NHS North West Genomics
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NHS North West Genomics, published by NHS North West Genomics. This guide is not an authorized publication; it is the continuous build for version 2.0.3 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

Resource Profile: Specimen - Detailed Descriptions

Draft as of 2026-06-01

Definitions for the Specimen resource profile.

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

0. Specimen
Definition

Laboratory specimen


A sample to be used for analysis.

ShortLaboratory SpecimenSample for analysis
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Specimen.extension:focus
Slice Namefocus
Definition

Specimen focus, Extension to represent the entity from which the specimen is collected when it is not the subject of record.

ShortAnimal specimen source
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Specimen Focus) (Extension Type: Reference(RelatedPerson, Group, Device, Substance, Location))
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Specimen.extension:focus.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional 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..0*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Specimen.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. Specimen.extension:focus.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
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.eu/fhir/laboratory/StructureDefinition/specimen-focus
    10. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    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 Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Specimen.identifier
    Definition

    Id for specimen.

    ShortExternal Identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Specimen.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ type
    • 14. Specimen.identifier:PlacerSpecimenNumber
      Slice NamePlacerSpecimenNumber
      Definition

      Id for specimen.

      ShortIdentifier assigned by the Order Placer.External Identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:populateOrder Placer
        SHALL:populateRequestor (ILW)
        SHOULD:populate-if-knownOrder Filler
        SHOULD:populate-if-knownSubcontractor (ILW)
        SHOULD:populate-if-knownAutomation Manager
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Specimen.identifier:PlacerSpecimenNumber.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Specimen.identifier:PlacerSpecimenNumber.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

        Control10..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PLAC"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Specimen.identifier:FillerSpecimenNumber
        Slice NameFillerSpecimenNumber
        Definition

        Id for specimen.

        ShortIdentifier assigned by the lab (Order Filler)External Identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:populateOrder Filler
          SHOULD:populate-if-knownOrder Placer
          SHOULD:populate-if-knownAutomation Manager
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Specimen.identifier:FillerSpecimenNumber.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. Specimen.identifier:FillerSpecimenNumber.type
          Definition

          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

          ShortDescription of identifier
          Comments

          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

          Control10..1
          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
          (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows users to make use of identifiers when the identifier system is not known.

          Pattern Value{
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
              "code" : "FILL"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Specimen.identifier:ShipmentTrackingNumber
          Slice NameShipmentTrackingNumber
          Definition

          Id for specimen.

          ShortIdentifier assigned by the Order PlacerExternal Identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1*
          TypeIdentifier(Shipment Tracking Number)
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHOULD:populateOrder Filler
            SHALL:populate-if-knownOrder Placer
            SHOULD:populate-if-knownAutomation Manager
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Specimen.identifier:GS1SSCC
            Slice NameGS1SSCC
            Definition

            Id for specimen.

            ShortExternal Identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1*
            TypeIdentifier(GS1 Serial Shipping Container Code (SSCC))
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. 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.

            ShortDiscourage - in future FHIR versions accessionIdentifier becomes an identifier, it is recommeded to follow that conventionIdentifier assigned by the lab
            Control0..1
            TypeIdentifier(Specimen Accession Number)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. 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|4.0.1
            (required to http://hl7.org/fhir/ValueSet/specimen-status|4.0.1)

            Codes providing the status/availability of a specimen.

            Typecode
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Specimen.type
            Definition

            The kind of material that forms the specimen.

            ShortKind of material that forms the specimen
            Comments

            If the specimen.type conveys information about the site the specimen has been collected from, then, if the bodySite if present it shall be coherent with the type. For a non-identifiable animal specimen source (e.g. 710069003 | Tick specimen (specimen) |), Specimen.type with the appropriate code shall be used.


            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.

            Control10..1
            BindingThe codes SHALL be taken from For example codes, see Specimen Typehttp://terminology.hl7.org/ValueSet/v2-0487
            (required to https://fhir.nwgenomics.nhs.uk/ValueSet/specimen-type)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Specimen.subject
            Definition

            Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.

            ShortWhere the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device
            Control10..1
            TypeReference(Patient, Patient, Group, Device, Substance, Location)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Must know the subject context.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Specimen.subject.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier(Correlation Identifier)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Specimen.collection
            Definition

            Details concerning the specimen collection.

