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NHS North West Genomics
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Official URL: https://fhir.nwgenomics.nhs.uk/ImplementationGuide/fhir.nwgenomics.nhs.uk				Version: 0.1.0
Draft as of 2026-02-03				Computable Name: NWGMSA

Overview
Message Based Workflow
Data and Document Sharing
- Regional Data and Document Sharing - Genomic Data Repository (GDR)
Conversational (Event) Based Workflow
- FHIR Workflow
- Health Information Exchange (HIE)
How to Read this IG
SNOMED CT
Dependencies
Credits

Overview

Diagnostic testing is essential to modern clinical care, offering objective information that supports decision-making at every stage of a patient’s journey—from initial evaluation to long-term monitoring and assessment of outcomes.

Genomic diagnostic testing contributes to this process by examining a patient’s DNA or RNA to detect genetic variations that influence disease susceptibility, diagnosis, treatment choices, and prognosis. By delivering highly specific and personalised insights, genomic testing improves the accuracy and effectiveness of clinical management.

NW Genomics Overview

NHS North West Genomics is a new regional NHS service that consolidates clinical genomic testing across the North West of England. Although the service is delivered regionally, it also processes genomic test requests from across the UK. The service is hosted by Manchester University NHS Foundation Trust.

As part of the service transition, existing systems for electronic test ordering and reporting will be enhanced through the introduction of a Regional Integration Engine (RIE) and a Genomic Clinical Data Repository. These components enable seamless data exchange between local clinical systems and regional genomic laboratory services.

Message Based Workflow

NW Genomics Technical Overview

Traditional Point-To-Point Messaging Transformation

The diagram below illustrates point to point messaging between an Order Placer and an Order Filler. The Order Filler is typically a Laboratory Information Management System (LIMS), while the Order Placer is usually a clinical system such as an Electronic Patient Record (EPR).

Not all interactions will necessarily be electronic. For example, reports may be sent by email, and orders may be submitted via email or physically accompany the specimen.

graph LR
    OrderPlacer[<b>Order Placer</b><br/>EPR] --> |1. General Order<br/>HL7 v2 ORM_O01| OrderFiller
    OrderFiller[<b>Order Filler</b><br/>LIMS] --> |2. Laboratory Report<br/>HL7 v2 ORU_R01| OrderPlacer  
    
    classDef purple fill:#E1D5E7;
    class OrderPlacer,OrderFiller purple

In many NHS Trusts, a Trust Integration Engine (TIE) is used to facilitate this point-to-point messaging.

graph LR

    OrderPlacer[<b>Order Placer</b><br/>EPR] --> |1. General Order<br/>HL7 v2 ORM_O01| TIE["Trust Integration Engine (TIE)"]
    TIE --> |2. General Order<br/>HL7 v2 ORM_O01| OrderFiller
    OrderFiller[<b>Order Filler</b><br/>LIMS] --> |3. Laboratory Report<br/>HL7 v2 ORU_R01| TIE
    TIE --> |4. Laboratory Report<br/>HL7 v2 ORU_R01| OrderPlacer 
    
    classDef purple fill:#E1D5E7;
    class OrderPlacer,OrderFiller purple

TIEs typically handle transformations between the different HL7 v2 variants used by Order Placers (e.g. EPRs) and Order Fillers (e.g. LIMS).

