HL7 Czech Base and Core Implementation Guide
0.3.0-ballot - ci-build

HL7 Czech Base and Core Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.3.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/cz-core/ and changes regularly. See the Directory of published versions

## Resource Profile: CZ_Specimen - Detailed Descriptions

Draft as of 2025-12-19

Definitions for the cz-specimen resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. Specimen
Definition | Czech national profile defines how to represent Specimens in HL7 FHIR. A sample to be used for analysis.
Short | Czech SpecimenSample for analysis
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If 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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Specimen.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Specimen.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Specimen.identifier
Definition | Business identifier for specimen is RECOMMENDED to include when available. Id for specimen.
Short | External Identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Specimen.status
Definition | The availability of the specimen.
Short | available | unavailable | unsatisfactory | entered-in-error
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 0..1
Binding | The codes SHALL be taken from SpecimenStatus http://hl7.org/fhir/ValueSet/specimen-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/specimen-status|4.0.1` ) Codes providing the status/availability of a specimen.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Specimen.type
Definition | The kind of material that forms the specimen. RECOMMENDED to include. The kind of material that forms the specimen.
Short | Kind of material that forms the specimen
Comments | The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.
Control | 0..1
Binding | The codes SHOULD be taken from For example codes, see https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-type-vs http://terminology.hl7.org/ValueSet/v2-0487 (preferred to `https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-type-vs` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Specimen.subject
Definition | Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.
Short | In the initial iteration of the Czech interoperability project, this is CZ_PatientCore.Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device
Control | 0..1
Type | Reference(Group, Device: Performer/Observer (CZ), Medical Device (CZ), Substance, Location (CZ core), Patient (CZ core), Patient, Group, Device, Substance, Location)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | Must know the subject context.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Specimen.receivedTime
Definition | Time when specimen was received for processing or testing.
Short | The time when specimen was received for processing
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Specimen.parent
Definition | Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen.
Short | Specimen from which this specimen originated
Comments | The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.
Control | 0..*
Type | Reference(Specimen (CZ), Specimen)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Specimen.request
Definition | Details concerning a service request that required a specimen to be collected.
Short | Why the specimen was collected
Comments | The request may be explicit or implied such with a ServiceRequest that requires a blood draw.
Control | 0..*
Type | Reference(ServiceRequest)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Specimen.processing
Definition | Details concerning processing and processing steps for the specimen.
Short | Processing and processing step details to include when not implicit from specimen.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Specimen.processing.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Specimen.processing.additive
Definition | Material used in the processing step.
Short | Material used in the processing step
Control | 0..*
Type | Reference(Substance, Substance: Specimen Additive Substance (CZ), Substance)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Specimen.condition
Definition | A mode or state of being that describes the nature of the specimen.
Short | State of the specimen
Comments | Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from hl7VS-specimenCondition http://terminology.hl7.org/ValueSet/v2-0493 (extensible to `http://terminology.hl7.org/ValueSet/v2-0493` ) Codes describing the state of the specimen.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | The specimen condition can be used to assess its quality or appropriateness for a specific test.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Specimen.note
Definition | To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).
Short | Comments
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Specimen
Definition | Czech national profile defines how to represent Specimens in HL7 FHIR.
Short | Czech Specimen
2. Specimen.identifier
Definition | Business identifier for specimen is RECOMMENDED to include when available.
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
4. Specimen.status
Must Support | true
6. Specimen.type
Definition | The kind of material that forms the specimen. RECOMMENDED to include.
Binding | The codes SHOULD be taken from https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-type-vs (preferred to `https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-type-vs` )
8. Specimen.subject
Short | In the initial iteration of the Czech interoperability project, this is CZ_PatientCore.
Type | Reference(Group, Device: Performer/Observer (CZ), Medical Device (CZ), Substance, Location (CZ core), Patient (CZ core))
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
10. Specimen.receivedTime
Must Support | true
12. Specimen.parent
Type | Reference(Specimen (CZ))
Must Support | true
14. Specimen.request
Must Support | true
16. Specimen.collection
18. Specimen.collection.extension
Slicing | This element introduces a set of slices on `Specimen.collection.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
20. Specimen.collection.extension:bodySite
Slice Name | bodySite
Control | 0..1
Type | Extension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
22. Specimen.collection.extension:bodySite.value[x]
Type | Reference(Body Structure (CZ))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
24. Specimen.collection.collector
Type | Reference(Practitioner (CZ core), Practitioner Role (CZ core))
26. Specimen.collection.bodySite
Comments | If the specimen.type conveys information about the site the specimen has been collected from, then, if the bodySite is present, it shall be coherent with the type
Binding | The codes SHOULD be taken from SNOMEDCTBodyStructures (preferred to `http://hl7.org/fhir/ValueSet/body-site` )
28. Specimen.processing
Short | Processing and processing step details to include when not implicit from specimen.
30. Specimen.processing.additive
Type | Reference(Substance, Substance: Specimen Additive Substance (CZ))
32. Specimen.container
34. Specimen.container.extension
Slicing | This element introduces a set of slices on `Specimen.container.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
36. Specimen.container.extension:device
Slice Name | device
Control | 0..1
Type | Extension(Extension Definition for Specimen.container.device for Version 5.0) (Extension Type: Reference(Device))
38. Specimen.container.extension:device.value[x]
Type | Reference(Medical Device (CZ))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
40. Specimen.container.type
Binding | The codes SHOULD be taken from https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-container (preferred to `https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-container` )
42. Specimen.container.additive[x]
Control | 0..0
44. Specimen.condition
Must Support | true
46. Specimen.note
Must Support | true