            ShortCollection details
            Control0..1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Specimen.collection.extension:bodySite
            Slice NamebodySite
            Definition

            Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

            ShortTarget anatomic location or structure
            Control0..1
            TypeExtension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            44. Specimen.collection.extension:bodySite.extension
            Definition

            An Extension


            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortExtensionAdditional 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..0*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Specimen.collection.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 46. Specimen.collection.extension:bodySite.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
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/bodySite
              48. Specimen.collection.extension:bodySite.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Control10..1
              This element is affected by the following invariants: ext-1
              TypeReference(BodyStructure (EU core)), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              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 Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              52. Specimen.collection.collector
              Definition

              Person who collected the specimen.

              ShortWho collected the specimen
              Control0..1
              TypeReference(PractitionerRole, Practitioner, PractitionerRole)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. Specimen.collection.collected[x]
              Definition

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

              ShortCollection time
              Control0..1
              TypedateTime, Period
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. Specimen.collection.quantity
              Definition

              The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.

              ShortThe quantity of specimen collected
              Control0..1
              TypeQuantity(SimpleQuantity)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. Specimen.collection.bodySite
              Definition

              Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.

              ShortAnatomical collection site
              Comments

              If the specimen.type conveys information about the site the specimen has been collected from, then, if the bodySite is present, it shall be coherent with the type


              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 bodySite.

              Control0..1
              BindingThe codes SHOULD be taken from For example codes, see Specimen Body Sitehttp://hl7.org/fhir/ValueSet/body-site|4.0.1
              (preferred to https://fhir.nwgenomics.nhs.uk/ValueSet/specimen-bodysite)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

              0. Specimen
              2. Specimen.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..?
              Must Supporttrue
              SlicingThis element introduces a set of slices on Specimen.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ type
              • 4. Specimen.identifier:PlacerSpecimenNumber
                Slice NamePlacerSpecimenNumber
                ShortIdentifier assigned by the Order Placer.
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:populateOrder Placer
                  SHALL:populateRequestor (ILW)
                  SHOULD:populate-if-knownOrder Filler
                  SHOULD:populate-if-knownSubcontractor (ILW)
                  SHOULD:populate-if-knownAutomation Manager
                  6. Specimen.identifier:PlacerSpecimenNumber.type
                  Control1..?
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code" : "PLAC"
                    }]
                  }
                  8. Specimen.identifier:FillerSpecimenNumber
                  Slice NameFillerSpecimenNumber
                  ShortIdentifier assigned by the lab (Order Filler)
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:populateOrder Filler
                    SHOULD:populate-if-knownOrder Placer
                    SHOULD:populate-if-knownAutomation Manager
                    10. Specimen.identifier:FillerSpecimenNumber.type
                    Control1..?
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code" : "FILL"
                      }]
                    }
                    12. Specimen.identifier:ShipmentTrackingNumber
                    Slice NameShipmentTrackingNumber
                    ShortIdentifier assigned by the Order Placer
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    TypeIdentifier(Shipment Tracking Number)
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHOULD:populateOrder Filler
                      SHALL:populate-if-knownOrder Placer
                      SHOULD:populate-if-knownAutomation Manager
                      14. Specimen.identifier:GS1SSCC
                      Slice NameGS1SSCC
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier(GS1 Serial Shipping Container Code (SSCC))
                      16. Specimen.accessionIdentifier
                      ShortDiscourage - in future FHIR versions accessionIdentifier becomes an identifier, it is recommeded to follow that convention
                      TypeIdentifier(Specimen Accession Number)
                      18. Specimen.type
                      BindingThe codes SHALL be taken from Specimen Type
                      (required to https://fhir.nwgenomics.nhs.uk/ValueSet/specimen-type)
                      Must Supporttrue
                      20. Specimen.subject
                      Control1..?
                      TypeReference(Patient)
                      Must Supporttrue
                      22. Specimen.subject.identifier
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      TypeIdentifier(Correlation Identifier)
                      24. Specimen.collection
                      26. Specimen.collection.collector
                      TypeReference(PractitionerRole)
                      Must Supporttrue
                      28. Specimen.collection.collected[x]
                      TypedateTime, 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
                      Must Supporttrue
                      30. Specimen.collection.quantity
                      Must Supporttrue
                      32. Specimen.collection.bodySite
                      BindingThe codes SHOULD be taken from Specimen Body Site
                      (preferred to https://fhir.nwgenomics.nhs.uk/ValueSet/specimen-bodysite)
                      Must Supporttrue