Regional Integration Engine (RIE) – Initial Interoperability For Existing Messaging Flows

Existing interfaces to NW Genomics LIMS will be migrated to use the Regional Integration Engine (RIE). The RIE performs similar functions to NHS Trust TIEs, and in the interim phase will perform pass through routing of messages only.

graph LR

    OrderPlacer[<b>Order Placer</b><br/>EPR] --> |1. General Order<br/>HL7 v2 ORM_O01| TIE["Trust Integration Engine (TIE)"]
    TIE --> |2. General Order<br/>HL7 v2 ORM_O01| RIE
    RIE["Regional Integration Engine (RIE)"] --> |3. General Order<br/>HL7 v2 ORM_O01| OrderFiller
    OrderFiller[<b>Order Filler</b><br/>LIMS] --> |4. Laboratory Report<br/>HL7 v2 ORU_R01| RIE
    RIE --> |5. Laboratory Report<br/>HL7 v2 ORU_R01| TIE
    TIE --> |6. Laboratory Report<br/>HL7 v2 ORU_R01| OrderPlacer
    
    classDef purple fill:#E1D5E7;
    class OrderPlacer,OrderFiller purple

Regional Integration Engine (RIE) - Regional Interoperability

The regional genomic service supports more than 20 NHS Trusts, each potentially operating different clinical systems. Within NHS North West Genomics itself, multiple LIMS and supporting clinical systems are in use. Under a traditional point-to-point integration model, this rapidly leads to a highly complex and fragile integration landscape.

graph LR

    OrderPlacerA[<b>Order Placer</b><br/>NHS Trust A]
    OrderPlacerB[<b>Order Placer</b><br/>NHS Trust B]
    OrderPlacerC[<b>Order Placer</b><br/>NHS Trust C]

    LIMSA[<b>Order Filler</b><br>LIMS iGene]
    LIMSB[<b>Order Filler</b><br>LIMS B]
    LIMSC[<b>Order Filler</b><br>LIMS C]
    LIMSD[<b>Order Filler</b><br>LIMS D]

    OrderPlacerA <--> LIMSA
    OrderPlacerA <--> LIMSB
    OrderPlacerA <--> LIMSC
    OrderPlacerA <--> LIMSD

    OrderPlacerB <--> LIMSA
    OrderPlacerB <--> LIMSB
    OrderPlacerB <--> LIMSC
    OrderPlacerB <--> LIMSD

    OrderPlacerC <--> LIMSA
    OrderPlacerC <--> LIMSB
    OrderPlacerC <--> LIMSC
    OrderPlacerC <--> LIMSD

To address this challenge, the RIE acts as a central routing and interoperability hub. All orders and reports are exchanged between NHS Trust ordering systems and North West Genomics LIMS platforms via the RIE.

Rather than maintaining multiple bespoke integrations, each participant integrates once with the RIE. Trust Integration Engines remain responsible for transforming messages between local EPR systems and the regional standard used by the RIE.

A key element of this approach is the introduction of standardised message formats and interactions between Trust TIEs and the RIE. These standards are based on a single, shared data model known as the Data Contract.

graph LR
  
    subgraph NHSTrustA[NHS Trust A]
        NHSA[<b>Order Placer</b><br/>EPR]
      
    end    

    subgraph NHSTrustB[NHS Trust B]
        NHSB[<b>Order Placer</b><br/>EPR] 
        
    end
    subgraph DataContracts[Data Contract]
        TIEA["NHS Trust A Integration Engine (TIE)"]
        TIEB["NHS Trust B Integration Engine (TIE)"]
        RIE["Regional Integration Engine (RIE)"]
    end
    NHSA --> |Laboratory Order<br/>HL7 ORM_O01| TIEA
    NHSB --> |Laboratory Order<br/>HL7 OML_O21| TIEB 
    TIEA --> |Laboratory Order<br/>HL7 OML_O21<br/>HE LTW LAB-1| RIE
    TIEB --> |Laboratory Order<br/>HL7 OML_O21<br/>HE LTW LAB-1| RIE
 
    NHSB --> RIE
    RIE --> |Laboratory Order<br/>HL7 v2 OML_O21| LIMSA
    RIE --> LIMSB
    RIE --> LIMSC
    RIE --> LIMSD
     
    LIMSA[<b>Order Filler</b><br>LIMS iGene]
    LIMSB[<b>Order Filler</b><br>LIMS Shire]
    LIMSC[<b>Order Filler</b><br>LIMS C]
    LIMSD[<b>Order Filler</b><br>LIMS D]

