RIVO-Noord Zorgviewer Implementation Guide
1.8.0 - CI build Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.8.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

Resource Profile: Specimen - Detailed Descriptions

Active as of 2024-11-19

Definitions for the Specimen resource profile.

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

0. Specimen
2. Specimen.type
4. Specimen.type.text
Must Supporttrue
6. Specimen.note
8. Specimen.note.text
Must Supporttrue

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

0. Specimen
Definition

A sample to be used for analysis. The HCIM LaboratoryTestResult only contains Specimen details at container and collection level. It is not prohibited, rather expected that other details will be present too.


A sample to be used for analysis.

ShortSpecimenSample for analysis
Control0..*
Alternate NamesMonster
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
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.

ShortA 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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
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. Usually modifier elements provide negation or qualification. In order 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.

ShortExtensions 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.

Control0..*
TypeExtension
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
6. Specimen.status
Definition

The availability of the specimen.

Shortavailable | 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.

Control0..1
BindingThe codes SHALL be taken from SpecimenStatushttp://hl7.org/fhir/ValueSet/specimen-status
(required to http://hl7.org/fhir/ValueSet/specimen-status)

Codes providing the status/availability of a specimen.

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
8. Specimen.type
Definition

SpecimenMaterial describes the material obtained or the isolate that was derived from the material. If the LOINC test code also implicitly describes a material, this element may not conflict with the description. If desired, this component can provide a more detailed description of the material: LOINC codes only contain the materials at a main level. This is in line with the agreements made in the IHE/Nictiz program e-Lab.

If the test is carried out on derived material (such as plasma), this element will still contain the material drawn (in this case, blood). In this case, the LOINC code will generally refer to plasma.


The kind of material that forms the specimen.

ShortSpecimenMaterialKind 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.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see MonstermateriaalCodelijsthttp://hl7.org/fhir/ValueSet/v2-0487
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.6--20171231000000)
TypeCodeableConcept
Summarytrue
Alternate NamesMonstermateriaal
10. Specimen.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

ShortPlain text representation of the concept
Comments

Very often the text is the same as a displayName of one of the codings.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

12. Specimen.subject
Definition

If the material is not collected directly from the patient but comes from a patient-related object, e.g. a cathetertip, this source of material can be recorded here using the HCIM MedicalDeviceProduct.


Where the specimen came from. This may be from the patient(s) or from the environment or a device.

ShortSpecimenSourceWhere the specimen came from. This may be from the patient(s) or from the environment or a device
Control1..1
TypeReference(nl-core-patient, Group, HCIM MedicalDevice Product, Substance, Patient, Device)
Summarytrue
Requirements

Must know the subject context.

Alternate NamesBronMonster
14. 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).

ShortCommentComments
Control0..*
TypeAnnotation
Alternate NamesToelichting
16. Specimen.note.text
Definition

The text of the annotation.

ShortThe annotation - text content
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue

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

0. Specimen
Definition

A sample to be used for analysis. The HCIM LaboratoryTestResult only contains Specimen details at container and collection level. It is not prohibited, rather expected that other details will be present too.

ShortSpecimen
Control0..*
Alternate NamesMonster
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
2. Specimen.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical 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.

Control0..1
Typeid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. Specimen.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Summarytrue
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.

ShortA 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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
8. Specimen.language
Definition

The base language in which the resource is written.

ShortLanguage 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).

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
All LanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. Specimen.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

ShortText 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 in formation is added later.

Control0..1
This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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.

ShortContained, 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.

Control0..*
TypeResource
Alternate Namesinline 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. In order 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.

ShortAdditional 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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. Usually modifier elements provide negation or qualification. In order 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.

ShortExtensions 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.

Control0..*
TypeExtension
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
18. Specimen.identifier
Definition

Identification number of the material obtained, as a reference for inquiries to the source organization. In a transmural setting, this number will consist of a specimen number including the identification of the issuing organization, to be unique outside of the borders of an organization.

ShortSpecimenId
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
Alternate NamesMonsternummer
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.

