NHS North West Genomics
0.0.8 - ci-build United Kingdom flag

NHS North West Genomics, published by NHS North West Genomics. This guide is not an authorized publication; it is the continuous build for version 0.0.8 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/nw-gmsa/nw-gmsa.github.com/ and changes regularly. See the Directory of published versions

ExampleScenario: Collect Specimen - Biopsy Procedure for obtaining a specimen, part of a diagnostic pathway. Day case admission.

Official URL: https://fhir.nwgenomics.nhs.uk/ExampleScenario/BiopsyProcedure Version: 0.0.8
Draft as of 2025-10-30 Computable Name: Biopsy Procedure

Actors

NameTypeDescription
Nurse System

TODO

Form Manager System

This may be part of the EPR or be paper based

Electronic Patient Record System
Patient/relative/carer System

TODO

Consultant System

TODO

Diagnostic Testing System

TODO

Diagram

​Biopsy ProcedureNurseNurseForm ManagerForm ManagerElectronic Patient RecordElectronic Patient RecordPatient/relative/carerPatient/relative/carerConsultantConsultantDiagnostic TestingDiagnostic TestingAdmissiondetailsSelect Admission Forms(payload)response(payload)Pre-populate Admission Form(payload)Complete Admission Form.(payload)response(payload)Complete Admission Form.(payload)Perform BiopsydetailsDocument Procedure - Record procedure details(payload)Document Procedure - Update specimen details(payload)Send specimen(payload)Monitor and Discharge PatientdetailsMonitor Patient - Update specimen details(payload)Discharge Patient(payload)

Processes

Process: Admission

Admit Patient. The process roughly follows FHIR Structured Data Capture

Pre-conditions:

Test Order has been created (Genomic Test Order Process)

StepNameDescriptionInitiatorReceiverRequestResponse
1 Select Admission Forms - search-type (Details: FHIR Restful Interactions code search-type)

This may be paper based

 Nurse Form Manager Query Questionnaire Dummy
2 Pre-populate Admission Form - create (Details: FHIR Restful Interactions code create)

If using electronic forms and their is a connection to an EPR or Health Information Exchange - the forms may be pre-populated

 Form Manager Electronic Patient Record Query Observation and MedicationRequest
3 Complete Admission Form. - read (Details: FHIR Restful Interactions code read)

This includes enquiring about the patients medical history, such as conditions and medications. This also includes taking the patient vital signs - device data may be automatically uploaded into the EPR.

 Nurse Patient/relative/carer Create QuestionnaireResponse Dummy
4 Complete Admission Form. - create (Details: FHIR Restful Interactions code create)

Enter answers to questions in the forms. The end of this process is likely to be signalled via a IHE Patient Administration HL7 v2 ADT Admission event.

 Nurse Form Manager Create Observation and MedicationStatement from QuestionnaireResponse
Process: Perform Biopsy

Perform Biopsy Procedure

StepNameDescriptionInitiatorReceiverRequestResponse
5 Document Procedure - Record procedure details - create (Details: FHIR Restful Interactions code create)

TODO

 Consultant Electronic Patient Record Update Procedure -Biopsy
6 Document Procedure - Update specimen details - update (Details: FHIR Restful Interactions code update)

Ideally the updated specimen record should result in an update to the original order.

 Nurse Electronic Patient Record Update Specimen
7 Send specimen - create (Details: FHIR Restful Interactions code create)

If the specimen is being sent via a courier, then the specimen record should be updated with a tracking id

 Nurse Diagnostic Testing Update Specimen with tracking number
Process: Monitor and Discharge Patient

Monitor patient post procedure and Discharge Patient

StepNameDescriptionInitiatorReceiverRequestResponse
8 Monitor Patient - Update specimen details - update (Details: FHIR Restful Interactions code update)

This probably includes taking of vital signs to ensure the patient is stable

 Nurse Electronic Patient Record Create Observation - Vital Signs
9 Discharge Patient - update (Details: FHIR Restful Interactions code update)

This includes a IHE Patient Administration - HL7 v2 ADT Discharge event and may include clinical notes

 Nurse Electronic Patient Record Create Disharge Letter

Instances

NameTypeContentDescription
Query Questionnaire Questionnaire

Query for Froms: GET https://example.nhs.uk/FHIR/R4/Questionnaire

Query Observation and MedicationRequest Observation
Create QuestionnaireResponse QuestionnaireResponse
Create Observation and MedicationStatement from QuestionnaireResponse Observation
Dummy Binary
Dummy Binary
Update Procedure -Biopsy Procedure
  • Procedure Liver Biopsy
 here
Update Specimen Specimen
Update Specimen with tracking number Specimen
Dummy Binary
Dummy Binary
Dummy Binary
Create Observation - Vital Signs Observation
Create Disharge Letter Binary
Dummy Binary
Dummy Binary