Equivalent patterns apply to laboratory reports.

graph LR
    subgraph NHSTrustA[NHS Trust A]
        NHSA[<b>Order Placer</b><br/>EPR]
    end    

    subgraph NHSTrustB[NHS Trust B]
        NHSB[<b>Order Placer</b><br/>EPR] 
    end

    subgraph DataContracts[Data Contract]
        RIE["Regional Integration Engine (RIE)"]
        TIEA["NHS Trust A Integration Engine (TIE)"]
        TIEB["NHS Trust B Integration Engine (TIE)"]
  
    end 
    ICSA[NHS ICS A]
    ICSB[NHS ICS B]
    APPA[NW Genomics Application 1]
    APPB[NW Genomics Application 2]

    LIMSA[<b>Order Filler</b><br>LIMS iGene]
    LIMSB[<b>Order Filler</b><br>LIMS Shire]
    LIMSC[<b>Order Filler</b><br>LIMS C]
    LIMSD[<b>Order Filler</b><br>LIMS D]
   
    LIMSA --> |Laboratory Report<br/>HL7 v2 ORU_R01| RIE
    LIMSB --> RIE
    LIMSC --> RIE
    LIMSD --> RIE
    RIE["Regional Integration Engine (RIE)"] --> |Laboratory Report<br/>HL7 v2 ORU_R01<br/>IHE LTW LAB-3| TIEA
    RIE --> |Laboratory Report<br/>HL7 v2 ORU_R01<br/>IHE LTW LAB-3| TIEB
    TIEA --> |Laboratory Report<br/>HL7 v2 ORU_R01| NHSA
    TIEB --> |Laboratory Report<br/>HL7 v2 ORU_R01| NHSB
    RIE --> |Document Notification<br/>HL7 MDM_T02<br/>IHE XDS/MHD| ICSA
    RIE --> ICSB
    RIE --> |Laboratory Report<br/>HL7 v2 ORU_R01<br/>IHE LTW LAB-3| APPB
    RIE --> APPA

RIE vs Trust Integration Engine

The primary distinction between a Regional Integration Engine and a Trust Integration Engine is scope:

Trust Integration Engines focus on internal interoperability within a single organisation.
The Regional Integration Engine operates at a regional level, providing centralised routing and orchestration across multiple organisations.

This hub-and-spoke model significantly reduces integration complexity, improves maintainability, and supports consistent data quality across the region. The main distinction between a Regional Integration Engine (RIE) and a Trust Integration Engine is that the RIE functions as a central routing hub. Each participant connects only to the RIE rather than individually integrating with multiple other systems. This significantly reduces integration complexity. Trust TIEs will still be responsible for transforming messages between their internal EPR systems and the RIE.

Identifier and Codes (Terminology) Standardisation

Because the RIE operates at a regional level, certain HL7 v2 message components must be standardised or updated. These changes ensure global uniqueness for identifiers such as:

Patient identifiers: NHS Number (England and Wales), CHI Number (Scotland), HSCN Number (Northern Ireland), and local NHS Trust medical record numbers
Order identifiers: placer and filler order numbers
Report identifiers
Visit identifiers: spell or episode numbers
Specimen identifiers: including accession and pathology specimen identifiers

Standard clinical terminologies are used to ensure semantic interoperability:

SNOMED CT for clinical concepts
LOINC (and SNOMED CT) for laboratory observations and orderable items

These requirements are outlined in the Data Contract. HL7 v2 message exchanges are aligned with HL7 v2.5.1 and the following IHE profiles (API Contracts):

IHE Laboratory Testing Workflow (LTW) profile
IHE Inter Laboratory Workflow (ILW) profile (Future)
IHE Specimen Event Tracking (SET) profile (Future)

Practical Implementation

From a practical perspective, the RIE is introduced into the existing point-to-point messaging flow. It is at this boundary—between the TIE and the RIE—that the use of the Data Contracts , including HL7 v2.5.1 and adoption of IHE LTW, is mandated.

