NHS North West Genomics
2.2.5 - ci-build
NHS North West Genomics
2.2.5 - ci-build
NHS North West Genomics - Local Development build (v2.2.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Unknown as of 2026-11-05 |
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="GeneticClinicalReferral"/>
<meta>
<profile
value="https://fhir.nwgenomics.nhs.uk/StructureDefinition/NWQuestionnaire"/>
</meta>
<language value="en"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire GeneticClinicalReferral</b></p><a name="GeneticClinicalReferral"> </a><a name="hcGeneticClinicalReferral"> </a><div style="display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-NWQuestionnaire.html">Questionnaire</a></p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" class="xhtTableBorder1"><tr class="xhtRowBorder2"><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="" style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> </td><td style="" class="hierarchy xhtCellBorder1">**For analysis purposes only - not an active or planned project.** See
[Genetic Referrals](GeneticReferrals.html) for the narrative use case this
Questionnaire sketches a computable data model for, and [Genetic Clinical
Referral - Differences from Genomic Test
Order](StructureDefinition-GeneticClinicalReferral.html#differences-from-genomic-test-order)
for how this compares to [Genomic Test
Order](StructureDefinition-GenomicTestOrder.html).
This is a closed-loop clinical referral into a genomics/clinical genetics
service (see [Genetic Referrals](GeneticReferrals.html)), modelled on HL7 v2
`OMG^O19` (IHE 360X referral order, for future use) - not a laboratory order. Where a data item is
genuinely the same one [Genomic Test Order](StructureDefinition-GenomicTestOrder.html)
already captures (e.g. patient demographics), this Questionnaire reuses the
same item, per the "check for existing patterns" principle in [How To
Engineer (scale and deliver)
Interoperability](HowToEngineerInteroperability.html#check-for-existing-patterns-before-modelling-new-ones).</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Questionnaire</td><td style="" class="hierarchy xhtCellBorder1">https://fhir.nwgenomics.nhs.uk/Questionnaire/GeneticClinicalReferral#2.2.5</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Patient" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> Patient</td><td style="" class="hierarchy xhtCellBorder1">Patient</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient">Patient</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.Patient-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>Patient-designNote</td><td style="" class="hierarchy xhtCellBorder1">Reuses the same items as Genomic Test Order's Patient group - both populate the same HL7 v2 PID segment.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LN/45394-4" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/45394-4</td><td style="" class="hierarchy xhtCellBorder1">Patient surname</td><td style="" class="hierarchy xhtCellBorder1">1..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.name.family">Patient.name.family</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LN/45392-8" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/45392-8</td><td style="" class="hierarchy xhtCellBorder1">Patient first name</td><td style="" class="hierarchy xhtCellBorder1">1..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.name.given">Patient.name.given</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LN/21112-8" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/21112-8</td><td style="" class="hierarchy xhtCellBorder1">Date of birth</td><td style="" class="hierarchy xhtCellBorder1">1..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.birthDate">Patient.birthDate</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck111.png)" id="item.LN/56799-0" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/56799-0</td><td style="" class="hierarchy xhtCellBorder1">Address</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address">Patient.address</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1110.png)" id="item.HL7/PID-11-1" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / LN/56799-0 / </span>HL7/PID-11-1</td><td style="" class="hierarchy xhtCellBorder1">Address Line</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address.line">Patient.address.line</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1100.png)" id="item.LN/45401-7" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / LN/56799-0 / </span>LN/45401-7</td><td style="" class="hierarchy xhtCellBorder1">Postcode</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.address.postalCode">Patient.address.postalCode</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LN/46098-0" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/46098-0</td><td style="" class="hierarchy xhtCellBorder1">Sex registered at birth</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.gender">Patient.gender</a><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-administrative-gender.html">AdministrativeGender</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LN/89061-6" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/89061-6</td><td style="" class="hierarchy xhtCellBorder1">NHS Number</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.identifier:nhsNumber">Patient.identifier:nhsNumber</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LN/76435-7" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/76435-7</td><td style="" class="hierarchy xhtCellBorder1">Hospital Number (Medical Record Number)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/patient.html#Patient.identifier:MedicalRecordNumber">Patient.identifier:MedicalRecordNumber</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck111.png)" id="item.LN/56797-4" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>LN/56797-4</td><td style="" class="hierarchy xhtCellBorder1">Account Number (Episode or Stay Number)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.encounter.identifier.value">ServiceRequest.encounter.identifier.value</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1100.png)" id="item.LN/56797-4-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / LN/56797-4 / </span>LN/56797-4-designNote</td><td style="" class="hierarchy xhtCellBorder1">PV1-19 (Visit/Account Number) - not the unrelated v2 ACC segment.