{
  "resourceType" : "ExampleScenario",
  "id" : "ClinicalAndGenomicWorkflow",
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ExampleScenario ClinicalAndGenomicWorkflow</b></p><a name=\"ClinicalAndGenomicWorkflow\"> </a><a name=\"hcClinicalAndGenomicWorkflow\"> </a><p><b>url</b>: <a href=\"ExampleScenario-ClinicalAndGenomicWorkflow.html\">ClinicalAndGenomicWorkflow</a></p><p><b>version</b>: 2.1.4</p><p><b>name</b>: ClinicalAndGenomicWorkflow</p><p><b>status</b>: Draft</p><p><b>date</b>: 2026-07-24 08:52:06+0000</p><p><b>publisher</b>: NHS North West Genomics</p><p><b>contact</b>: <a href=\"https://www.nwgenomics.nhs.uk/contact-us\">https://www.nwgenomics.nhs.uk/contact-us</a></p><p><b>jurisdiction</b>: <span title=\"Codes:{urn:iso:std:iso:3166 GB}\">United Kingdom of Great Britain and Northern Ireland</span></p><blockquote><p><b>actor</b></p><p><b>actorId</b>: diagnostics</p><p><b>type</b>: System</p><p><b>name</b>: Genomic Diagnostic Testing</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: counsellor</p><p><b>type</b>: System</p><p><b>name</b>: Genomic counsellor</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: cdr</p><p><b>type</b>: System</p><p><b>name</b>: Regional - Genomic Data Platform</p><p><b>description</b>: </p><div><p>Clinical Data Repository</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: consultant</p><p><b>type</b>: System</p><p><b>name</b>: Consultant</p><p><b>description</b>: </p><div><p>Primary Care doctor or Secondary Care Consultant</p>\n</div></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: epr</p><p><b>type</b>: System</p><p><b>name</b>: Electronic Patient Record</p><p><b>description</b>: </p><div><p><a href=\"ActorDefinition-ProviderInformationSource.html\">Provider Information Source</a></p>\n</div></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request1</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Variant</p><p><b>description</b>: </p><div><p>TODO</p>\n</div><blockquote><p><b>version</b></p><p><b>R5: Label for instance version (new)</b>: Variant NTHL1</p><p><b>R5: Example instance version data (new)</b>: <a href=\"Observation-8385c2fd-313d-4fd5-b98e-d5ea4bae6f99.html\">Observation Genetic variant assessment</a></p><p><b>versionId</b>: 1</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request2</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Diagnostic Implication</p><p><b>description</b>: </p><div><p>TODO</p>\n</div><blockquote><p><b>version</b></p><p><b>R5: Label for instance version (new)</b>: Diagnostic Implication Lynch syndrome</p><p><b>R5: Example instance version data (new)</b>: <a href=\"Observation-6beb613f-d303-42af-b025-86e8e0872061.html\">Observation Diagnostic Implication</a></p><p><b>versionId</b>: 2</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request3</p><p><b>resourceType</b>: Condition</p><p><b>name</b>: Condition</p><p><b>description</b>: </p><div><p>TODO</p>\n</div><blockquote><p><b>version</b></p><p><b>R5: Label for instance version (new)</b>: Condition Lynch syndrome</p><p><b>R5: Example instance version data (new)</b>: <a href=\"Condition-c8f82825-e4cb-4e1f-b728-3fd2808e93db.html\">Condition Lynch syndrome</a></p><p><b>versionId</b>: 3</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request4</p><p><b>resourceType</b>: FamilyMemberHistory</p><p><b>name</b>: FamilyMemberHistory Son</p><p><b>description</b>: </p><div><p>TODO</p>\n</div><blockquote><p><b>version</b></p><p><b>R5: Label for instance version (new)</b>: FamilyMemberHistory Ricky LEEDS</p><p><b>R5: Example instance version data (new)</b>: <a href=\"FamilyMemberHistory-074ea905-8d91-452c-af3c-15b5b860fdb2.html\">FamilyMemberHistory: identifier = National Health Plan Identifier\u00a0(use:\u00a0official,\u00a0); status = completed; relationship = natural son; sex = Male</a></p><p><b>versionId</b>: 4</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Request5</p><p><b>resourceType</b>: FamilyMemberHistory</p><p><b>name</b>: FamilyMemberHistory Mother</p><p><b>description</b>: </p><div><p>TODO</p>\n</div><blockquote><p><b>version</b></p><p><b>R5: Label for instance version (new)</b>: FamilyMemberHistory Sarah-Jane NOTTINGHAM</p><p><b>R5: Example instance version data (new)</b>: <a href=\"FamilyMemberHistory-c76b8bc2-ec36-4ce1-a2ea-8c57215115e2.html\">FamilyMemberHistory Sarah-Jane Nottingham</a></p><p><b>versionId</b>: 5</p><p><b>description</b>: </p><div><p>TODO</p>\n</div></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Create Diagnostic Testing Report</p><p><b>description</b>: </p><div><p>This step creates the <a href=\"StructureDefinition-DiagnosticReport.html\">Genomics Test Report</a></p>\n</div><p><b>preConditions</b>: </p><div><p>Genomic Testing has Completed</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: create</p><p><b>name</b>: Variant NTHL1 is added to Genomic CDR</p><p><b>initiator</b>: diagnostics</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>This step is performed by middleware - RIE</p>\n</div><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Request1</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 2</p><p><b>type</b>: create</p><p><b>name</b>: Diagnostic Implication Lynch Syndrome is added to Genomic CDR</p><p><b>initiator</b>: diagnostics</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>This step is performed by middleware - RIE</p>\n</div><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Request2</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Review Diagnostic Testing Report</p><p><b>description</b>: </p><div><p>This step reviews the <a href=\"StructureDefinition-DiagnosticReport.html\">Genomics Test Report</a></p>\n</div><p><b>preConditions</b>: </p><div><p>Genomic Testing Received has been received</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 3</p><p><b>type</b>: create</p><p><b>name</b>: Condition Lynch Syndrome is added to Acute or Primary Care EPR</p><p><b>initiator</b>: consultant</p><p><b>receiver</b>: epr</p><p><b>description</b>: </p><div><p>This step is assumed to be a manual entry</p>\n</div><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Request3</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Perform Genomic Counselling</p><p><b>description</b>: </p><div><p>This step acts on the <a href=\"StructureDefinition-DiagnosticReport.html\">Genomics Test Report</a></p>\n</div><p><b>preConditions</b>: </p><div><p>A Task has been received to perform Genomic Counselling</p>\n</div><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 4</p><p><b>type</b>: create</p><p><b>name</b>: Family History for Son Leeds is added to Genomic CDR</p><p><b>initiator</b>: counsellor</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>Probably Gen-O</p>\n</div><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Request4</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 5</p><p><b>type</b>: create</p><p><b>name</b>: Family History for Mother Nottingham is added to Genomic CDR</p><p><b>initiator</b>: counsellor</p><p><b>receiver</b>: cdr</p><p><b>description</b>: </p><div><p>Probably Gen-O</p>\n</div><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Request5</td></tr></table></blockquote></blockquote></blockquote></div>"
  },
  "url" : "https://fhir.nwgenomics.nhs.uk/ExampleScenario/ClinicalAndGenomicWorkflow",
  "version" : "2.1.4",
  "name" : "ClinicalAndGenomicWorkflow",
  "status" : "draft",
  "date" : "2026-07-24T08:52:06+00:00",
  "publisher" : "NHS North West Genomics",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.nwgenomics.nhs.uk/contact-us"
    }]
  }],
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "GB",
      "display" : "United Kingdom of Great Britain and Northern Ireland"
    }]
  }],
  "actor" : [{
    "actorId" : "diagnostics",
    "type" : "entity",
    "name" : "Genomic Diagnostic Testing",
    "description" : "TODO"
  },
  {
    "actorId" : "counsellor",
    "type" : "entity",
    "name" : "Genomic counsellor",
    "description" : "TODO"
  },
  {
    "actorId" : "cdr",
    "type" : "entity",
    "name" : "Regional - Genomic Data Platform",
    "description" : " Clinical Data Repository "
  },
  {
    "actorId" : "consultant",
    "type" : "entity",
    "name" : "Consultant",
    "description" : "Primary Care doctor or Secondary Care Consultant"
  },
  {
    "actorId" : "epr",
    "type" : "entity",
    "name" : "Electronic Patient Record",
    "description" : " [Provider Information Source](ActorDefinition-ProviderInformationSource.html) "
  }],
  "instance" : [{
    "resourceId" : "Request1",
    "resourceType" : "Observation",
    "name" : "Variant",
    "description" : " TODO ",
    "version" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
        "valueString" : "Variant NTHL1"
      },
      {
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
        "valueReference" : {
          "reference" : "Observation/8385c2fd-313d-4fd5-b98e-d5ea4bae6f99"
        }
      }],
      "versionId" : "1",
      "description" : " TODO "
    }]
  },
  {
    "resourceId" : "Request2",
    "resourceType" : "Observation",
    "name" : "Diagnostic Implication",
    "description" : " TODO ",