Data Contracts are not mandated between the RIE and LIMS, nor between the TIE and EPR. For practical reasons, these systems may require changes in the future to align with the central Data Contracts.

NHS Trust TIEs do not interface directly with the LIMS within NHS North West Genomics and, going forward, will not interface directly with LIMS from other regional genomic systems and NHS England Genomic Order Management Service. All such interactions will be managed by the RIE.

graph LR
    OrderPlacer[<b>Order Placer</b><br/>EPR] --> |1. General Order<br/>HL7 v2 ORM_O01/OML_O21| TIE
    subgraph DataContract[Data Contract]
        TIE["Trust Integration Engine (TIE)"]
        RIE["Regional Integration Engine (RIE)"]
    end 
    TIE --> |2. General Order<br/>HL7 v2.5.1 OML_O21| RIE
    RIE --> |3. General Order<br/>HL7 v2 ORM_O01/OML_O21| OrderFiller
    
    OrderFiller[<b>Order Filler</b><br/>LIMS] --> |4. Laboratory Report<br/>HL7 v2 ORU_R01| RIE
    RIE --> |5. Laboratory Report<br/>HL7 v2.5.1 ORU_R01| TIE 
    TIE --> |6. Laboratory Report<br/>HL7 v2 ORU_R01| OrderPlacer

Traditional messaging focuses solely on communication between two systems—the order placer and the order filler—and does not support wider sharing of genomic data across multiple organisations such as NHS Trusts, GP practices, or other clinical teams.

To address this, a central Genomic Data Repository (GDR) will be established. This repository will provide a read-only FHIR RESTful (read only API) and will be populated via data flows through the RIE (See Health Information Exhange (HIE)) and will focus primarily on sharing data produced by NHS North West Genomics.

graph TD
    subgraph DataContracts[Data Contract]
        CDR["<b>Data Source</b>Genomic Data Repository (GDR)"]
        NHSA[<b>Data Consumer</b><br/>NHS GP/Trust/Board/ICS A]
        NHSB[<b>Document Consumer</b><br/>NHS GP/Trust/Board/ICS B] 

        APPA[<b>Data Consumer</b><br/>Application 1]
        APPB[<b>Document Consumer</b><br/>Application 2]
    end
    NHSE[<b>Document Consumer</b><br/>NHS England<br/>Summary Care Record<br/>National Record Locator] 

    CDR --> |HL7 FHIR RESTful<br/>IHE QEDm| NHSA
    CDR --> |HL7 FHIR RESTful<br/>IHE MHD| NHSB
    CDR --> |HL7 FHIR RESTful| NHSE
    CDR --> |HL7 FHIR RESTful<br/>IHE QEDm|APPA
    CDR --> |HL7 FHIR RESTful<br/>IHE MHD| APPB
    
    classDef purple fill:#E1D5E7;
    class CDR,NHSA,NHSB,APPA,APPB,NHSE purple

The Data Contract and data structures used in the FHIR interfaces follow the same conventions as those used in the HL7 v2 message exchanges.

The CDR is expected to adopt emerging IHE Europe standards for clinical data and document sharing. These currently include (API Contract):

IHE Mobile access to Health Documents (MHD) ITI-66 and ITI-67 HL7 FHIR
IHE Query for Existing Data for Mobile (QEDm) PCC-44 HL7 FHIR
IHE Patient Demographics Query for Mobile (PDQm) ITI-78 HL7 FHIR
IHE Internet User Authorization (IUA) OAuth2
IHE Basic Audit Log Patterns (BALP) HL7 FHIR

Conversational (Event) Based Workflow

FHIR Workflow

The introduction of data and document sharing using HL7 FHIR RESTful APIs enables a transition from a traditional message-based workflow to an event-based workflow (see FHIR Workflow).