ShortIdentifier assigned by the lab
Control0..1
TypeIdentifier
Summarytrue
22. Specimen.status
Definition

The availability of the specimen.

Shortavailable | 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.

Control0..1
BindingThe codes SHALL be taken from SpecimenStatus
(required to http://hl7.org/fhir/ValueSet/specimen-status)

Codes providing the status/availability of a specimen.

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
24. Specimen.type
Definition

SpecimenMaterial describes the material obtained or the isolate that was derived from the material. If the LOINC test code also implicitly describes a material, this element may not conflict with the description. If desired, this component can provide a more detailed description of the material: LOINC codes only contain the materials at a main level. This is in line with the agreements made in the IHE/Nictiz program e-Lab.

If the test is carried out on derived material (such as plasma), this element will still contain the material drawn (in this case, blood). In this case, the LOINC code will generally refer to plasma.

ShortSpecimenMaterial
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.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from MonstermateriaalCodelijst
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.6--20171231000000)
TypeCodeableConcept
Summarytrue
Alternate NamesMonstermateriaal
26. Specimen.type.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
28. Specimen.type.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

ShortAdditional 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on Specimen.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 30. Specimen.type.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Summarytrue
    Requirements

    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

    32. Specimen.type.text
    Definition

    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

    ShortPlain text representation of the concept
    Comments

    Very often the text is the same as a displayName of one of the codings.

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

    34. Specimen.subject
    Definition

    If the material is not collected directly from the patient but comes from a patient-related object, e.g. a cathetertip, this source of material can be recorded here using the HCIM MedicalDeviceProduct.

    ShortSpecimenSource
    Control1..1
    TypeReference(nl-core-patient, Group, HCIM MedicalDevice Product, Substance)
    Summarytrue
    Requirements

    Must know the subject context.

    Alternate NamesBronMonster
    36. Specimen.receivedTime
    Definition

    Date and time that the material is handed over at the laboratory or specimen collection center. This is the issue with material that is collected by the patient himself.

    ShortReceivedDateTime
    Control0..1
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate NamesAannameDatumTijd
    38. 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.

    ShortSpecimen 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.

    Control0..*
    TypeReference(HCIM LaboratoryTestResult Specimen, HCIM LaboratoryTestResult Specimen Isolate)
    40. Specimen.request
    Definition

    Details concerning a test or procedure request that required a specimen to be collected.

    ShortWhy the specimen was collected
    Comments

    The request may be explicit or implied such with a ProcedureRequest that requires a blood draw.

    Control0..*
    TypeReference(ProcedureRequest)
    42. Specimen.collection
    Definition

    Details concerning the specimen collection.

    ShortCollection details
    Control0..1
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    44. 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.

    Shortxml:id (or equivalent in JSON)
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    46. Specimen.collection.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

    ShortAdditional 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.

    Control0..*
    TypeExtension
    Alternate Namesextensions, user content
    48. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

    ShortExtensions 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.

    Control0..*
    TypeExtension
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Summarytrue
    Alternate Namesextensions, user content, modifiers
    50. Specimen.collection.collector
    Definition

    Person who collected the specimen.

    ShortWho collected the specimen
    Control0..1
    TypeReference(Practitioner)
    Summarytrue
    52. Specimen.collection.collected[x]
    Definition

    Time at which the material was collected.

    If the material has not been collected at a single point in time but over a certain period, this period can be captured in this concept. An example is 24 hour urine.

    ShortCollection time
    Control0..1
    TypeChoice of: dateTime, Period
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    SlicingThis element introduces a set of slices on Specimen.collection.collected[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 54. Specimen.collection.collected[x]:collectedDateTime
      Slice NamecollectedDateTime
      Definition

      Time when specimen was collected from subject - the physiologically relevant time.

      ShortCollectionDateTime
      Control0..1
      TypedateTime
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesAfnameDatumTijd
      56. Specimen.collection.collected[x]:collectedPeriod
      Slice NamecollectedPeriod
      Definition

      Time when specimen was collected from subject - the physiologically relevant time.