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck101.png)" id="item.pedigreeNumber" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / </span>pedigreeNumber</td><td style="" class="hierarchy xhtCellBorder1">G Number (Pedigree Number)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/observation.html#Observation.valueString">Observation.valueString</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1000.png)" id="item.pedigreeNumber-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Patient / pedigreeNumber / </span>pedigreeNumber-designNote</td><td style="" class="hierarchy xhtCellBorder1">Links the proband to consultands (at-risk relatives) referred as part of the same family investigation - see Distributed WGS (dWGS) Family Structure/Participant Type pattern. Modelled as Observation.valueString, not a Patient identifier - see Genomic General Ask At Order Entry's own G Number (Pedigree Number) item and WholeGenomicSequence.html for why.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" id="item.ReferringProvider" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> ReferringProvider</td><td style="" class="hierarchy xhtCellBorder1">Referring Provider/Organisation (ORC-12 / ORC-21)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole">PractitionerRole</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ReferringProvider-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>ReferringProvider-designNote</td><td style="" class="hierarchy xhtCellBorder1">OMG^O19 ORC-12 (ordering provider) and ORC-21 (ordering facility). Reuses the same items as Genomic Test Order's Healthcare Professional group.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LN/18705-4" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>LN/18705-4</td><td style="" class="hierarchy xhtCellBorder1">Referring Clinician Name</td><td style="" class="hierarchy xhtCellBorder1">1..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.practitioner.display">PractitionerRole.practitioner.display</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LN/18707-0" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>LN/18707-0</td><td style="" class="hierarchy xhtCellBorder1">Referring Clinician Current Speciality</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.specialty.coding.code">PractitionerRole.specialty.coding.code</a><br/>Value Set: <a href="https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&canonical=https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode">UK Core Practice Setting Code</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LN/46608-6" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>LN/46608-6</td><td style="" class="hierarchy xhtCellBorder1">Referring Clinician Professional Identifier</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.practitioner.identifier.value">PractitionerRole.practitioner.identifier.value</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.LN/89058-2" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>LN/89058-2</td><td style="" class="hierarchy xhtCellBorder1">Email</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.telecom.value">PractitionerRole.telecom.value</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LN/81230-5" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>LN/81230-5</td><td style="" class="hierarchy xhtCellBorder1">Phone</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.telecom.value">PractitionerRole.telecom.value</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck100.png)" id="item.HL7/ORC-21" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferringProvider / </span>HL7/ORC-21</td><td style="" class="hierarchy xhtCellBorder1">Referring Organisation ODS Code</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.organization.identifier.value">PractitionerRole.organization.identifier.value</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck11.png)" id="item.ReferredToProvider" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> ReferredToProvider</td><td style="" class="hierarchy xhtCellBorder1">Referred-to Provider/Service (MSH-5 / MSH-6)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.performer">ServiceRequest.performer</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ReferredToProvider-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferredToProvider / </span>ReferredToProvider-designNote</td><td style="" class="hierarchy xhtCellBorder1">OMG^O19 MSH-5 / MSH-6 (receiving application / facility) - who/what the
referral is being sent to. Genomic Test Order has no equivalent group: an
order's Order Filler is implicit/fixed (the destination LIMS), whereas a
referral explicitly names the receiving clinic/service - see Differences
from Genomic Test Order below. May be a named clinician (PractitionerRole)