graph LR
    subgraph OrderPlacerM[Order Placer]
        OrderPlacer[<b>Order Placer</b><br/>EPR]

        DataO["<b>Data Source and Consumer</b>"]
    end 
    subgraph OrderFillerM[Order Filler]
        OrderFiller[<b>Order Filler</b><br/>LIMS] 
        DataF["<b>Data Source and Consumer</b>"]
       
    end 

    OrderPlacer--> |Event Notification - FHIR Task| OrderFiller
    OrderFiller --> |Event Notification - FHIR Task| OrderPlacer  

    DataO --> |HL7 FHIR RESTful<r/>IHE QEDm/MHD/PDQm| DataF
    DataF --> |HL7 FHIR RESTful<r/>IHE QEDm/MHD/PDQm| DataO
    
    classDef purple fill:#E1D5E7;
    class OrderPlacer,OrderFiller,DataO,DataF purple

In this model, orders and reports are no longer exchanged directly between the Order Placer and the Order Filler. Instead, both systems communicate through FHIR Tasks, using event notifications to coordinate activities and state changes.

This represents a shift from a message-oriented workflow (see EIP Messaging Patterns) to a conversation-based workflow (see EIP Conversation Patterns). Rather than relying on single, transactional messages, the workflow is managed as an ongoing conversation between participants.

Although this approach involves multiple exchanges between the Order Placer and the Order Filler, it more accurately reflects real-world clinical workflows, where work progresses through a series of coordinated steps, acknowledgements, and state transitions rather than a single request–response interaction.

It is anticipated that event notifications will be implemented using FHIR Subscriptions, which support a publish–subscribe (pub/sub) pattern, or alternatively through the NHS England Multicast Notification Service API.


sequenceDiagram
    participant OrderPlacer As Order Placer
    participant DataO as Data Source <br/> Order Placer
    participant OrderFiller As Order Filler
    participant DataF as Data Source <br/> Order Filler

    OrderPlacer ->> DataO: Create Order
    OrderPlacer ->> OrderFiller: DiagnosticRequest - Event Notification (FHIR Task (requested))
    OrderFiller ->> DataO: Retrieve Laboratory Order (FHIR RESTful API Query) 
    alt is accepted
        OrderFiller ->> OrderPlacer: Task Diagnostic Request - Event Notification (FHIR Task (accepted))
        Note over OrderFiller: Starts Testing
         OrderFiller ->> OrderPlacer: Task Diagnostic Request - Event Notification (FHIR Task (in-progress))
        Note over OrderFiller: Interpretation of results and write Report
        OrderFiller ->> DataF: Creates Laboratory Order
        OrderFiller ->> OrderPlacer: Task DiagnosticRequest - Event Notification (FHIR Task (completed))
        OrderPlacer ->> DataF : Retrieve Laboratory Report (FHIR RESTful API Query)
    else is rejected 
        OrderFiller ->> OrderPlacer: Task Diagnostic Request - Event Notification (FHIR Task (rejected))
    end

This diagram illustrates an event-based, conversation-driven laboratory ordering workflow using HL7 FHIR Tasks.

The Order Placer creates a diagnostic order and notifies the Order Filler via a FHIR Task. The Order Filler retrieves the order using FHIR RESTful queries, accepts or rejects the request, and communicates status updates (accepted, in-progress, completed, or rejected) back to the Order Placer through task-based event notifications. Laboratory testing, result interpretation, and report creation occur asynchronously, with reports retrieved by the Order Placer via FHIR RESTful APIs upon task completion.

Health Information Exchange (HIE)

A conversational (event-based) workflow, also referred to as a conversation-based workflow, represents a modern approach to clinical messaging. This paradigm assumes that both the Order Placer and the Order Filler can share data using HL7 FHIR RESTful APIs.