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

                      0. Specimen
                      Definition

                      Laboratory specimen

                      ShortLaboratory Specimen
                      Control0..*
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                      dom-6: A resource should have narrative for robust management (text.`div`.exists())
                      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
                      Is Modifierfalse
                      Summarytrue
                      4. Specimen.meta
                      Definition

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

                      ShortMetadata about the resource
                      Control0..1
                      TypeMeta
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                      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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                      Control0..1
                      Typeuri
                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      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
                      BindingThe codes SHOULD be taken from CommonLanguages
                      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                      A human language.

                      Additional BindingsPurpose
                      AllLanguagesMax Binding
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      10. Specimen.text
                      Definition

                      A human-readable narrative that contains a summary of the resource and can 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 information is added later.

                      Control0..1
                      TypeNarrative
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesnarrative, html, xhtml, display
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                      Control0..*
                      TypeResource
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. Specimen.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Specimen.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 16. Specimen.extension:focus
                        Slice Namefocus
                        Definition

                        Specimen focus, Extension to represent the entity from which the specimen is collected when it is not the subject of record.

                        ShortAnimal specimen source
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Specimen Focus) (Extension Type: Reference(RelatedPerson, Group, Device, Substance, Location))
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        18. Specimen.extension:focus.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        20. Specimen.extension:focus.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..0
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Specimen.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 22. Specimen.extension:focus.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
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          Fixed Valuehttp://hl7.eu/fhir/laboratory/StructureDefinition/specimen-focus
                          24. Specimen.extension:focus.value[x]
                          Definition

                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                          ShortValue of extension
                          Control0..1
                          TypeReference(RelatedPerson: AnimalSpecimen, Group, Device, Substance, Location)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          26. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          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 Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                          Summaryfalse
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          28. Specimen.identifier
                          Definition

                          Id for specimen.

                          ShortExternal Identifier
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control1..*
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Specimen.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ type
                          • 30. Specimen.identifier:PlacerSpecimenNumber
                            Slice NamePlacerSpecimenNumber
                            Definition

                            Id for specimen.

                            ShortIdentifier assigned by the Order Placer.
                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier
                            Is Modifierfalse
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:populateOrder Placer
                              SHALL:populateRequestor (ILW)
                              SHOULD:populate-if-knownOrder Filler
                              SHOULD:populate-if-knownSubcontractor (ILW)
                              SHOULD:populate-if-knownAutomation Manager
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              32. Specimen.identifier:PlacerSpecimenNumber.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              34. Specimen.identifier:PlacerSpecimenNumber.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. 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 can 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
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Specimen.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 36. Specimen.identifier:PlacerSpecimenNumber.use
                                Definition

                                The purpose of this identifier.

                                Shortusual | official | temp | secondary | old (If known)
                                Comments

                                Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                Control0..1
                                BindingThe codes SHALL be taken from IdentifierUse
                                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                Identifies the purpose for this identifier, if known .

                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                38. Specimen.identifier:PlacerSpecimenNumber.type
                                Definition

                                A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                ShortDescription of identifier
                                Comments

                                This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                Control1..1
                                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

                                A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Allows users to make use of identifiers when the identifier system is not known.

                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                    "code" : "PLAC"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                40. Specimen.identifier:PlacerSpecimenNumber.system
                                Definition

                                Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                ShortThe namespace for the identifier value
                                Comments

                                Identifier.system is always case sensitive.

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

                                There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                ExampleGeneral: http://www.acme.com/identifiers/patient
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                42. Specimen.identifier:PlacerSpecimenNumber.value
                                Definition

                                The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                ShortThe value that is unique
                                Comments

                                If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                ExampleGeneral: 123456
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                44. Specimen.identifier:PlacerSpecimenNumber.period
                                Definition

                                Time period during which identifier is/was valid for use.