or a service/clinic (HealthcareService) rather than a named individual.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.ReferredToProvider/serviceName" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferredToProvider / </span>ReferredToProvider/serviceName</td><td style="" class="hierarchy xhtCellBorder1">Referred-to Service/Clinic Name</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/healthcareservice.html#HealthcareService.name">HealthcareService.name</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.ReferredToProvider/organisationCode" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferredToProvider / </span>ReferredToProvider/organisationCode</td><td style="" class="hierarchy xhtCellBorder1">Referred-to Organisation ODS Code</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.organization.identifier.value">PractitionerRole.organization.identifier.value</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" id="item.ReferredToProvider/clinicianName" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReferredToProvider / </span>ReferredToProvider/clinicianName</td><td style="" class="hierarchy xhtCellBorder1">Named Consultant/Clinician (if known)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/practitionerrole.html#PractitionerRole.practitioner.display">PractitionerRole.practitioner.display</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.Referral" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> Referral</td><td style="" class="hierarchy xhtCellBorder1">Referral (ORC / OBR)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest">ServiceRequest</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.HL7/ORC-2" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Referral / </span>HL7/ORC-2</td><td style="" class="hierarchy xhtCellBorder1">Referral Identifier</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.identifier:OrderIdentifier">ServiceRequest.identifier:OrderIdentifier</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HL7/ORC-5" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Referral / </span>HL7/ORC-5</td><td style="" class="hierarchy xhtCellBorder1">Referral Status</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.status">ServiceRequest.status</a><br/>Value Set: <a href="http://hl7.org/fhir/R4/valueset-request-status.html">RequestStatus</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.LN/82768-3" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Referral / </span>LN/82768-3</td><td style="" class="hierarchy xhtCellBorder1">Priority</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.priority">ServiceRequest.priority</a><br/>Value Set: <a href="ValueSet-RequestPriority.html">Request Priority</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck101.png)" id="item.HL7/OBR-4" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Referral / </span>HL7/OBR-4</td><td style="" class="hierarchy xhtCellBorder1">Referral Type / Service Requested</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.code">ServiceRequest.code</a><br/>Options: <a href="#opt-item.HL7/OBR-4">1 option</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1000.png)" id="item.HL7/OBR-4-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">Referral / HL7/OBR-4 / </span>HL7/OBR-4-designNote</td><td style="" class="hierarchy xhtCellBorder1">For a clinical genetics referral this is SNOMED CT 306119003. Unlike Genomic Test Order's Test Code, this is not a Genomic Test Directory code: it names the clinical service/assessment being requested (e.g. genetic counselling, cascade testing), not a specific lab test.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.ReasonForReferral" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> ReasonForReferral</td><td style="" class="hierarchy xhtCellBorder1">Reason for Referral (OBR-31 / DG1)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck100.png)" id="item.LN/51967-8" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="" style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">ReasonForReferral / </span>LN/51967-8</td><td style="" class="hierarchy xhtCellBorder1">Suspected/confirmed condition (reason for referral)</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.reasonCode">ServiceRequest.reasonCode</a><br/>Value Set: <a href="ValueSet-GenomicClinicalIndicationCodes.html">Genomic Clinical Indication Codes</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck11.png)" id="item.FamilyHistory" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="group" class="hierarchy"/> FamilyHistory</td><td style="" class="hierarchy xhtCellBorder1">Family History (Family Letter)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck110.png)" id="item.FamilyHistory-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">FamilyHistory / </span>FamilyHistory-designNote</td><td style="" class="hierarchy xhtCellBorder1">Genomic Test Order's order/test-type-specific detail is captured by
structured Ask At Order Entry Questionnaires. A referral has no equivalent
structured sub-Questionnaire today: the corresponding detail - who else in
the family is affected, the inheritance pattern, degree of relationship of
at-risk relatives - travels as free text or an attached document within the
unstructured **family letter** (see Genetic Referrals and Cancer
Background Information for Use Cases - Genetic Counselling Referral
Across Regions), not as discrete data items. A future structured
representation could use FamilyMemberHistory per relative (see the
FamilyMemberHistory examples on Genomic Test Report), but that is not
attempted here.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck110.png)" id="item.HL7/NTE-1" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">FamilyHistory / </span>HL7/NTE-1</td><td style="" class="hierarchy xhtCellBorder1">Family Letter / Clinical Details (free text)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.note">ServiceRequest.note</a></td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck101.png)" id="item.FamilyHistory/attachment" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-reference.png" alt="" style="background-color: white; background-color: inherit" title="reference" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">FamilyHistory / </span>FamilyHistory/attachment</td><td style="" class="hierarchy xhtCellBorder1">Family Letter (attached document)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference">reference</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.supportingInfo">ServiceRequest.supportingInfo</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck1000.png)" id="item.FamilyHistory/attachment-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">FamilyHistory / FamilyHistory/attachment / </span>FamilyHistory/attachment-designNote</td><td style="" class="hierarchy xhtCellBorder1">ServiceRequest.supportingInfo references a DocumentReference (the