Guidance on how to interpret the contents of this table can be foundhere

0. Specimen
Definition | Czech national profile defines how to represent Specimens in HL7 FHIR.
Short | Czech Specimen
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If 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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. Specimen.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Specimen.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Specimen.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Specimen.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Specimen.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Specimen.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Specimen.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. Specimen.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Specimen.identifier
Definition | Business identifier for specimen is RECOMMENDED to include when available.
Short | External Identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. Specimen.accessionIdentifier
Definition | The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.
Short | Identifier assigned by the lab
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. Specimen.status
Definition | The availability of the specimen.
Short | available | unavailable | unsatisfactory | entered-in-error
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 0..1
Binding | The codes SHALL be taken from SpecimenStatus (required to `http://hl7.org/fhir/ValueSet/specimen-status|4.0.1` ) Codes providing the status/availability of a specimen.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. Specimen.type
Definition | The kind of material that forms the specimen. RECOMMENDED to include.
Short | Kind of material that forms the specimen
Comments | The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.
Control | 0..1
Binding | The codes SHOULD be taken from https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-type-vs (preferred to `https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-type-vs` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Specimen.subject
Definition | Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.
Short | In the initial iteration of the Czech interoperability project, this is CZ_PatientCore.
Control | 0..1
Type | Reference(Group, Device: Performer/Observer (CZ), Medical Device (CZ), Substance, Location (CZ core), Patient (CZ core))
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | Must know the subject context.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. Specimen.receivedTime
Definition | Time when specimen was received for processing or testing.
Short | The time when specimen was received for processing
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. Specimen.parent
Definition | Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen.
Short | Specimen from which this specimen originated
Comments | The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.
Control | 0..*
Type | Reference(Specimen (CZ))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. Specimen.request
Definition | Details concerning a service request that required a specimen to be collected.
Short | Why the specimen was collected
Comments | The request may be explicit or implied such with a ServiceRequest that requires a blood draw.
Control | 0..*
Type | Reference(ServiceRequest)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. Specimen.collection
Definition | Details concerning the specimen collection.
Short | Collection details
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. Specimen.collection.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
38. Specimen.collection.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Specimen.collection.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
40. Specimen.collection.extension:bodySite
Slice Name | bodySite
Definition | Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.
Short | Target anatomic location or structure
Control | 0..1
Type | Extension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
42. Specimen.collection.extension:bodySite.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
44. Specimen.collection.extension:bodySite.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Specimen.collection.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. Specimen.collection.extension:bodySite.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/bodySite`
48. Specimen.collection.extension:bodySite.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ext-1
Type | Reference(Body Structure (CZ))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Specimen.collection.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
52. Specimen.collection.collector
Definition | Person who collected the specimen.
Short | Who collected the specimen
Control | 0..1
Type | Reference(Practitioner (CZ core), Practitioner Role (CZ core))
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Specimen.collection.collected[x]
Definition | Time when specimen was collected from subject - the physiologically relevant time.
Short | Collection time
Control | 0..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Specimen.collection.duration
Definition | The span of time over which the collection of a specimen occurred.
Short | How long it took to collect specimen
Control | 0..1
Type | Duration
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Specimen.collection.quantity
Definition | The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.
Short | The quantity of specimen collected
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Specimen.collection.method
Definition | A coded value specifying the technique that is used to perform the procedure.
Short | Technique used to perform collection
Control | 0..1
Binding | For example codes, see FHIRSpecimenCollectionMethod (example to `http://hl7.org/fhir/ValueSet/specimen-collection-method|4.0.1` ) The technique that is used to perform the procedure.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Specimen.collection.bodySite
Definition | Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.
Short | Anatomical collection site
Comments | If the specimen.type conveys information about the site the specimen has been collected from, then, if the bodySite is present, it shall be coherent with the type
