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

• Narrative Content
• XML
• JSON

: Clinical and Genomic Workflow - XML Representation

Draft as of 2025-10-30

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<ExampleScenario xmlns="http://hl7.org/fhir">
  <id value="ClinicalAndGenomicWorkflow"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ExampleScenario ClinicalAndGenomicWorkflow</b></p><a name="ClinicalAndGenomicWorkflow"> </a><a name="hcClinicalAndGenomicWorkflow"> </a><p><b>url</b>: <a href="ExampleScenario-ClinicalAndGenomicWorkflow.html">Clinical And Genomic Workflow</a></p><p><b>version</b>: 0.0.8</p><p><b>name</b>: Clinical And Genomic Workflow</p><p><b>status</b>: Draft</p><p><b>date</b>: 2025-10-30 11:13:25+0000</p><p><b>publisher</b>: NHS North West Genomics</p><p><b>contact</b>: <a href="https://www.nwgenomics.nhs.uk/contact-us">https://www.nwgenomics.nhs.uk/contact-us</a></p><p><b>jurisdiction</b>: <span title="Codes:{urn:iso:std:iso:3166 GB}">United Kingdom of Great Britain and Northern Ireland</span></p><blockquote><p><b>actor</b></p><p><b>actorId</b>: diagnostics</p><p><b>type</b>: System</p><p><b>name</b>: Genomic Diagnostic Testing</p><p><b>description</b>: </p><div><p>TODO</p>
</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: counsellor</p><p><b>type</b>: System</p><p><b>name</b>: Genomic counsellor</p><p><b>description</b>: </p><div><p>TODO</p>
</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: cdr</p><p><b>type</b>: System</p><p><b>name</b>: Regional - Genomic Data Repository</p><p><b>description</b>: </p><div><p>Clinical Data Repository</p>
</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: consultant</p><p><b>type</b>: System</p><p><b>name</b>: Consultant</p><p><b>description</b>: </p><div><p>Primary Care doctor or Secondary Care Consultant</p>
</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: epr</p><p><b>type</b>: System</p><p><b>name</b>: Electronic Patient Record</p><p><b>description</b>: </p><div><p><a href="ActorDefinition-ProviderInformationSource.html">Provider Information Source</a></p>
</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request1</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Variant</p><p><b>description</b>: </p><div><p>TODO</p>
</div><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Variant NTHL1</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href="Observation-8385c2fd-313d-4fd5-b98e-d5ea4bae6f99.html">Observation Genetic variant assessment</a></p><p><b>versionId</b>: 1</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request2</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Diagnostic Implication</p><p><b>description</b>: </p><div><p>TODO</p>
</div><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Diagnostic Implication Lynch syndrome</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href="Observation-6beb613f-d303-42af-b025-86e8e0872061.html">Observation Diagnostic Implication</a></p><p><b>versionId</b>: 2</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request3</p><p><b>resourceType</b>: Condition</p><p><b>name</b>: Condition</p><p><b>description</b>: </p><div><p>TODO</p>
</div><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Condition Lynch syndrome</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href="Condition-c8f82825-e4cb-4e1f-b728-3fd2808e93db.html">Condition Lynch syndrome gene mutation detected</a></p><p><b>versionId</b>: 3</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request4</p><p><b>resourceType</b>: FamilyMemberHistory</p><p><b>name</b>: FamilyMemberHistory Son</p><p><b>description</b>: </p><div><p>TODO</p>
</div><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: FamilyMemberHistory Ricky LEEDS</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href="FamilyMemberHistory-074ea905-8d91-452c-af3c-15b5b860fdb2.html">FamilyMemberHistory: identifier = National Health Plan Identifier (use: official, ); status = completed; relationship = natural son; sex = male</a></p><p><b>versionId</b>: 4</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request5</p><p><b>resourceType</b>: FamilyMemberHistory</p><p><b>name</b>: FamilyMemberHistory Mother</p><p><b>description</b>: </p><div><p>TODO</p>
</div><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: FamilyMemberHistory Sarah-Jane NOTTINGHAM</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href="FamilyMemberHistory-c76b8bc2-ec36-4ce1-a2ea-8c57215115e2.html">FamilyMemberHistory Sarah-Jane Nottingham</a></p><p><b>versionId</b>: 5</p></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Create Diagnostic Testing Report</p><p><b>description</b>: </p><div><p>This step creates the <a href="Questionnaire-GenomicTestReport.html">Genomics Test Report</a></p>
</div><p><b>preConditions</b>: </p><div><p>Genomic Testing has Completed</p>
</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: create</p><p><b>name</b>: Variant NTHL1 is added to Genomic CDR</p><p><b>initiator</b>: diagnostics</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>This step is performed by middleware - RIE</p>