      ShortCollectionPeriod
      Control0..1
      TypePeriod
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Summarytrue
      Alternate NamesVerzamelperiode
      58. Specimen.collection.collected[x]:collectedPeriod.id
      Definition

      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      Shortxml:id (or equivalent in JSON)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      60. Specimen.collection.collected[x]:collectedPeriod.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      SlicingThis element introduces a set of slices on Specimen.collection.collected[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 62. Specimen.collection.collected[x]:collectedPeriod.extension:period-duration
        Slice Nameperiod-duration
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        TypeExtension(Period Duration) (Extension Type: Duration)
        64. Specimen.collection.collected[x]:collectedPeriod.start
        Definition

        The start of the period. The boundary is inclusive.

        ShortStarting time with inclusive boundary
        Comments

        If the low element is missing, the meaning is that the low boundary is not known.

        Control0..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        66. Specimen.collection.collected[x]:collectedPeriod.end
        Definition

        The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        ShortEnd time with inclusive boundary, if not ongoing
        Comments

        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

        Control0..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
        68. Specimen.collection.quantity
        Definition

        Total volume of the collected material. If it is necessary to determine the absolute amount of a particular substance in the collected material, the volume thereof must be given.

        ShortCollectedVolume
        Control0..1
        TypeQuantity(SimpleQuantity)
        Alternate NamesVerzamelvolume
        70. Specimen.collection.method
        Definition

        If relevant for the results, the method of obtaining the specimen can be entered as well.

        ShortCollectionMethod
        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from AfnameprocedureCodelijst
        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.2--20171231000000)
        TypeCodeableConcept
        Alternate NamesAfnameprocedure
        72. Specimen.collection.bodySite
        Definition

        Anatomic location where the material is collected, e.g. elbow.

        ShortAnatomicalLocation
        Comments

        If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension body-site-instance.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from MonsterAnatomischeLocatieCodelijst
        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.11--20171231000000)

        SpecimenAnatomicalLocationCodelist

        TypeCodeableConcept
        Alternate NamesAnatomischeLocatie
        74. Specimen.collection.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.

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        76. Specimen.collection.bodySite.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        SlicingThis element introduces a set of slices on Specimen.collection.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 78. Specimen.collection.bodySite.extension:laterality
          Slice Namelaterality
          Definition

          Laterality adds information about body side to the anatomic location, e.g. left

          ShortLaterality
          Control0..*
          TypeExtension(BodySite Qualifier) (Extension Type: CodeableConcept)
          80. Specimen.collection.bodySite.extension:laterality.id
          Definition

          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          82. Specimen.collection.bodySite.extension:laterality.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

          ShortAdditional 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.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Specimen.collection.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 84. Specimen.collection.bodySite.extension:laterality.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies 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.

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier
            86. Specimen.collection.bodySite.extension:laterality.value[x]
            Definition

            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

            ShortValue of extension
            Control0..1
            TypeCodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on Specimen.collection.bodySite.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 88. Specimen.collection.bodySite.extension:laterality.value[x]:valueCodeableConcept
              Slice NamevalueCodeableConcept
              Definition

              Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

              ShortBodySite qualifier
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from LateraliteitCodelijst
              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.12--20171231000000)

              LateralityCodelist

              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              90. Specimen.collection.bodySite.extension:morphology
              Slice Namemorphology
              Definition

              Morphology describes morphological abnormalities of the anatomical location where the material is taken, for example wound, ulcer.

              ShortMorphology
              Control0..*
              TypeExtension(BodySite Morphology) (Extension Type: CodeableConcept)
              Alternate NamesMorfologie
              92. Specimen.collection.bodySite.extension:morphology.id
              Definition

              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              94. Specimen.collection.bodySite.extension:morphology.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

              ShortAdditional 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.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on Specimen.collection.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 96. Specimen.collection.bodySite.extension:morphology.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies 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.

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/BodySite-Morphology
                98. Specimen.collection.bodySite.extension:morphology.value[x]
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control0..1
                TypeCodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                SlicingThis element introduces a set of slices on Specimen.collection.bodySite.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 100. Specimen.collection.bodySite.extension:morphology.value[x]:valueCodeableConcept
                  Slice NamevalueCodeableConcept
                  Definition

                  Morphology describes morphological abnormalities of the anatomical location where the material is taken, for example wound, ulcer.