family letter), whose own DocumentReference.content.attachment.url
points at a Binary holding the actual document - the same pattern NHS
e-Referral Service (eRS) itself already uses for referral attachments
(ReferralRequest.supportingInfo -> DocumentReference) - see Genetic
Referrals - eRS FHIR Resource Model.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck01.png)" id="item.SupportingInformation" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: white; background-color: inherit" title="group" class="hierarchy"/> SupportingInformation</td><td style="" class="hierarchy xhtCellBorder1">Supporting Information (Forms and Clinical Documents)</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.supportingInfo">ServiceRequest.supportingInfo</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck010.png)" id="item.SupportingInformation-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / </span>SupportingInformation-designNote</td><td style="" class="hierarchy xhtCellBorder1">Clinical content travels as forms and clinical documents referenced from
the referral, not copied into it - see Genetic Clinical Referral (logical
model) - From Logical Model to Implementation Model.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck011.png)" id="item.SupportingInformation/forms" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-reference.png" alt="" style="background-color: white; background-color: inherit" title="reference" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / </span>SupportingInformation/forms</td><td style="" class="hierarchy xhtCellBorder1">Referral Forms</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference">reference</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.supportingInfo">ServiceRequest.supportingInfo</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck0100.png)" id="item.SupportingInformation/forms-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / SupportingInformation/forms / </span>SupportingInformation/forms-designNote</td><td style="" class="hierarchy xhtCellBorder1">Completed referral forms (e.g. a national GMS test order form or a
service-specific referral form) as QuestionnaireResponse - structured
answers, not a clinical document.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck011.png)" id="item.SupportingInformation/pathologyReport" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-reference.png" alt="" style="background-color: white; background-color: inherit" title="reference" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / </span>SupportingInformation/pathologyReport</td><td style="" class="hierarchy xhtCellBorder1">Pathology Report</td><td style="" class="hierarchy xhtCellBorder1">0..*</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference">reference</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.supportingInfo">ServiceRequest.supportingInfo</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck0100.png)" id="item.SupportingInformation/pathologyReport-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / SupportingInformation/pathologyReport / </span>SupportingInformation/pathologyReport-designNote</td><td style="" class="hierarchy xhtCellBorder1">Target: a reference to the pathology report as a clinical document
shared by the NHS England Single Patient Record (SPR), either a
DocumentReference or a FHIR Document Bundle. Interim: an attached PDF -
a DocumentReference whose content.attachment.url points at a Binary
(HL7 v2 OBX type ED).</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck001.png)" id="item.SupportingInformation/patientSummary" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-reference.png" alt="" style="background-color: white; background-color: inherit" title="reference" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / </span>SupportingInformation/patientSummary</td><td style="" class="hierarchy xhtCellBorder1">Patient Summary</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference">reference</a></td><td style="" class="hierarchy xhtCellBorder1">Definition: <a href="http://hl7.org/fhir/R4/servicerequest.html#ServiceRequest.supportingInfo">ServiceRequest.supportingInfo</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck0000.png)" id="item.SupportingInformation/patientSummary-designNote" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">SupportingInformation / SupportingInformation/patientSummary / </span>SupportingInformation/patientSummary-designNote</td><td style="" class="hierarchy xhtCellBorder1">A clinical document - a DocumentReference or a FHIR Document Bundle,
implemented the same way as the Pathology Report. Not part of the NHS
England Genomics ServiceRequest specification.</td><td style="" class="hierarchy xhtCellBorder1">0..1</td><td style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.HL7/OBR-4"> </a><p><b>Answer options for HL7/OBR-4 </b></p><ul><li style="font-size: 11px">http://snomed.info/sct#306119003</li></ul></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm">
<valueCoding>
<system value="http://hl7.org/fhir/version-algorithm"/>
<code value="semver"/>
</valueCoding>
</extension>
<url
value="https://fhir.nwgenomics.nhs.uk/Questionnaire/GeneticClinicalReferral"/>
<version value="2.2.5"/>
<title value="Genetic Clinical Referral"/>
<status value="unknown"/>
<date value="2026-11-05T06:40:21+00:00"/>
<publisher value="NHS North West Genomics"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.nwgenomics.nhs.uk/contact-us"/>
</telecom>
</contact>
<description
value="**For analysis purposes only - not an active or planned project.** See
[Genetic Referrals](GeneticReferrals.html) for the narrative use case this
Questionnaire sketches a computable data model for, and [Genetic Clinical
Referral - Differences from Genomic Test
Order](StructureDefinition-GeneticClinicalReferral.html#differences-from-genomic-test-order)
for how this compares to [Genomic Test
Order](StructureDefinition-GenomicTestOrder.html).