                                ShortTime period when id is/was valid for use
                                Control0..1
                                TypePeriod
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                46. Specimen.identifier:PlacerSpecimenNumber.assigner
                                Definition

                                Organization that issued/manages the identifier.

                                ShortOrganization that issued id (may be just text)
                                Comments

                                The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                Control0..1
                                TypeReference(Organization)
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                48. Specimen.identifier:FillerSpecimenNumber
                                Slice NameFillerSpecimenNumber
                                Definition

                                Id for specimen.

                                ShortIdentifier assigned by the lab (Order Filler)
                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control0..1
                                TypeIdentifier
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populateOrder Filler
                                  SHOULD:populate-if-knownOrder Placer
                                  SHOULD:populate-if-knownAutomation Manager
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  50. Specimen.identifier:FillerSpecimenNumber.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  52. Specimen.identifier:FillerSpecimenNumber.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can 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
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Specimen.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 54. Specimen.identifier:FillerSpecimenNumber.use
                                    Definition

                                    The purpose of this identifier.

                                    Shortusual | official | temp | secondary | old (If known)
                                    Comments

                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                    Control0..1
                                    BindingThe codes SHALL be taken from IdentifierUse
                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                    Identifies the purpose for this identifier, if known .

                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    56. Specimen.identifier:FillerSpecimenNumber.type
                                    Definition

                                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                    ShortDescription of identifier
                                    Comments

                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                    Control1..1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

                                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows users to make use of identifiers when the identifier system is not known.

                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                                        "code" : "FILL"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    58. Specimen.identifier:FillerSpecimenNumber.system
                                    Definition

                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

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

                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    60. Specimen.identifier:FillerSpecimenNumber.value
                                    Definition

                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                    ShortThe value that is unique
                                    Comments

                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    62. Specimen.identifier:FillerSpecimenNumber.period
                                    Definition

                                    Time period during which identifier is/was valid for use.

                                    ShortTime period when id is/was valid for use
                                    Control0..1
                                    TypePeriod
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    64. Specimen.identifier:FillerSpecimenNumber.assigner
                                    Definition

                                    Organization that issued/manages the identifier.

                                    ShortOrganization that issued id (may be just text)
                                    Comments

                                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                    Control0..1
                                    TypeReference(Organization)
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    66. Specimen.identifier:ShipmentTrackingNumber
                                    Slice NameShipmentTrackingNumber
                                    Definition

                                    Id for specimen.

                                    ShortIdentifier assigned by the Order Placer
                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control0..1
                                    TypeIdentifier(Shipment Tracking Number)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHOULD:populateOrder Filler
                                      SHALL:populate-if-knownOrder Placer
                                      SHOULD:populate-if-knownAutomation Manager
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      68. Specimen.identifier:GS1SSCC
                                      Slice NameGS1SSCC
                                      Definition

                                      Id for specimen.

                                      ShortExternal Identifier
                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..1
                                      TypeIdentifier(GS1 Serial Shipping Container Code (SSCC))
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      70. 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.

                                      ShortDiscourage - in future FHIR versions accessionIdentifier becomes an identifier, it is recommeded to follow that convention
                                      Control0..1
                                      TypeIdentifier(Specimen Accession Number)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      72. 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|4.0.1)

                                      Codes providing the status/availability of a specimen.

                                      Typecode
                                      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      74. Specimen.type
                                      Definition

                                      The kind of material that forms the specimen.

                                      ShortKind of material that forms the specimen
                                      Comments

                                      If the specimen.type conveys information about the site the specimen has been collected from, then, if the bodySite if present it shall be coherent with the type. For a non-identifiable animal specimen source (e.g. 710069003 | Tick specimen (specimen) |), Specimen.type with the appropriate code shall be used.

                                      Control1..1
                                      BindingThe codes SHALL be taken from Specimen Type
                                      (required to https://fhir.nwgenomics.nhs.uk/ValueSet/specimen-type)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      76. Specimen.subject
                                      Definition

                                      Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.

