimenStatus (required): Codes providing the status/availability of a specimen.

    ... type SΣ1..1CodeableConceptKind of material that forms the specimen
    Binding: Specimen type . (extensible)
    ... subject SΣ0..1Reference(US Core Patient Profile S | Group | Device | Substance | US Core Location Profile)The patient where the specimen came from.
    ... receivedTime Σ0..1dateTimeThe time when specimen was received for processing
    ... parent 0..*Reference(Specimen)Specimen from which this specimen originated
    ... request 0..*Reference(ServiceRequest)Why the specimen was collected
    ... collection 0..1BackboneElement𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Collection details
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... collector Σ0..1Reference(Practitioner | PractitionerRole)Who collected the specimen
    .... collected[x] Σ0..1Collection time
    ..... collectedDateTimedateTime
    ..... collectedPeriodPeriod
    .... duration Σ0..1DurationHow long it took to collect specimen
    .... quantity 0..1SimpleQuantityThe quantity of specimen collected
    .... method 0..1CodeableConceptTechnique used to perform collection
    Binding: FHIRSpecimenCollectionMethod (example): The technique that is used to perform the procedure.

    .... bodySite 0..1CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen Source Site
    Binding: SNOMEDCTBodyStructures (extensible)
    .... fastingStatus[x] Σ0..1Whether or how long patient abstained from food and/or drink
    Binding: hl7VS-relevantClincialInformation (extensible): Codes describing the fasting status of the patient.

    ..... fastingStatusCodeableConceptCodeableConcept
    ..... fastingStatusDurationDuration
    ... processing 0..*BackboneElementProcessing and processing step details
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... description 0..1stringTextual description of procedure
    .... procedure 0..1CodeableConceptIndicates the treatment step applied to the specimen
    Binding: SpecimenProcessingProcedure (example): Type indicating the technique used to process the specimen.

    .... additive 0..*Reference(Substance)Material used in the processing step
    .... time[x] 0..1Date and time of specimen processing
    ..... timeDateTimedateTime
    ..... timePeriodPeriod
    ... container 0..*BackboneElementDirect container of specimen (tube/slide, etc.)
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... identifier Σ0..*IdentifierId for the container
    .... description 0..1stringTextual description of the container
    .... type 0..1CodeableConceptKind of container directly associated with specimen
    Binding: SpecimenContainerType (example): Type of specimen container.

    .... capacity 0..1SimpleQuantityContainer volume or size
    .... specimenQuantity 0..1SimpleQuantityQuantity of specimen within container
    .... additive[x] 0..1Additive associated with container
    Binding: hl7VS-additivePreservative (example): Substance added to specimen container.

    ..... additiveCodeableConceptCodeableConcept
    ..... additiveReferenceReference(Substance)
    ... condition Σ0..*CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen condition
    Binding: hl7VS-specimenCondition (extensible)
    ... note 0..*AnnotationComments

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Specimen.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Specimen.statusrequiredSpecimenStatus
    http://hl7.org/fhir/ValueSet/specimen-status|4.0.1
    from the FHIR Standard
    Specimen.typeextensibleSpecimenType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54
    Specimen.collection.methodexampleFHIRSpecimenCollectionMethod
    http://hl7.org/fhir/ValueSet/specimen-collection-method
    from the FHIR Standard
    Specimen.collection.bodySiteextensibleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Specimen.collection.fastingStatus[x]extensibleHl7VSRelevantClincialInformation
    http://terminology.hl7.org/ValueSet/v2-0916
    Specimen.processing.procedureexampleSpecimenProcessingProcedure
    http://hl7.org/fhir/ValueSet/specimen-processing-procedure
    from the FHIR Standard
    Specimen.container.typeexampleSpecimenContainerType
    http://hl7.org/fhir/ValueSet/specimen-container-type
    from the FHIR Standard
    Specimen.container.additive[x]exampleHl7VSAdditivePreservative
    http://terminology.hl7.org/ValueSet/v2-0371
    Specimen.conditionextensibleHl7VSSpecimenCondition
    http://terminology.hl7.org/ValueSet/v2-0493

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorSpecimenIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorSpecimenIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceSpecimenA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    This structure is derived from Specimen