This is a closed-loop clinical referral into a genomics/clinical genetics
service (see [Genetic Referrals](GeneticReferrals.html)), modelled on HL7 v2
`OMG^O19` (IHE 360X referral order, for future use) - not a laboratory order. Where a data item is
genuinely the same one [Genomic Test Order](StructureDefinition-GenomicTestOrder.html)
already captures (e.g. patient demographics), this Questionnaire reuses the
same item, per the "check for existing patterns" principle in [How To
Engineer (scale and deliver)
Interoperability](HowToEngineerInteroperability.html#check-for-existing-patterns-before-modelling-new-ones)."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="GB"/>
<display value="United Kingdom of Great Britain and Northern Ireland"/>
</coding>
</jurisdiction>
<item>
<linkId value="Patient"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient"/>
<text value="Patient"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="Patient-designNote"/>
<text
value="Reuses the same items as Genomic Test Order's Patient group - both populate the same HL7 v2 PID segment."/>
<type value="display"/>
</item>
<item>
<linkId value="LN/45394-4"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.family"/>
<code>
<system value="http://loinc.org"/>
<code value="45394-4"/>
</code>
<text value="Patient surname"/>
<type value="string"/>
<required value="true"/>
</item>
<item>
<linkId value="LN/45392-8"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.given"/>
<code>
<system value="http://loinc.org"/>
<code value="45392-8"/>
</code>
<text value="Patient first name"/>
<type value="string"/>
<required value="true"/>
</item>
<item>
<linkId value="LN/21112-8"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.birthDate"/>
<code>
<system value="http://loinc.org"/>
<code value="21112-8"/>
</code>
<text value="Date of birth"/>
<type value="date"/>
<required value="true"/>
</item>
<item>
<linkId value="LN/56799-0"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address"/>
<code>
<system value="http://loinc.org"/>
<code value="56799-0"/>
</code>
<text value="Address"/>
<type value="group"/>
<item>
<linkId value="HL7/PID-11-1"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.line"/>
<text value="Address Line"/>
<type value="string"/>
<repeats value="true"/>
</item>
<item>
<linkId value="LN/45401-7"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.address.postalCode"/>
<code>
<system value="http://loinc.org"/>
<code value="45401-7"/>
</code>
<text value="Postcode"/>
<type value="string"/>
</item>
</item>
<item>
<linkId value="LN/46098-0"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.gender"/>
<code>
<system value="http://loinc.org"/>
<code value="46098-0"/>
</code>
<text value="Sex registered at birth"/>
<type value="choice"/>
<answerValueSet
value="http://hl7.org/fhir/ValueSet/administrative-gender"/>
</item>
<item>
<linkId value="LN/89061-6"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.identifier:nhsNumber"/>
<code>
<system value="http://loinc.org"/>
<code value="89061-6"/>
</code>
<text value="NHS Number"/>
<type value="string"/>
</item>
<item>
<linkId value="LN/76435-7"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Patient#Patient.identifier:MedicalRecordNumber"/>
<code>
<system value="http://loinc.org"/>
<code value="76435-7"/>
</code>
<text value="Hospital Number (Medical Record Number)"/>
<type value="string"/>
</item>
<item>
<linkId value="LN/56797-4"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.encounter.identifier.value"/>
<code>
<system value="http://loinc.org"/>
<code value="56797-4"/>
</code>
<text value="Account Number (Episode or Stay Number)"/>
<type value="string"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="LN/56797-4-designNote"/>
<text
value="PV1-19 (Visit/Account Number) - not the unrelated v2 ACC segment."/>
<type value="display"/>
</item>
</item>
<item>
<linkId value="pedigreeNumber"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/Observation#Observation.valueString"/>
<code>
<system value="http://loinc.org"/>
<code value="74027-4"/>
<display value="Family pedigree identifier"/>
</code>
<text value="G Number (Pedigree Number)"/>
<type value="string"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="pedigreeNumber-designNote"/>
<text
value="Links the proband to consultands (at-risk relatives) referred as part of the same family investigation - see Distributed WGS (dWGS) Family Structure/Participant Type pattern. Modelled as Observation.valueString, not a Patient identifier - see Genomic General Ask At Order Entry's own G Number (Pedigree Number) item and WholeGenomicSequence.html for why."/>