                                      ShortWhere the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device
                                      Control1..1
                                      TypeReference(Patient)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Must know the subject context.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      78. Specimen.subject.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      80. Specimen.subject.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can 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
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Specimen.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 82. Specimen.subject.reference
                                        Definition

                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                        ShortLiteral reference, Relative, internal or absolute URL
                                        Comments

                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                        Control0..1
                                        This element is affected by the following invariants: ref-1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        84. Specimen.subject.type
                                        Definition

                                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                        ShortType the reference refers to (e.g. "Patient")
                                        Comments

                                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                        Control0..1
                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                        Aa resource (or, for logical models, the URI of the logical model).

                                        Typeuri
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        86. Specimen.subject.identifier
                                        Definition

                                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                        ShortLogical reference, when literal reference is not known
                                        Comments

                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control0..1
                                        TypeIdentifier(Correlation Identifier)
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        88. Specimen.subject.display
                                        Definition

                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                        ShortText alternative for the resource
                                        Comments

                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        90. Specimen.receivedTime
                                        Definition

                                        Time when specimen was received for processing or testing.

                                        ShortThe time when specimen was received for processing
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        92. 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(Specimen: Laboratory)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        94. Specimen.request
                                        Definition

                                        Details concerning a service request that required a specimen to be collected.

                                        ShortWhy the specimen was collected.
                                        Comments

                                        If the specimen information are known when the order is created then the ServiceRequest.specimen should be used. If the ServiceRequest can be updated when the specimen is collected then the ServiceRequest.specimen or the Specimen.request could be used. Otherwise the relationship is recorded in the Specimen.request element

                                        Control0..*
                                        TypeReference(ServiceRequest)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        96. Specimen.collection
                                        Definition

                                        Details concerning the specimen collection.

                                        ShortCollection details
                                        Control0..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        98. 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.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        100. Specimen.collection.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Specimen.collection.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 102. Specimen.collection.extension:bodySite
                                          Slice NamebodySite
                                          Definition

                                          Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

                                          ShortTarget anatomic location or structure
                                          Control0..1
                                          TypeExtension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          104. Specimen.collection.extension: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.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          106. Specimen.collection.extension:bodySite.extension
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..0
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Specimen.collection.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 108. Specimen.collection.extension:bodySite.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
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/bodySite
                                            110. Specimen.collection.extension:bodySite.value[x]
                                            Definition

                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                            ShortValue of extension
                                            Control1..1
                                            This element is affected by the following invariants: ext-1
                                            TypeReference(BodyStructure (EU core))
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            112. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            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 Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            114. Specimen.collection.collector
                                            Definition

                                            Person who collected the specimen.

                                            ShortWho collected the specimen
                                            Control0..1
                                            TypeReference(PractitionerRole)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            116. Specimen.collection.collected[x]
                                            Definition

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

                                            ShortCollection time
                                            Control0..1
                                            TypedateTime
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            118. Specimen.collection.duration
                                            Definition

                                            The span of time over which the collection of a specimen occurred.

                                            ShortHow long it took to collect specimen
                                            Control0..1
                                            TypeDuration
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            120. Specimen.collection.quantity
                                            Definition

                                            The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.

                                            ShortThe quantity of specimen collected
                                            Control0..1
                                            TypeQuantity(SimpleQuantity)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            122. Specimen.collection.method
                                            Definition

                                            A coded value specifying the technique that is used to perform the procedure.

                                            ShortTechnique used to perform collection
                                            Control0..1
                                            BindingFor example codes, see FHIRSpecimenCollectionMethod
                                            (example to http://hl7.org/fhir/ValueSet/specimen-collection-method|4.0.1)

                                            The technique that is used to perform the procedure.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            124. Specimen.collection.bodySite
                                            Definition

                                            Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.

                                            ShortAnatomical collection site
                                            Comments

                                            If the specimen.type conveys information about the site the specimen has been collected from, then, if the bodySite is present, it shall be coherent with the type

                                            Control0..1
                                            BindingThe codes SHOULD be taken from Specimen Body Site
                                            (preferred to https://fhir.nwgenomics.nhs.uk/ValueSet/specimen-bodysite)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            126. Specimen.collection.fastingStatus[x]
                                            Definition

                                            Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection.

                                            ShortWhether or how long patient abstained from food and/or drink
                                            Comments

                                            Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/​time] in 2 hour Urine --12 hours fasting), or using a component observation such asObservation.component code` = LOINC 49541-6 (Fasting status - Reported).