</div><h3>Requests</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ResourceId</b></td></tr><tr><td style="display: none">*</td><td>Request1</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 2</p><p><b>type</b>: create</p><p><b>name</b>: Diagnostic Implication Lynch Syndrome is added to Genomic CDR</p><p><b>initiator</b>: diagnostics</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>This step is performed by middleware - RIE</p>
</div><h3>Requests</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ResourceId</b></td></tr><tr><td style="display: none">*</td><td>Request2</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Review Diagnostic Testing Report</p><p><b>description</b>: </p><div><p>This step reviews the <a href="Questionnaire-GenomicTestReport.html">Genomics Test Report</a></p>
</div><p><b>preConditions</b>: </p><div><p>Genomic Testing Received has been received</p>
</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 3</p><p><b>type</b>: create</p><p><b>name</b>: Condition Lynch Syndrome is added to Acute or Primary Care EPR</p><p><b>initiator</b>: consultant</p><p><b>receiver</b>: epr</p><p><b>description</b>: </p><div><p>This step is assumed to be a manual entry</p>
</div><h3>Requests</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ResourceId</b></td></tr><tr><td style="display: none">*</td><td>Request3</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Perform Genomic Counselling</p><p><b>description</b>: </p><div><p>This step acts on the <a href="Questionnaire-GenomicTestReport.html">Genomics Test Report</a></p>
</div><p><b>preConditions</b>: </p><div><p>A Task has been received to perform Genomic Counselling</p>
</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 4</p><p><b>type</b>: create</p><p><b>name</b>: Family History for Son Leeds is added to Genomic CDR </p><p><b>initiator</b>: counsellor</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>Probably Gen-O</p>
</div><h3>Requests</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ResourceId</b></td></tr><tr><td style="display: none">*</td><td>Request4</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 5</p><p><b>type</b>: create</p><p><b>name</b>: Family History for Mother Nottingham is added to Genomic CDR</p><p><b>initiator</b>: counsellor</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>Probably Gen-O</p>
</div><h3>Requests</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ResourceId</b></td></tr><tr><td style="display: none">*</td><td>Request5</td></tr></table></blockquote></blockquote></blockquote></div>
  </text>
  <url
       value="https://fhir.nwgenomics.nhs.uk/ExampleScenario/ClinicalAndGenomicWorkflow"/>
  <version value="0.0.8"/>
  <name value="Clinical And Genomic Workflow"/>
  <status value="draft"/>
  <date value="2025-10-30T11:13:25+00:00"/>
  <publisher value="NHS North West Genomics"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="https://www.nwgenomics.nhs.uk/contact-us"/>
    </telecom>
  </contact>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="GB"/>
      <display value="United Kingdom of Great Britain and Northern Ireland"/>
    </coding>
  </jurisdiction>
  <actor>
    <actorId value="diagnostics"/>
    <type value="entity"/>
    <name value="Genomic Diagnostic Testing"/>
    <description value="TODO"/>
  </actor>
  <actor>
    <actorId value="counsellor"/>
    <type value="entity"/>
    <name value="Genomic counsellor"/>
    <description value="TODO"/>
  </actor>
  <actor>
    <actorId value="cdr"/>
    <type value="entity"/>
    <name value="Regional - Genomic Data Repository"/>
    <description value=" Clinical Data Repository "/>
  </actor>
  <actor>
    <actorId value="consultant"/>
    <type value="entity"/>
    <name value="Consultant"/>
    <description value="Primary Care doctor or Secondary Care Consultant"/>
  </actor>
  <actor>
    <actorId value="epr"/>
    <type value="entity"/>
    <name value="Electronic Patient Record"/>
    <description
                 value=" [Provider Information Source](ActorDefinition-ProviderInformationSource.html) "/>
  </actor>
  <instance>
    <resourceId value="Request1"/>
    <resourceType value="Observation"/>
    <name value="Variant"/>
    <description value=" TODO "/>
    <version>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title">
        <valueString value="Variant NTHL1"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content">
        <valueReference>🔗 
          <reference
                     value="Observation/8385c2fd-313d-4fd5-b98e-d5ea4bae6f99"/>
        </valueReference>
      </extension>
      <versionId value="1"/>
    </version>
  </instance>
  <instance>
    <resourceId value="Request2"/>
    <resourceType value="Observation"/>
    <name value="Diagnostic Implication"/>
    <description value=" TODO "/>
    <version>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title">
        <valueString value="Diagnostic Implication Lynch syndrome"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content">