    "version" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
        "valueString" : "Diagnostic Implication Lynch syndrome"
      },
      {
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
        "valueReference" : {
          "reference" : "Observation/6beb613f-d303-42af-b025-86e8e0872061"
        }
      }],
      "versionId" : "2",
      "description" : " TODO "
    }]
  },
  {
    "resourceId" : "Request3",
    "resourceType" : "Condition",
    "name" : "Condition",
    "description" : " TODO ",
    "version" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
        "valueString" : "Condition Lynch syndrome"
      },
      {
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
        "valueReference" : {
          "reference" : "Condition/c8f82825-e4cb-4e1f-b728-3fd2808e93db"
        }
      }],
      "versionId" : "3",
      "description" : " TODO "
    }]
  },
  {
    "resourceId" : "Request4",
    "resourceType" : "FamilyMemberHistory",
    "name" : "FamilyMemberHistory Son",
    "description" : " TODO ",
    "version" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
        "valueString" : "FamilyMemberHistory Ricky LEEDS"
      },
      {
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
        "valueReference" : {
          "reference" : "FamilyMemberHistory/074ea905-8d91-452c-af3c-15b5b860fdb2"
        }
      }],
      "versionId" : "4",
      "description" : " TODO "
    }]
  },
  {
    "resourceId" : "Request5",
    "resourceType" : "FamilyMemberHistory",
    "name" : "FamilyMemberHistory Mother",
    "description" : " TODO ",
    "version" : [{
      "extension" : [{
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
        "valueString" : "FamilyMemberHistory Sarah-Jane NOTTINGHAM"
      },
      {
        "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
        "valueReference" : {
          "reference" : "FamilyMemberHistory/c76b8bc2-ec36-4ce1-a2ea-8c57215115e2"
        }
      }],
      "versionId" : "5",
      "description" : " TODO "
    }]
  }],
  "process" : [{
    "title" : "Create Diagnostic Testing Report",
    "description" : "This step creates the [Genomics Test Report](StructureDefinition-DiagnosticReport.html)",
    "preConditions" : "Genomic Testing has Completed",
    "step" : [{
      "operation" : {
        "number" : "1",
        "type" : "create",
        "name" : "Variant NTHL1 is added to Genomic CDR",
        "initiator" : "diagnostics",
        "receiver" : "cdr",
        "description" : "This step is performed by middleware - RIE",
        "request" : {
          "resourceId" : "Request1"
        }
      }
    },
    {
      "operation" : {
        "number" : "2",
        "type" : "create",
        "name" : "Diagnostic Implication Lynch Syndrome is added to Genomic CDR",
        "initiator" : "diagnostics",
        "receiver" : "cdr",
        "description" : "This step is performed by middleware - RIE",
        "request" : {
          "resourceId" : "Request2"
        }
      }
    }]
  },
  {
    "title" : "Review Diagnostic Testing Report",
    "description" : "This step reviews the [Genomics Test Report](StructureDefinition-DiagnosticReport.html)",
    "preConditions" : "Genomic Testing Received has been received",
    "step" : [{
      "operation" : {
        "number" : "3",
        "type" : "create",
        "name" : "Condition Lynch Syndrome is added to Acute or Primary Care EPR",
        "initiator" : "consultant",
        "receiver" : "epr",
        "description" : "This step is assumed to be a manual entry",
        "request" : {
          "resourceId" : "Request3"
        }
      }
    }]
  },
  {
    "title" : "Perform Genomic Counselling",
    "description" : "This step acts on the [Genomics Test Report](StructureDefinition-DiagnosticReport.html)",
    "preConditions" : "A Task has been received to perform Genomic Counselling",
    "step" : [{
      "operation" : {
        "number" : "4",
        "type" : "create",
        "name" : "Family History for Son Leeds is added to Genomic CDR",
        "initiator" : "counsellor",
        "receiver" : "cdr",
        "description" : "Probably Gen-O",
        "request" : {
          "resourceId" : "Request4"
        }
      }
    },
    {
      "operation" : {
        "number" : "5",
        "type" : "create",
        "name" : "Family History for Mother Nottingham is added to Genomic CDR",
        "initiator" : "counsellor",
        "receiver" : "cdr",
        "description" : "Probably Gen-O",
        "request" : {
          "resourceId" : "Request5"
        }
      }
    }]
  }]
}