Control | 0..1
Binding | The codes SHOULD be taken from SNOMEDCTBodyStructures (preferred to `http://hl7.org/fhir/ValueSet/body-site` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Specimen.collection.fastingStatus[x]
Definition | Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection.
Short | Whether or how long patient abstained from food and/or drink
Comments | Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/​time] in 2 hour Urine --12 hours fasting), or using a component observation `such as`Observation.component code` = LOINC 49541-6 (Fasting status - Reported).
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from hl7VS-relevantClincialInformation (extensible to `http://terminology.hl7.org/ValueSet/v2-0916` ) Codes describing the fasting status of the patient.
Type | Choice of: CodeableConcept, Duration
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | Many diagnostic tests require fasting to facilitate accurate interpretation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Specimen.processing
Definition | Details concerning processing and processing steps for the specimen.
Short | Processing and processing step details to include when not implicit from specimen.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Specimen.processing.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
70. Specimen.processing.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
72. Specimen.processing.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
74. Specimen.processing.description
Definition | Textual description of procedure.
Short | Textual description of procedure
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Specimen.processing.procedure
Definition | A coded value specifying the procedure used to process the specimen.
Short | Indicates the treatment step applied to the specimen
Control | 0..1
Binding | For example codes, see SpecimenProcessingProcedure (example to `http://hl7.org/fhir/ValueSet/specimen-processing-procedure|4.0.1` ) Type indicating the technique used to process the specimen.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Specimen.processing.additive
Definition | Material used in the processing step.
Short | Material used in the processing step
Control | 0..*
Type | Reference(Substance, Substance: Specimen Additive Substance (CZ))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Specimen.processing.time[x]
Definition | A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin.
Short | Date and time of specimen processing
Control | 0..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Specimen.container
Definition | The container holding the specimen. The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here.
Short | Direct container of specimen (tube/slide, etc.)
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Specimen.container.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
86. Specimen.container.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Specimen.container.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
88. Specimen.container.extension:device
Slice Name | device
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension Definition for Specimen.container.device for Version 5.0) (Extension Type: Reference(Device))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
90. Specimen.container.extension:device.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
92. Specimen.container.extension:device.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Specimen.container.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
94. Specimen.container.extension:device.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.device`
96. Specimen.container.extension:device.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Reference(Medical Device (CZ))
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Specimen.container.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
100. Specimen.container.identifier
Definition | Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.
Short | Id for the container
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Specimen.container.description
Definition | Textual description of the container.
Short | Textual description of the container
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Specimen.container.type
Definition | The type of container associated with the specimen (e.g. slide, aliquot, etc.).
Short | Kind of container directly associated with specimen
Control | 0..1
Binding | The codes SHOULD be taken from https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-container (preferred to `https://ncez.mzcr.cz/terminology/ValueSet/cz-specimen-container` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Specimen.container.capacity
Definition | The capacity (volume or other measure) the container may contain.
Short | Container volume or size
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Specimen.container.specimenQuantity
Definition | The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.
Short | Quantity of specimen within container
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. Specimen.container.additive[x]
Definition | Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.
Short | Additive associated with container
Control | 0..0
Binding | For example codes, see hl7VS-additivePreservative (example to `http://terminology.hl7.org/ValueSet/v2-0371` ) Substance added to specimen container.
Type | Choice of: CodeableConcept, Reference(Substance)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. Specimen.condition
Definition | A mode or state of being that describes the nature of the specimen.
Short | State of the specimen
Comments | Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from hl7VS-specimenCondition (extensible to `http://terminology.hl7.org/ValueSet/v2-0493` ) Codes describing the state of the specimen.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | The specimen condition can be used to assess its quality or appropriateness for a specific test.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Specimen.note
Definition | To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).
Short | Comments
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)