        <valueReference>🔗 
          <reference
                     value="Observation/6beb613f-d303-42af-b025-86e8e0872061"/>
        </valueReference>
      </extension>
      <versionId value="2"/>
    </version>
  </instance>
  <instance>
    <resourceId value="Request3"/>
    <resourceType value="Condition"/>
    <name value="Condition"/>
    <description value=" TODO "/>
    <version>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title">
        <valueString value="Condition Lynch syndrome"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content">
        <valueReference>🔗 
          <reference value="Condition/c8f82825-e4cb-4e1f-b728-3fd2808e93db"/>
        </valueReference>
      </extension>
      <versionId value="3"/>
    </version>
  </instance>
  <instance>
    <resourceId value="Request4"/>
    <resourceType value="FamilyMemberHistory"/>
    <name value="FamilyMemberHistory Son"/>
    <description value=" TODO "/>
    <version>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title">
        <valueString value="FamilyMemberHistory Ricky LEEDS"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content">
        <valueReference>🔗 
          <reference
                     value="FamilyMemberHistory/074ea905-8d91-452c-af3c-15b5b860fdb2"/>
        </valueReference>
      </extension>
      <versionId value="4"/>
    </version>
  </instance>
  <instance>
    <resourceId value="Request5"/>
    <resourceType value="FamilyMemberHistory"/>
    <name value="FamilyMemberHistory Mother"/>
    <description value=" TODO "/>
    <version>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title">
        <valueString value="FamilyMemberHistory Sarah-Jane NOTTINGHAM"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content">
        <valueReference>🔗 
          <reference
                     value="FamilyMemberHistory/c76b8bc2-ec36-4ce1-a2ea-8c57215115e2"/>
        </valueReference>
      </extension>
      <versionId value="5"/>
    </version>
  </instance>
  <process>
    <title value="Create Diagnostic Testing Report"/>
    <description
                 value="This step creates the [Genomics Test Report](Questionnaire-GenomicTestReport.html)"/>
    <preConditions value="Genomic Testing has Completed"/>
    <step>
      <operation>
        <number value="1"/>
        <type value="create"/>
        <name value="Variant NTHL1 is added to Genomic CDR"/>
        <initiator value="diagnostics"/>
        <receiver value="cdr"/>
        <description value="This step is performed by middleware - RIE"/>
        <request>
          <resourceId value="Request1"/>
        </request>
      </operation>
    </step>
    <step>
      <operation>
        <number value="2"/>
        <type value="create"/>
        <name
              value="Diagnostic Implication Lynch Syndrome is added to Genomic CDR"/>
        <initiator value="diagnostics"/>
        <receiver value="cdr"/>
        <description value="This step is performed by middleware - RIE"/>
        <request>
          <resourceId value="Request2"/>
        </request>
      </operation>
    </step>
  </process>
  <process>
    <title value="Review Diagnostic Testing Report"/>
    <description
                 value="This step reviews the [Genomics Test Report](Questionnaire-GenomicTestReport.html)"/>
    <preConditions value="Genomic Testing Received has been received"/>
    <step>
      <operation>
        <number value="3"/>
        <type value="create"/>
        <name
              value="Condition Lynch Syndrome is added to Acute or Primary Care EPR"/>
        <initiator value="consultant"/>
        <receiver value="epr"/>
        <description value="This step is assumed to be a manual entry"/>
        <request>
          <resourceId value="Request3"/>
        </request>
      </operation>
    </step>
  </process>
  <process>
    <title value="Perform Genomic Counselling"/>
    <description
                 value="This step acts on the [Genomics Test Report](Questionnaire-GenomicTestReport.html)"/>
    <preConditions
                   value="A Task has been received to perform Genomic Counselling"/>
    <step>
      <operation>
        <number value="4"/>
        <type value="create"/>
        <name value="Family History for Son Leeds is added to Genomic CDR "/>
        <initiator value="counsellor"/>
        <receiver value="cdr"/>
        <description value="Probably Gen-O"/>
        <request>
          <resourceId value="Request4"/>
        </request>
      </operation>
    </step>
    <step>
      <operation>
        <number value="5"/>
        <type value="create"/>
        <name
              value="Family History for Mother Nottingham is added to Genomic CDR"/>
        <initiator value="counsellor"/>
        <receiver value="cdr"/>
        <description value="Probably Gen-O"/>
        <request>
          <resourceId value="Request5"/>
        </request>
      </operation>
    </step>
  </process>
</ExampleScenario>