NHS North West Genomics
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: Shire Cytogenetics Report R01 - Future Structured Example

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{
  "resourceType" : "Bundle",
  "id" : "Shire1StructuredR01",
  "language" : "en",
  "identifier" : {
    "value" : "SHIRE:CPP:RTST-260416-2"
  },
  "type" : "message",
  "timestamp" : "2026-04-16T11:09:00+00:00",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:09eefbd5-5414-4d7e-80db-82b8d0cdeaba",
      "resource" : {
        "resourceType" : "MessageHeader",
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader </b></p><p><b>event</b>: <a href=\"http://terminology.hl7.org/7.3.0/CodeSystem-v2-0003.html#v2-0003-R01\">event: R01</a> (ORU/ACK - Unsolicited transmission of an observation message)</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&amp;canonical=http://fhir.org/packages/fhir.r4.ukcore.stu3.currentbuild/https//fhir.mft.nhs.uk/Endpoint/HODS\">https//fhir.mft.nhs.uk/Endpoint/HODS</a></td><td>Identifier: <a href=\"NamingSystem-ods-organization-code-namingsystem.html\" title=\"The identifier system for an Organisation registered with the Organisation Data Service (ODS).\">ODS Organisation Code</a>/HODS</td></tr></table><p><b>sender</b>: Identifier: <a href=\"NamingSystem-ods-organization-code-namingsystem.html\" title=\"The identifier system for an Organisation registered with the Organisation Data Service (ODS).\">ODS Organisation Code</a>/CPP</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Software</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>NW GLH</td><td><a href=\"https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&amp;canonical=https://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE\">https://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-Shire1StructuredR01.html#urn-uuid-d918c758-03a0-42e8-9da7-1586e6369980\">Diagnostic Report for 'Karyotype [Identifier] in Bone marrow Nominal' for '-&gt;SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)'</a></p></div>"
        },
        "eventCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0003",
          "code" : "R01"
        },
        "destination" : [
          {
            "endpoint" : "https//fhir.mft.nhs.uk/Endpoint/HODS",
            "receiver" : {
              "identifier" : {
                "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
                "value" : "HODS"
              }
            }
          }
        ],
        "sender" : {
          "identifier" : {
            "system" : "https://fhir.nhs.uk/Id/ods-organization-code",
            "value" : "CPP"
          }
        },
        "source" : {
          "software" : "NW GLH",
          "endpoint" : "https://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE"
        },
        "focus" : [
          {
            "reference" : "urn:uuid:d918c758-03a0-42e8-9da7-1586e6369980"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8",
      "resource" : {
        "resourceType" : "Patient",
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient </b></p><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</p><hr/></div>"
        },
        "identifier" : [
          {
            "extension" : [
              {
                "url" : "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland",
                      "code" : "05",
                      "display" : "Trace needs to be resolved - (NHS number or patient detail conflict)"
                    }
                  ]
                }
              }
            ],
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "NH"
                }
              ]
            },
            "system" : "https://fhir.nhs.uk/Id/nhs-number",
            "value" : "9737383192"
          }
        ],
        "name" : [
          {
            "family" : "MANCHESTER",
            "given" : [
              "SANSA"
            ]
          }
        ],
        "gender" : "female",
        "birthDate" : "1972-09-21"
      }
    },
    {
      "fullUrl" : "urn:uuid:1d085155-0068-4cfe-b3ba-0fac6fcd630b",
      "resource" : {
        "resourceType" : "Observation",
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation </b></p><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 62356-1}\">Chromosome analysis result in ISCN expression</span></p><p><b>subject</b>: <a href=\"Bundle-Shire1StructuredR01.html#urn-uuid-dad58958-991b-4431-bd91-35c113dfafb8\">SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</a></p><p><b>value</b>: 46,XY,del(20)(q*q*)[]</p><p><b>note</b>: </p><blockquote><div><p>Chromosome analysis has shown an abnormal karyotype with a deletion in the long arm of chromosome 20.</p>\n</div></blockquote></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "62356-1",
              "display" : "Chromosome analysis result in ISCN expression"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"
        },
        "valueString" : "46,XY,del(20)(q*q*)[]",
        "note" : [
          {
            "text" : "Chromosome analysis has shown an abnormal karyotype with a deletion in the long arm of chromosome 20."
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:72387d7b-3b87-4845-875e-7910cd245b7f",
      "resource" : {
        "resourceType" : "Observation",
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation </b></p><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 62389-2}\">Chromosome analysis master panel</span></p><p><b>subject</b>: <a href=\"Bundle-Shire1StructuredR01.html#urn-uuid-dad58958-991b-4431-bd91-35c113dfafb8\">SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</a></p><p><b>hasMember</b>: <a href=\"Bundle-Shire1StructuredR01.html#urn-uuid-1d085155-0068-4cfe-b3ba-0fac6fcd630b\">Observation Chromosome analysis result in ISCN expression</a></p></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "62389-2",
              "display" : "Chromosome analysis master panel"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"
        },
        "hasMember" : [
          {
            "reference" : "urn:uuid:1d085155-0068-4cfe-b3ba-0fac6fcd630b"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:d918c758-03a0-42e8-9da7-1586e6369980",
      "resource" : {
        "resourceType" : "DiagnosticReport",
        "language" : "en",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DiagnosticReport_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: DiagnosticReport </b></p><h2><span title=\"Codes:{http://loinc.org 33893-9}\">Karyotype [Identifier] in Bone marrow Nominal</span> (<span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}\">Genetics</span>) </h2><table class=\"grid\"><tr><td>Subject</td><td>SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</td></tr></table><p><b>Report Details</b></p><table class=\"grid\"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td></tr><tr><td><a href=\"Bundle-Shire1StructuredR01.html#urn-uuid-72387d7b-3b87-4845-875e-7910cd245b7f\"><span title=\"Codes:{http://loinc.org 62389-2}\">Chromosome analysis master panel</span></a></td><td/><td>Final</td></tr></table></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "GE"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "33893-9",
              "display" : "Karyotype [Identifier] in Bone marrow Nominal"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"
        },
        "result" : [
          {
            "reference" : "urn:uuid:72387d7b-3b87-4845-875e-7910cd245b7f"
          }
        ]
      }
    }
  ]
}