    Differential View

    This structure is derived from Specimen

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Specimen 0..*SpecimenSample for analysis
    ... identifier S0..*IdentifierSpecimen identifier
    ... accessionIdentifier S0..1IdentifierIdentifier assigned by the lab
    ... type S1..1CodeableConceptKind of material that forms the specimen
    Binding: Specimen type . (extensible)
    ... subject S0..1Reference(US Core Patient Profile S | Group | Device | Substance | US Core Location Profile)The patient where the specimen came from.
    ... collection 0..1BackboneElement𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Collection details
    .... bodySite 0..1CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen Source Site
    Binding: SNOMEDCTBodyStructures (extensible)
    ... condition 0..*CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen condition
    Binding: hl7VS-specimenCondition (extensible)

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Specimen.typeextensibleSpecimenType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54
    Specimen.collection.bodySiteextensibleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Specimen.conditionextensibleHl7VSSpecimenCondition
    http://terminology.hl7.org/ValueSet/v2-0493

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Specimen 0..*SpecimenSample for analysis
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier SΣ0..*IdentifierSpecimen identifier
    ... accessionIdentifier SΣ0..1IdentifierIdentifier assigned by the lab
    ... status ?!Σ0..1codeavailable | unavailable | unsatisfactory | entered-in-error
    Binding: SpecimenStatus (required): Codes providing the status/availability of a specimen.

    ... type SΣ1..1CodeableConceptKind of material that forms the specimen
    Binding: Specimen type . (extensible)
    ... subject SΣ0..1Reference(US Core Patient Profile)The patient where the specimen came from.
    ... collection 0..1BackboneElement𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Collection details
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... bodySite 0..1CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen Source Site
    Binding: SNOMEDCTBodyStructures (extensible)
    ... condition Σ0..*CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen condition
    Binding: hl7VS-specimenCondition (extensible)

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Specimen.statusrequiredSpecimenStatus
    http://hl7.org/fhir/ValueSet/specimen-status|4.0.1
    from the FHIR Standard
    Specimen.typeextensibleSpecimenType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54
    Specimen.collection.bodySiteextensibleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Specimen.conditionextensibleHl7VSSpecimenCondition
    http://terminology.hl7.org/ValueSet/v2-0493

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorSpecimenIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorSpecimenIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceSpecimenA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Specimen 0..*SpecimenSample for analysis
    ... id Σ0..1idLogical id of this artifact
    ... meta Σ0..1MetaMetadata about the resource
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... language 0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    ... text 0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... extension 0..*ExtensionAdditional content defined by implementations
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier SΣ0..*IdentifierSpecimen identifier
    ... accessionIdentifier SΣ0..1IdentifierIdentifier assigned by the lab
    ... status ?!Σ0..1codeavailable | unavailable | unsatisfactory | entered-in-error
    Binding: SpecimenStatus (required): Codes providing the status/availability of a specimen.

    ... type SΣ1..1CodeableConceptKind of material that forms the specimen
    Binding: Specimen type . (extensible)
    ... subject SΣ0..1Reference(US Core Patient Profile S | Group | Device | Substance | US Core Location Profile)The patient where the specimen came from.
    ... receivedTime Σ0..1dateTimeThe time when specimen was received for processing
    ... parent 0..*Reference(Specimen)Specimen from which this specimen originated
    ... request 0..*Reference(ServiceRequest)Why the specimen was collected
    ... collection 0..1BackboneElement𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Collection details
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... collector Σ0..1Reference(Practitioner | PractitionerRole)Who collected the specimen
    .... collected[x] Σ0..1Collection time
    ..... collectedDateTimedateTime
    ..... collectedPeriodPeriod
    .... duration Σ0..1DurationHow long it took to collect specimen
    .... quantity 0..1SimpleQuantityThe quantity of specimen collected
    .... method 0..1CodeableConceptTechnique used to perform collection
    Binding: FHIRSpecimenCollectionMethod (example): The technique that is used to perform the procedure.

    .... bodySite 0..1CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen Source Site
    Binding: SNOMEDCTBodyStructures (extensible)
    .... fastingStatus[x] Σ0..1Whether or how long patient abstained from food and/or drink
    Binding: hl7VS-relevantClincialInformation (extensible): Codes describing the fasting status of the patient.

    ..... fastingStatusCodeableConceptCodeableConcept
    ..... fastingStatusDurationDuration
    ... processing 0..*BackboneElementProcessing and processing step details
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... description 0..1stringTextual description of procedure
    .... procedure 0..1CodeableConceptIndicates the treatment step applied to the specimen
    Binding: SpecimenProcessingProcedure (example): Type indicating the technique used to process the specimen.