In practice, this capability may not always be available. For example, Laboratory Information Management Systems (LIMS) within NHS North West Genomics may not support FHIR RESTful APIs. In such cases, the Genomic Data Repository (GDR) is used to share genomic laboratory reports and other genomic data. Similarly, if Electronic Patient Record (EPR) systems do not support FHIR RESTful APIs, the GDR is used to facilitate the sharing of laboratory orders.

Together, the Regional Integration Engine (RIE) and the Genomic Data Repository (GDR) collectively constitute the Health Information Exchange (HIE).

Health Information Exchange (HIE)

How to Read this IG

Menu Item	Description	Audience
Analysis and Design (Volume 1)	Description of the processes and corresponding technical frameworks	General
Interfaces (Volume 2)	Description of the processes and corresponding technical frameworks (HL7 v2 and FHIR Interactions)	Detailed Technical (Integration Developer)
Data Models (Volume 3)	NHS North West Forms, Templates, Reports, and Compositions	Data Modeling (Detailed Technical)
Artefacts (Volume 4)	NHS North West Common Data Models	Detailed Technical
Development	Testing, Suppport and Architecture	Detailed Technical (Developer)

Diagnostic Process	Analysis and Design	Interfaces	Domain Archetype	Domain Entity (Resources) Data Contract
Workflow Management	FHIR Workflow			Task
Laboratory Order	Send Laboratory Order (IHE LTW)	HL7 FHIR IHE LTW LAB-1	North West Genomics Test Order	ServiceRequest
	Read & Search Laboratory Order (HIE)	HL7 FHIR IHE QEDm PCC-44		Various Resource Profiles
Laboratory Report	Laboratory Testing Workflow (LTW)	HL7 FHIR IHE LAB-3 and HL7 v2 ORU LAB-3/R01	North West Genomics Test Report	DiagnosticReport
	Inter Laboratory Workflow (ILW)
	Send Laboratory Report Document (HIE)	HL7 v2 MDM T02	North West Genomics Test Report	DocumentReference
	Read & Search Laboratory Report Data (HIE)	HL7 FHIR IHE QEDm PCC-44		Various Resource Profiles
	Read & Seerch Laboratory Report Documents (HIE)	HL7 FHIR IHE MHD ITI-66 and ITI-67		DocumentReference
Specimen Collection	Specimen Event Tracking (SET)			Specimen
Other	Patient Administration	HL7 FHIR IHE PDQm ITI-78		Patient Encounter
	Authorisation (OAuth2	OAUth2 IHE IUA ITI-103 ITI-71 ITI-102

Diagnostic Process

Analysis and Design

Interfaces

Domain Archetype

Domain Entity (Resources)
Data Contract

Workflow Management

FHIR Workflow

Task

Laboratory Order

Send Laboratory Order (IHE LTW)

HL7 FHIR IHE LTW LAB-1

North West Genomics Test Order

ServiceRequest

Read & Search Laboratory Order (HIE)

HL7 FHIR IHE QEDm PCC-44

Various Resource Profiles

Laboratory Report

Laboratory Testing Workflow (LTW)

HL7 FHIR IHE LAB-3 and HL7 v2 ORU LAB-3/R01

North West Genomics Test Report

DiagnosticReport

Inter Laboratory Workflow (ILW)

Send Laboratory Report Document (HIE)

HL7 v2 MDM T02

North West Genomics Test Report

DocumentReference

Read & Search Laboratory Report Data (HIE)

HL7 FHIR IHE QEDm PCC-44

Various Resource Profiles

Read & Seerch Laboratory Report Documents (HIE)

HL7 FHIR IHE MHD ITI-66 and ITI-67

DocumentReference

Specimen Collection

Specimen Event Tracking (SET)

Specimen

Other

Patient Administration

HL7 FHIR IHE PDQm ITI-78

Patient
Encounter

Authorisation (OAuth2

OAUth2 IHE IUA ITI-103 ITI-71 ITI-102

SNOMED CT

UK edition of SNOMED (83821000000107)