                  ShortBodySite morphology
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from MorfologieCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.13--20171231000000)

                  MorphologyCodelist

                  TypeCodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Alternate NamesMorfologie
                  102. Specimen.collection.bodySite.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  TypeCoding
                  Summarytrue
                  Requirements

                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                  104. Specimen.collection.bodySite.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  106. Specimen.processing
                  Definition

                  Details concerning processing and processing steps for the specimen.

                  ShortProcessing and processing step details
                  Control0..*
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  108. 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.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  110. Specimen.processing.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                  ShortAdditional 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.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  112. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                  ShortExtensions 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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  114. Specimen.processing.description
                  Definition

                  Textual description of procedure.

                  ShortTextual description of procedure
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  116. Specimen.processing.procedure
                  Definition

                  A coded value specifying the procedure used to process the specimen.

                  ShortIndicates the treatment step applied to the specimen
                  Control0..1
                  BindingFor example codes, see SpecimenProcessingProcedure
                  (example to http://hl7.org/fhir/ValueSet/specimen-processing-procedure)

                  Type indicating the technique used to process the specimen

                  TypeCodeableConcept
                  118. Specimen.processing.additive
                  Definition

                  Material used in the processing step.

                  ShortMaterial used in the processing step
                  Control0..*
                  TypeReference(Substance)
                  120. 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.

                  ShortDate and time of specimen processing
                  Control0..1
                  TypeChoice of: dateTime, Period
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  122. 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.

                  ShortSpecimenContainer
                  Control0..*
                  TypeBackboneElement
                  Alternate NamesMonstercontainer
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  124. 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.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  126. Specimen.container.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                  ShortAdditional 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.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  128. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                  ShortExtensions 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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  130. Specimen.container.identifier
                  Definition

                  The specimen number extension is used when the collected material is distributed from the original tube or container across multiple tubes. In combination with the specimen Id the extension yield a unique identification of the tube or container

                  ShortSpecimenNumberExtension
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Summarytrue
                  Alternate NamesMonstervolgnummer
                  132. Specimen.container.description
                  Definition

                  Textual description of the container.

                  ShortTextual description of the container
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  134. Specimen.container.type
                  Definition

                  Container type describes the envelope in which the material is collected or sent. Examples include blood tubes, transport container, possibly including culture medium.

                  ShortContainerType
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ContainerTypeCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.13.1.9--20171231000000)

                  ContainerTypeCodelist

                  TypeCodeableConcept
                  Alternate NamesContainertype
                  136. Specimen.container.capacity
                  Definition

                  The capacity (volume or other measure) the container may contain.

                  ShortContainer volume or size
                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  138. Specimen.container.specimenQuantity
                  Definition

                  The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.

                  ShortQuantity of specimen within container
                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  140. Specimen.container.additive[x]
                  Definition

                  Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.

                  ShortAdditive associated with container
                  Control0..1
                  BindingFor example codes, see v2 Additive/Preservative
                  (example to http://hl7.org/fhir/ValueSet/v2-0371)

                  Substance added to specimen container

                  TypeChoice of: CodeableConcept, Reference(Substance)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  142. 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).

                  ShortComment
                  Control0..*
                  TypeAnnotation
                  Alternate NamesToelichting
                  144. Specimen.note.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  146. Specimen.note.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                  ShortAdditional 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.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on Specimen.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 148. Specimen.note.author[x]
                    Definition

                    The individual responsible for making the annotation.

                    ShortIndividual responsible for the annotation
                    Control0..1
                    TypeChoice of: Reference(Practitioner, Patient, RelatedPerson), string
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    150. Specimen.note.time
                    Definition

                    Indicates when this particular annotation was made.

                    ShortWhen the annotation was made
                    Control0..1
                    TypedateTime
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    152. Specimen.note.text
                    Definition

                    The text of the annotation.

                    ShortThe annotation - text content
                    Control1..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue