Lithuanian Laboratory Implementation Guide, published by Lithuanian Medical Library. 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/HL7LT/ig-lt-lab/ and changes regularly. See the Directory of published versions

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Official URL: https://hl7.lt/fhir/lab/ImplementationGuide/lt.hl7.fhir.lab				Version: 0.0.1	Highlight text changes?
					Computable Name: LtLab

Lithuanian Laboratory Implementation Guide

Introduction and Purpose

This Implementation Guide (IG) specifies how to consistently represent and exchange laboratory test results using the Fast Healthcare Interoperability Resources (FHIR) standard. It covers clinical chemistry, glycemic control, renal function, and anatomical pathology domains, enabling reliable interpretation by both clinicians and digital systems.

This guide supports the standardized exchange of laboratory data between laboratory information systems (LIS), electronic health records (EHRs), and national health data infrastructures in Lithuania.

Audience

This guide is intended for implementation guide authors, system vendors, integrators, healthcare solution developers, and other stakeholders involved in exchanging laboratory data using FHIR. Readers are expected to have at least a basic familiarity with FHIR and to refer to the core FHIR specification where additional background is needed.

Scope and Key Content

This guide provides structured FHIR profiles and implementation guidance for:

• Clinical Chemistry: Total cholesterol, HDL, LDL, non-HDL cholesterol, triglycerides, lipidogram panels, and venous blood glucose.
• Glycemic Control: Glycated hemoglobin (HbA1c) for diabetes monitoring.
• Renal Function: Albumin-to-creatinine ratio (ACR), serum creatinine, and estimated glomerular filtration rate (eGFR).
• Anatomical Pathology: Synoptic pathology reports, biopsy procedures, HER2 receptor status (IHC and FISH/CISH/SISH), estrogen and progesterone receptor status, Ki-67 proliferation index, tumor measurements, and prostate cancer staging with TNM.
• Specimen Handling: Specimen identification, collection, tissue blocks, additive substances, adequacy assessment, and physical measurements.

Why Use This Guide?

By adopting these profiles and guidance, implementers can support a standardized approach to:

• Interoperability: Facilitate seamless, semantic exchange of laboratory data between LIS, EHR systems, and national health information infrastructures.
• Data Quality: Improve the consistency, completeness, and reliability of test results through standardized structures, terminology bindings, and units of measure.
• Clinical Utility: Support accurate clinical workflows, including longitudinal monitoring, risk assessment, screening programmes, and clinical decision support based on structured laboratory data.

How to Navigate This Guide

This guide is organized into several sections that support implementation from overview to detailed conformance artifacts. All conformance and example resources are listed on the Artifacts page. Key sections include:

• Artifacts — Complete list of profiles, extensions, terminology resources, and example instances defined by this guide.
• Profiles — StructureDefinitions for laboratory observations, pathology documents, specimen resources, and extensions.
• Terminology — ValueSets and CodeSystems used by the profiles.
• Examples — Example instances for observations, specimens, reports, and related resources.
• Pathology Workflow — Specimen journey from order through processing to final report.
• Pathology Report — Incremental reporting structure and TNM staging.

Contributors

Name	Role	Organization
Igor Bossenko	Primary Author	HELEX Solutions
Kati Laidus	Co-Author	HELEX Solutions
Martynas Bieliauskas	Co-Author	LMB