{ "resourceType" : "Bundle", "id" : "Shire2StructuredR01", "language" : "en", "identifier" : { "value" : "SHIRE:CPP:RTST-260416-0" }, "type" : "message", "timestamp" : "2026-04-16T10:38:39+00:00", "entry" : [{ "fullUrl" : "urn:uuid:45a1d9f7-aebc-4e5c-bc88-6a39632bc2af", "resource" : { "resourceType" : "MessageHeader", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: MessageHeader

event: event: R01 (ORU/ACK - Unsolicited transmission of an observation message)

Destinations

-EndpointReceiver
*https//fhir.mft.nhs.uk/Endpoint/HODSIdentifier: ODS Organisation Code/HODS

sender: Identifier: ODS Organisation Code/CPP

Sources

-SoftwareEndpoint
*NW GLHhttps://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE

focus: Diagnostic Report for 'Karyotype [Identifier] in Bone marrow Nominal' for '->NED LIVERPOOL Unknown, DoB: 1942-06-18 ( National Health Plan Identifier)'

" }, "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:2ebb9c8d-eb68-42cc-ab53-c07f55869788" }] } }, { "fullUrl" : "urn:uuid:52f677f9-6ab0-4a95-8b68-8b12762eedfb", "resource" : { "resourceType" : "Patient", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: Patient

NED LIVERPOOL Unknown, DoB: 1942-06-18 ( National Health Plan Identifier)

Other Id:Patient internal identifier/00123456789
" }, "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" : "9737383206" }, { "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "PI" }] }, "value" : "00123456789" }], "name" : [{ "family" : "LIVERPOOL", "given" : ["NED"] }], "gender" : "unknown", "birthDate" : "1942-06-18" } }, { "fullUrl" : "urn:uuid:7b14e763-b7a6-49de-9686-2fcd0e1da322", "resource" : { "resourceType" : "Observation", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: Observation

status: Final

category: Laboratory

code: Chromosome analysis result in ISCN expression

subject: NED LIVERPOOL Unknown, DoB: 1942-06-18 ( National Health Plan Identifier)

value: 48~50,XY,+X,-Y,-3,-6,-7,del(7)(q?31q36),+8,+11,add(12)(p11.2),+14,+15,-16,+19,+20,+22-,+1~2mar[cp10]

note:

48\\R\\50,XY,+X,-Y,-3,-6,-7,del(7)(q?31q36),+8,+11,add(12)(p11.2),+14,+15,-16,+19,+20,+22- ,+1\\R\\2mar[cp10] -Amendment 14/10/20

\n
" }, "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:52f677f9-6ab0-4a95-8b68-8b12762eedfb" }, "valueString" : "48~50,XY,+X,-Y,-3,-6,-7,del(7)(q?31q36),+8,+11,add(12)(p11.2),+14,+15,-16,+19,+20,+22-,+1~2mar[cp10]", "note" : [{ "text" : "48\\R\\50,XY,+X,-Y,-3,-6,-7,del(7)(q?31q36),+8,+11,add(12)(p11.2),+14,+15,-16,+19,+20,+22- ,+1\\R\\2mar[cp10] -Amendment 14/10/20" }] } }, { "fullUrl" : "urn:uuid:b6fedd0a-7cf6-4308-948e-5c9531ccda0d", "resource" : { "resourceType" : "Observation", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: Observation

status: Final

category: Laboratory

code: Chromosome analysis panel by FISH

subject: NED LIVERPOOL Unknown, DoB: 1942-06-18 ( National Health Plan Identifier)

value: 7q deletion detected.

component

code: Interphase cells positive

value: 93 cells

component

code: Cells counted [#]

value: 100 cells

" }, "status" : "final", "category" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }] }], "code" : { "coding" : [{ "system" : "http://loinc.org", "code" : "62367-8", "display" : "Chromosome analysis panel by FISH" }] }, "subject" : { "reference" : "urn:uuid:52f677f9-6ab0-4a95-8b68-8b12762eedfb" }, "valueString" : "7q deletion detected.", "component" : [{ "code" : { "text" : "Interphase cells positive" }, "valueQuantity" : { "value" : 93, "unit" : "cells" } }, { "code" : { "coding" : [{ "system" : "http://loinc.org", "code" : "62361-1", "display" : "Cells counted [#]" }] }, "valueQuantity" : { "value" : 100, "unit" : "cells" } }] } }, { "fullUrl" : "urn:uuid:d54744fb-f490-44a1-90a0-1bfbce716fc5", "resource" : { "resourceType" : "Observation", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: Observation

status: Final

category: Laboratory

code: Chromosome analysis master panel

subject: NED LIVERPOOL Unknown, DoB: 1942-06-18 ( National Health Plan Identifier)

hasMember:

" }, "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:52f677f9-6ab0-4a95-8b68-8b12762eedfb" }, "hasMember" : [{ "reference" : "urn:uuid:7b14e763-b7a6-49de-9686-2fcd0e1da322" }, { "reference" : "urn:uuid:b6fedd0a-7cf6-4308-948e-5c9531ccda0d" }] } }, { "fullUrl" : "urn:uuid:2ebb9c8d-eb68-42cc-ab53-c07f55869788", "resource" : { "resourceType" : "DiagnosticReport", "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: DiagnosticReport

Karyotype [Identifier] in Bone marrow Nominal (Genetics)

SubjectNED LIVERPOOL Unknown, DoB: 1942-06-18 ( National Health Plan Identifier)

Report Details

CodeValueFlags
Chromosome analysis master panelFinal

Complex abnormal hyperdiploid karyotype with gains of chromosomes 8 and\n11, and loss of 7q and 12p which are recognised findings in myeloid neoplasms\nincluding AML

" }, "status" : "corrected", "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:52f677f9-6ab0-4a95-8b68-8b12762eedfb" }, "result" : [{ "reference" : "urn:uuid:d54744fb-f490-44a1-90a0-1bfbce716fc5" }], "conclusion" : "Complex abnormal hyperdiploid karyotype with gains of chromosomes 8 and\n11, and loss of 7q and 12p which are recognised findings in myeloid neoplasms\nincluding AML" } }] }