                                            Control0..1
                                            BindingUnless not suitable, these codes SHALL be taken from Hl7VSRelevantClincialInformation (3.0.0)
                                            (extensible to http://terminology.hl7.org/ValueSet/v2-0916|3.0.0)

                                            Codes describing the fasting status of the patient.

                                            TypeChoice of: CodeableConcept, Duration
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Many diagnostic tests require fasting to facilitate accurate interpretation.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            128. Specimen.processing
                                            Definition

                                            Details concerning processing and processing steps for the specimen.

                                            ShortProcessing and processing step details
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            130. 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.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            132. Specimen.processing.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can 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
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            134. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            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 Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            136. Specimen.processing.description
                                            Definition

                                            Textual description of procedure.

                                            ShortTextual description of procedure
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            138. 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|4.0.1)

                                            Type indicating the technique used to process the specimen.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            140. Specimen.processing.additive
                                            Definition

                                            Material used in the processing step.

                                            ShortMaterial used in the processing step
                                            Control0..*
                                            TypeReference(Substance, Substance: Specimen Additive Substance)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            142. 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]
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            144. 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.

                                            ShortDirect container of specimen (tube/slide, etc.)
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            146. 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.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            148. Specimen.container.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Specimen.container.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 150. Specimen.container.extension:device
                                              Slice Namedevice
                                              Definition

                                              R5: Specimen.container.device (new:Reference(Device))

                                              ShortR5: Device resource for the container (new)
                                              Comments

                                              Element Specimen.container.device has a context of Specimen.container based on following the parent source element upwards and mapping to Specimen. Element Specimen.container.device has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(R5: Device resource for the container (new)) (Extension Type: Reference(Cross-version Profile for R5.Device for use in FHIR R4, Device))
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              152. Specimen.container.extension:device.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              154. Specimen.container.extension:device.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..0
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Specimen.container.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 156. Specimen.container.extension:device.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
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Specimen.container.device
                                                158. Specimen.container.extension:device.value[x]
                                                Definition

                                                The device resource for the the container holding the specimen. If the container is in a holder then the referenced device will point to a parent device.

                                                ShortDevice resource for the container
                                                Control1..1
                                                TypeReference(Device)
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                160. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                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 Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                162. Specimen.container.identifier
                                                Definition

                                                Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.

                                                ShortId for the container
                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                Control0..*
                                                TypeIdentifier
                                                Is Modifierfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                164. Specimen.container.description
                                                Definition

                                                Textual description of the container.

                                                ShortTextual description of the container
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                166. Specimen.container.type
                                                Definition

                                                The type of container associated with the specimen (e.g. slide, aliquot, etc.).

                                                ShortKind of container directly associated with specimen
                                                Control0..1
                                                BindingThe codes SHOULD be taken from Specimen Container
                                                (preferred to http://hl7.eu/fhir/laboratory/ValueSet/lab-specimenContainer-eu-lab)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                168. Specimen.container.capacity
                                                Definition

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

                                                ShortContainer volume or size
                                                Control0..1
                                                TypeQuantity(SimpleQuantity)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                170. 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)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                172. Specimen.container.additive[x]
                                                Definition

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

                                                ShortAdditive associated with container
                                                Control0..0
                                                BindingFor example codes, see Hl7VSAdditivePreservative (3.0.0)
                                                (example to http://terminology.hl7.org/ValueSet/v2-0371|3.0.0)

                                                Substance added to specimen container.

                                                TypeChoice of: CodeableConcept, Reference(Substance)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                174. Specimen.condition
                                                Definition

                                                A mode or state of being that describes the nature of the specimen.

                                                ShortState of the specimen
                                                Comments

                                                Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.

                                                Control0..*
                                                BindingUnless not suitable, these codes SHALL be taken from Hl7VSSpecimenCondition (3.0.0)
                                                (extensible to http://terminology.hl7.org/ValueSet/v2-0493|3.0.0)

                                                Codes describing the state of the specimen.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                The specimen condition can be used to assess its quality or appropriateness for a specific test.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                176. 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).

                                                ShortComments
                                                Control0..*
                                                TypeAnnotation
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))