Dependencies

IG	Package	FHIR	Comment
NHS North West Genomics	fhir.nwgenomics.nhs.uk#0.1.0	R4
HL7 Terminology (THO)	hl7.terminology.r4#7.0.1	R4	Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack	hl7.fhir.uv.extensions.r4#5.2.0	R4
fhir.r4.ukcore.stu3.currentbuild	fhir.r4.ukcore.stu3.currentbuild#0.0.19-pre-release	R4
Genomics Reporting Implementation Guide	hl7.fhir.uv.genomics-reporting#3.0.0	R4
HL7 Terminology (THO)	hl7.terminology.r4#6.1.0	R4
FHIR Extensions Pack	hl7.fhir.uv.extensions.r4#5.1.0	R4
HL7 Europe Laboratory Report	hl7.fhir.eu.laboratory#0.1.1	R4
HL7 Terminology (THO)	hl7.terminology.r4#6.2.0	R4
International Patient Summary Implementation Guide	hl7.fhir.uv.ips#1.1.0	R4
HL7 Terminology (THO)	hl7.terminology.r4#5.0.0	R4
fhir.dicom	fhir.dicom#2022.4.20221006	R4
Structured Data Capture	hl7.fhir.uv.sdc#3.0.0	R4
FHIR Tooling Extensions IG	hl7.fhir.uv.tools.r4#0.8.0	R4	for example references

Package hl7.fhir.uv.extensions.r4#5.2.0

This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package fhir.r4.ukcore.stu3.currentbuild#0.0.19-pre-release

UK Core FHIR profiles and Assets

Package hl7.fhir.uv.extensions.r4#5.1.0

This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.genomics-reporting#3.0.0

Guidelines for reporting of clinical genomics results using HL7 FHIR. (built Thu, Dec 12, 2024 20:34+0000+00:00)

Package hl7.fhir.uv.ips#1.1.0

International Patient Summary (IPS) FHIR Implementation Guide (built Tue, Nov 22, 2022 03:24+0000+00:00)

Package hl7.fhir.eu.laboratory#0.1.1

This guide describes how the Laboratory Report can be represented in the European REALM. (built Tue, Mar 25, 2025 12:00+0100+01:00)

Package hl7.fhir.uv.sdc#3.0.0

The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR.
This includes two components:
* Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains.
*Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Package hl7.fhir.uv.tools.r4#0.8.0

This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Aug 5, 2025 20:09+1000+10:00)

Credits

Role(s)	Contributor(s)
	North West Genomic Medicine Service Alliance
	Alder Hey Children's Hospital Trust
	Manchester University NHS Foundation Trust
	Liverpool Womens NHS Foundation Trust
	The Christie NHS Foundation Trust
	NHS England
Staff Engineer	Kevin Mayfield, Aire Logic & Mayfield IS

Role(s)

Contributor(s)

North West Genomic Medicine Service Alliance

Alder Hey Children's Hospital Trust

Manchester University NHS Foundation Trust

Liverpool Womens NHS Foundation Trust

The Christie NHS Foundation Trust

NHS England

Staff Engineer

Kevin Mayfield, Aire Logic & Mayfield IS

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Overview

Message Based Workflow

Traditional Point-To-Point Messaging Transformation

Regional Integration Engine (RIE) – Initial Interoperability For Existing Messaging Flows

Regional Integration Engine (RIE) - Regional Interoperability

RIE vs Trust Integration Engine

Identifier and Codes (Terminology) Standardisation

Practical Implementation

Data and Document Sharing

Regional Data and Document Sharing - Genomic Data Repository (GDR)

Conversational (Event) Based Workflow

FHIR Workflow

Health Information Exchange (HIE)

How to Read this IG

SNOMED CT

Dependencies

Credits