<type value="display"/>
</item>
</item>
</item>
<item>
<linkId value="ReferringProvider"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole"/>
<text value="Referring Provider/Organisation (ORC-12 / ORC-21)"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="ReferringProvider-designNote"/>
<text
value="OMG^O19 ORC-12 (ordering provider) and ORC-21 (ordering facility). Reuses the same items as Genomic Test Order's Healthcare Professional group."/>
<type value="display"/>
</item>
<item>
<linkId value="LN/18705-4"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.practitioner.display"/>
<code>
<system value="http://loinc.org"/>
<code value="18705-4"/>
</code>
<text value="Referring Clinician Name"/>
<type value="string"/>
<required value="true"/>
</item>
<item>
<linkId value="LN/18707-0"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.specialty.coding.code"/>
<code>
<system value="http://loinc.org"/>
<code value="18707-0"/>
</code>
<text value="Referring Clinician Current Speciality"/>
<type value="choice"/>
<answerValueSet
value="https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode"/>
</item>
<item>
<linkId value="LN/46608-6"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.practitioner.identifier.value"/>
<code>
<system value="http://loinc.org"/>
<code value="46608-6"/>
</code>
<text value="Referring Clinician Professional Identifier"/>
<type value="string"/>
</item>
<item>
<linkId value="LN/89058-2"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.telecom.value"/>
<code>
<system value="http://loinc.org"/>
<code value="89058-2"/>
<display value="Contact email address"/>
</code>
<text value="Email"/>
<type value="string"/>
<repeats value="true"/>
</item>
<item>
<linkId value="LN/81230-5"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.telecom.value"/>
<code>
<system value="http://loinc.org"/>
<code value="81230-5"/>
</code>
<text value="Phone"/>
<type value="string"/>
</item>
<item>
<linkId value="HL7/ORC-21"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.organization.identifier.value"/>
<text value="Referring Organisation ODS Code"/>
<type value="string"/>
</item>
</item>
<item>
<linkId value="ReferredToProvider"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.performer"/>
<text value="Referred-to Provider/Service (MSH-5 / MSH-6)"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="ReferredToProvider-designNote"/>
<text
value="OMG^O19 MSH-5 / MSH-6 (receiving application / facility) - who/what the
referral is being sent to. Genomic Test Order has no equivalent group: an
order's Order Filler is implicit/fixed (the destination LIMS), whereas a
referral explicitly names the receiving clinic/service - see Differences
from Genomic Test Order below. May be a named clinician (PractitionerRole)
or a service/clinic (HealthcareService) rather than a named individual."/>
<type value="display"/>
</item>
<item>
<linkId value="ReferredToProvider/serviceName"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/HealthcareService#HealthcareService.name"/>
<text value="Referred-to Service/Clinic Name"/>
<type value="string"/>
</item>
<item>
<linkId value="ReferredToProvider/organisationCode"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.organization.identifier.value"/>
<text value="Referred-to Organisation ODS Code"/>
<type value="string"/>
</item>
<item>
<linkId value="ReferredToProvider/clinicianName"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/PractitionerRole#PractitionerRole.practitioner.display"/>
<text value="Named Consultant/Clinician (if known)"/>
<type value="string"/>
<required value="false"/>
</item>
</item>
<item>
<linkId value="Referral"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest"/>
<text value="Referral (ORC / OBR)"/>
<type value="group"/>
<item>
<linkId value="HL7/ORC-2"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.identifier:OrderIdentifier"/>
<text value="Referral Identifier"/>
<type value="string"/>
</item>
<item>
<linkId value="HL7/ORC-5"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.status"/>
<text value="Referral Status"/>
<type value="choice"/>
<answerValueSet value="http://hl7.org/fhir/ValueSet/request-status"/>
</item>
<item>
<linkId value="LN/82768-3"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.priority"/>
<code>
<system value="http://loinc.org"/>
<code value="82768-3"/>
</code>
<text value="Priority"/>
<type value="choice"/>
<required value="false"/>
<answerValueSet
value="https://fhir.nwgenomics.nhs.uk/ValueSet/RequestPriority"/>
</item>
<item>
<linkId value="HL7/OBR-4"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.code"/>
<text value="Referral Type / Service Requested"/>
