HL7 Czech Laboratory Order IG, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/lab-order/ and changes regularly. See the Directory of published versions

Implementation notes

The following page contains notes on implementing the laboratory order. They relate to creating the composition (CZ_CompositionLabOrder), the bundle (BundleLabOrderCz) and populating the related profiles with the appropriate data.

Overview

classDiagram
  direction LR
  class BundleLabOrderCz{
    <<Bundle>>
  }
  BundleLabOrderCz *-- "1" CZ_CompositionLabOrder
  BundleLabOrderCz *-- "1" CZ_PatientCore
  BundleLabOrderCz *-- "0..*" CZ_ServiceRequest
  BundleLabOrderCz *-- "1..*" CZ_ConditionClinicalQuestion
  BundleLabOrderCz *-- "0..*" CZ_Coverage
  BundleLabOrderCz *-- "0..*" CZ_Encounter
  BundleLabOrderCz *-- "0..1" CZ_Appointment
  BundleLabOrderCz *-- "0..*" CZ_Specimen
  BundleLabOrderCz *-- "0..*" CZ_PractitionerCore
  BundleLabOrderCz *-- "0..*" CZ_PractitionerRoleCore
  BundleLabOrderCz *-- "0..*" CZ_OrganizationCore
  BundleLabOrderCz *-- "0..*" CZ_MedicationStatement
  BundleLabOrderCz *-- "0..*" CZ_ConditionLab
  BundleLabOrderCz *-- "0..*" CZ_AllergyIntolerance
  BundleLabOrderCz *-- "0..*" CZ_ObservationLab
  BundleLabOrderCz *-- "0..*" CZ_Attachment

  CZ_CompositionLabOrder --> CZ_ServiceRequest: section[serviceRequest]
  CZ_CompositionLabOrder --> CZ_ConditionClinicalQuestion: section[clinicalQuestion]
  CZ_CompositionLabOrder --> CZ_Coverage: section[coverage]
  CZ_CompositionLabOrder --> CZ_Appointment: section[appointment]
  CZ_CompositionLabOrder --> CZ_MedicationStatement: section[supportingInformation]
  CZ_CompositionLabOrder --> CZ_Attachment: section[attachments]
  CZ_CompositionLabOrder --> CZ_PractitionerRoleCore: author
  CZ_CompositionLabOrder --> CZ_Encounter: encounter
  CZ_CompositionLabOrder --> CZ_OrganizationCore: custodian
  CZ_CompositionLabOrder --> CZ_PatientCore: subject

  CZ_ServiceRequest --> CZ_Specimen: specimen
  CZ_ServiceRequest --> CZ_Coverage: insurance
  CZ_ServiceRequest --> CZ_PractitionerRoleCore: requester
  CZ_ServiceRequest --> CZ_PractitionerRoleCore: performer

The laboratory order is represented as a FHIR document Bundle whose first entry is CZ_CompositionLabOrder and which then contains all resources referenced by the composition and its sections (see the $document operation).

Description of the CZ_CompositionLabOrder content

Sections and content

The document is divided into a set of mandatory and optional sections. If no data is available for a mandatory section, the justification can be expressed in composition.section.emptyReason.

Document structure

The Laboratory Order holds the following sections in this order:

Laboratory Order Header

General information about the order. Most of the information elements in this part of the document overlap with other clinical documents. The document header includes information about the patient, source organization, author (indicating physician), intended performer of the examination, and the custodian of the document.

Clinical Encounter

This profile allows linking the order to a specific clinical encounter, such as an outpatient visit or hospitalization during which the order was created.

Body of the Laboratory Order

Requested examinations (ServiceRequest)

This mandatory section contains the list of individual requested laboratory examinations. Each examination is expressed as one CZ_ServiceRequest resource. Mandatory elements include the order identifier, category, authored date (authoredOn) and the code of the requested examination (code) taken from the national laboratory nomenclature (NČLP). Optionally, the priority of the examination (routine, urgent, stat, ASAP), the requested time of execution (occurrenceDateTime) and free-text instructions for the patient or laboratory (patientInstruction, note) may be supplied. When a specific specimen is associated with the examination, it is linked via specimen.

Coverage

This section allows specification of the way the order is paid for if it differs from the standard public health insurance coverage — for example a self-paying patient, co-payment, a different insurance company, or a specific program. While the section is required to be present, it does not have to be populated; in that case the order is assumed to be covered by the insurance indicated in the header.

Appointment

Optional section that may carry information about the agreed date and place for the planned biological material collection. It is typically used to inform the patient about when and where to attend, and the laboratory about the expected arrival of the specimen.

Supporting information

Optional section that may attach clinically relevant information influencing result interpretation — for example current medication (CZ_MedicationStatement) or already known conditions and findings (Condition). This information helps the laboratory to correctly evaluate the requested examinations.

Attachments

Optional section that allows any additional documents to be attached — such as outpatient reports, discharge summaries, previous results, or data provided by the patient (in digital form or as a scan). It serves to supplement the clinical context of the order.