Cancer Pathology Data Sharing
0.1.0 - STU 1 Ballot

Cancer Pathology Data Sharing, published by HL7 International - Orders and Observations. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of and changes regularly. See the Directory of published versions



  • Message Sender: An application sending a pathology report message to a consumer. This actor may be the creator of the message but could also be an intermediary. This can be thought of as the server in a client/server interaction.
  • Message Destination: An application that receives the pathology report message. This can be thought of as the client in a client/server interaction.

FHIR Paradigms Supported by This IG

  • RESTful API
  • FHIR Messaging

Resources and Profiles

Resource Profiles

This specification defines the following profiles:

  • US Pathology Bundle
  • US Pathology MessageHeader
  • US Pathology Diagnostic Report
  • US Pathology Specimen
  • US Pathology Next of Kin
  • US Pathology Related Practitioner Roles


This implementation guide defines no new extensions.

Claiming Conformance to This Specification

This specification conforms to US Core Profiles. To claim conformance to this specification, servers SHALL:

  • Be able to populate all profile data elements that have a minimum cardinality >= 1 and/or flagged as Must Support as defined by that profile’s StructureDefinition.
  • Conform to this IG’s Server Capability Statement expectations for that profile’s type.

Details on profiles and extensions present in this specification are available on the Artifact Index page.

Must Support and Missing Data

Systems claiming to conform to a profile SHALL support the elements in a profile as defined below. This guide adopts the following definitions of MustSupport for all direct transactions between the Sending and Receiving Systems.

All Sending Systems: Sending Systems are defined as Provider Systems and applications.

  • As part of the sending of a US Pathology Bundle, the Sender SHALL be capable of including all elements defined in the profiles that have a MustSupport flag and SHALL populate all elements with a MustSupport flag if the information exists.
  • In situations where information on a particular data element is not present, the Sender SHALL NOT include the data element in the resource instance if the cardinality is 0..n.
  • If the information does not exist and the cardinality of the element is >= 1..*, the Sender SHALL use the dataAbsentReason extension where it is defined. Note: populating the element with the value set absent reason or using the dataAbsent Reason SHOULD be handled by the Sending System and not require provider action.

**All Receiving Systems: **Receiving Systems are defined as Provider Systems and applications receiving transactions from the Sending System.

  • The Receiving System SHALL be capable of processing resource instances containing required and allowed data elements without generating an error or causing the application to fail.
  • Receiving Systems SHOULD be capable of processing (display, store, etc.) the data elements based on the utility of the specific element to the receiver.
  • When receiving a US Pathology Bundle from the Sender, the Receiving System SHALL interpret missing data elements within resource instances as data not present in the Senders systems.
  • Receiving Systems SHALL be able to process resource instances containing data elements asserting missing information without generating an error or causing the application to fail.

Conformance to US Core Profile

Where this IG does not additionally constrain a US Core profile, the actors shall follow the US Core definition of Must Support and Missing Data.

Privacy and Security

Systems implementing this guide are expected to follow the general FHIR Security guidelines, as well as all additionally applicable public and private laws and policies.