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: Genomic Test Report Process

Official URL: https://fhir.nwgenomics.nhs.uk/ExampleScenario/GenomicTestReportProcess Version: 0.0.8
Draft as of 2025-10-30 Computable Name: Genomic Test Report

Actors

NameTypeDescription
Order Filler System
Regional Integration Engine System
Trust Integration Engine System
Order Placer/Electronic Patient Record System
ICS - Health Information Exchange System

Intermediary found in LHCRE/ICS

Regional - Genomic Data Repository System

Clinical Data Repository

Diagram

​Genomic Test ReportOrder FillerOrder FillerRegional Integration EngineRegional Integration EngineTrust Integration EngineTrust Integration EngineOrder Placer/Electronic Patient RecordOrder Placer/Electronic Patient RecordICS - Health Information ExchangeICS - Health Information ExchangeRegional - Genomic Data RepositoryRegional - Genomic Data RepositorySend Report to Order PlacerdetailsSend Laboratory Report ORU_R01 v2(payload)Send Laboratory Report ORU_R01 v2(payload)Send Laboratory Report ORU_R01 v2(payload)Send Report to ICSdetailsPatient Demographics Query(payload)response(payload)Send Laboratory Report MDM_T02 v2(payload)Send Report to Regional Genomic CDRdetailsSend Laboratory Report R01 FHIR(payload)

Processes

Process: Send Report to Order Placer

The report is sent from the LIMS using HL7 ORU_R01 and this is sent to the Order Placer/EPR via middleware

Pre-conditions:

Test Order has been received (Genomic Test Order Process), specimen has been collected (e.g. Biopsy Procedure), has physically arrived and the test(s) have been performed

StepNameDescriptionInitiatorReceiverRequestResponse
1 Send Laboratory Report ORU_R01 v2 - create (Details: FHIR Restful Interactions code create)

TODO

 Order Filler Regional Integration Engine HL7 v2 ORU_R01 - supplier
2 Send Laboratory Report ORU_R01 v2 - create (Details: FHIR Restful Interactions code create)

Routes the report to NHS Trust which placed the order. At present the report will only be sent to regional NHS Trusts, in future this will include the NHS England Genomic Order Management Service to deliver reports to other NHS Trusts

 Regional Integration Engine Trust Integration Engine HL7 v2 ORU_R01 - regional
7 Send Laboratory Report ORU_R01 v2 - create (Details: FHIR Restful Interactions code create)

Routes the report to the Order Placer and/or EPR

 Trust Integration Engine Order Placer/Electronic Patient Record HL7 v2 ORU_R01 - supplier
Process: Send Report to ICS

The report to ICS HL7 MDM_T02. The report is routed to the ICS based on which general practice the patient is registered with

Pre-conditions:

Patient has a NHS Number

StepNameDescriptionInitiatorReceiverRequestResponse
4 Patient Demographics Query - search-type (Details: FHIR Restful Interactions code search-type)

This is an internal API which includes use of NHS England Personal Demographics Service

 Regional Integration Engine Regional - Genomic Data Repository Search for master Patient demographics record Search results
5 Send Laboratory Report MDM_T02 v2 - create (Details: FHIR Restful Interactions code create)

The report is routed to the ICS system which covers the Patients GP Surgery. For IHE XDS destinations this may include conversion to IHE ITI-41

 Regional Integration Engine ICS - Health Information Exchange HL7 v2 MDM_T02 - regional
Process: Send Report to Regional Genomic CDR

The report is sent to the regional Clinical Data Repository which shares the report using FHIR RESTful readonly APIs

StepNameDescriptionInitiatorReceiverRequestResponse
6 Send Laboratory Report R01 FHIR - create (Details: FHIR Restful Interactions code create)

The v2 message is transformed to a FHIR Message

 Regional Integration Engine Regional - Genomic Data Repository HL7 FHIR Message R01 - regional

Instances

NameTypeContentDescription
HL7 v2 ORU_R01 - supplier Binary
HL7 v2 ORU_R01 - regional Binary
HL7 v2 ORU_R01 - supplier Binary
Search for master Patient demographics record Binary

Query for Patient: GET https://example.nhs.uk/FHIR/R4/Patient?identifier=https://fhir.nhs.uk/Id/nhs-number|9449305552

Search results Bundle
  • Search Results
 here
HL7 v2 MDM_T02 - regional Binary

Regional Hl7 v2 MDM_T02 The format of the report is PDF, in future for England/EU document sharing the format may change to HL7 EU Laboratory Report

HL7 FHIR Message R01 - regional Bundle
  • HL7 FHIR Message R01
 here