    .... additive 0..*Reference(Substance)Material used in the processing step
    .... time[x] 0..1Date and time of specimen processing
    ..... timeDateTimedateTime
    ..... timePeriodPeriod
    ... container 0..*BackboneElementDirect container of specimen (tube/slide, etc.)
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... identifier Σ0..*IdentifierId for the container
    .... description 0..1stringTextual description of the container
    .... type 0..1CodeableConceptKind of container directly associated with specimen
    Binding: SpecimenContainerType (example): Type of specimen container.

    .... capacity 0..1SimpleQuantityContainer volume or size
    .... specimenQuantity 0..1SimpleQuantityQuantity of specimen within container
    .... additive[x] 0..1Additive associated with container
    Binding: hl7VS-additivePreservative (example): Substance added to specimen container.

    ..... additiveCodeableConceptCodeableConcept
    ..... additiveReferenceReference(Substance)
    ... condition Σ0..*CodeableConcept𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Specimen condition
    Binding: hl7VS-specimenCondition (extensible)
    ... note 0..*AnnotationComments

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Specimen.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Specimen.statusrequiredSpecimenStatus
    http://hl7.org/fhir/ValueSet/specimen-status|4.0.1
    from the FHIR Standard
    Specimen.typeextensibleSpecimenType .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54
    Specimen.collection.methodexampleFHIRSpecimenCollectionMethod
    http://hl7.org/fhir/ValueSet/specimen-collection-method
    from the FHIR Standard
    Specimen.collection.bodySiteextensibleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Specimen.collection.fastingStatus[x]extensibleHl7VSRelevantClincialInformation
    http://terminology.hl7.org/ValueSet/v2-0916
    Specimen.processing.procedureexampleSpecimenProcessingProcedure
    http://hl7.org/fhir/ValueSet/specimen-processing-procedure
    from the FHIR Standard
    Specimen.container.typeexampleSpecimenContainerType
    http://hl7.org/fhir/ValueSet/specimen-container-type
    from the FHIR Standard
    Specimen.container.additive[x]exampleHl7VSAdditivePreservative
    http://terminology.hl7.org/ValueSet/v2-0371
    Specimen.conditionextensibleHl7VSSpecimenCondition
    http://terminology.hl7.org/ValueSet/v2-0493

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-2errorSpecimenIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorSpecimenIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5errorSpecimenIf a resource is contained in another resource, it SHALL NOT have a security label
    : contained.meta.security.empty()
    dom-6best practiceSpecimenA resource should have narrative for robust management
    : text.`div`.exists()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() or (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    This structure is derived from Specimen

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:


    Quick Start


    Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • See the General Requirements section for additional rules and expectations when a server requires status parameters.
    • See the General Guidance section for additional guidance on searching for multiple <patient user system>s.

    US Core Scopes

    Servers providing access to specimen data SHALL support these US Core SMART Scopes:

    Mandatory Search Parameters:

    The following search parameters and search parameter combinations SHALL be supported:

    1. SHALL support both read Specimen by id AND Specimen search using the _id search parameter:

      GET [base]/Specimen/[id] or GET [base]/Specimen?_id=[id]

      Example:

      1. GET [base]/Specimen?_id=123

      Implementation Notes: (how to search by the logical id of the resource)

    Optional Search Parameters:

    The following search parameter combinations SHOULD be supported:

    1. SHOULD support searching for all specimens for a patient using the patient search parameter:

      GET [base]/Specimen?patient={Type/}[id]

      Example:

      1. GET [base]/Specimen?patient=1137192

      Implementation Notes: Fetches a bundle of all Specimen resources for the specified patient (how to search by reference)

    Including Specimen when searching for an Observation or DiagnosticReport

    Servers MAY support the _include parameter to request that additional resources be included in the response of a search query. For example, when searching for an Observation or DiagnosticReport that references Specimen, the client can use the _include parameter to retrieve information about a specimen associated with the search results. The syntax for querying an Observation and the associated Specimen is:

    GET [base]/[Resource-type]?[parameter1]=[value1]{&...}&_include=Observation:specimen

    Example:

    GET [base]/Observation?_id=9163726&_include=Observation:specimen