<type value="choice"/>
<answerOption>
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="306119003"/>
</valueCoding>
<initialSelected value="true"/>
</answerOption>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="HL7/OBR-4-designNote"/>
<text
value="For a clinical genetics referral this is SNOMED CT 306119003. Unlike Genomic Test Order's Test Code, this is not a Genomic Test Directory code: it names the clinical service/assessment being requested (e.g. genetic counselling, cascade testing), not a specific lab test."/>
<type value="display"/>
</item>
</item>
</item>
<item>
<linkId value="ReasonForReferral"/>
<text value="Reason for Referral (OBR-31 / DG1)"/>
<type value="group"/>
<item>
<linkId value="LN/51967-8"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.reasonCode"/>
<code>
<system value="http://loinc.org"/>
<code value="51967-8"/>
</code>
<code>
<system value="http://snomed.info/sct"/>
<code value="782964007"/>
<display value="Genetic disease"/>
</code>
<text value="Suspected/confirmed condition (reason for referral)"/>
<type value="choice"/>
<repeats value="true"/>
<answerValueSet
value="https://fhir.nwgenomics.nhs.uk/ValueSet/GenomicClinicalIndicationCodes"/>
</item>
</item>
<item>
<linkId value="FamilyHistory"/>
<text value="Family History (Family Letter)"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="FamilyHistory-designNote"/>
<text
value="Genomic Test Order's order/test-type-specific detail is captured by
structured Ask At Order Entry Questionnaires. A referral has no equivalent
structured sub-Questionnaire today: the corresponding detail - who else in
the family is affected, the inheritance pattern, degree of relationship of
at-risk relatives - travels as free text or an attached document within the
unstructured **family letter** (see Genetic Referrals and Cancer
Background Information for Use Cases - Genetic Counselling Referral
Across Regions), not as discrete data items. A future structured
representation could use FamilyMemberHistory per relative (see the
FamilyMemberHistory examples on Genomic Test Report), but that is not
attempted here."/>
<type value="display"/>
</item>
<item>
<linkId value="HL7/NTE-1"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.note"/>
<text value="Family Letter / Clinical Details (free text)"/>
<type value="string"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
<valueCanonical
value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
</extension>
<linkId value="FamilyHistory/attachment"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo"/>
<text value="Family Letter (attached document)"/>
<type value="reference"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="FamilyHistory/attachment-designNote"/>
<text
value="ServiceRequest.supportingInfo references a DocumentReference (the
family letter), whose own DocumentReference.content.attachment.url
points at a Binary holding the actual document - the same pattern NHS
e-Referral Service (eRS) itself already uses for referral attachments
(ReferralRequest.supportingInfo -> DocumentReference) - see Genetic
Referrals - eRS FHIR Resource Model."/>
<type value="display"/>
</item>
</item>
</item>
<item>
<linkId value="SupportingInformation"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo"/>
<text value="Supporting Information (Forms and Clinical Documents)"/>
<type value="group"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="SupportingInformation-designNote"/>
<text
value="Clinical content travels as forms and clinical documents referenced from
the referral, not copied into it - see Genetic Clinical Referral (logical
model) - From Logical Model to Implementation Model."/>
<type value="display"/>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
<valueCanonical
value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse"/>
</extension>
<linkId value="SupportingInformation/forms"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo"/>
<text value="Referral Forms"/>
<type value="reference"/>
<required value="false"/>
<repeats value="true"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="SupportingInformation/forms-designNote"/>
<text
value="Completed referral forms (e.g. a national GMS test order form or a
service-specific referral form) as QuestionnaireResponse - structured
answers, not a clinical document."/>
<type value="display"/>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
<valueCanonical
value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
</extension>
<linkId value="SupportingInformation/pathologyReport"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo"/>
<code>
<system value="http://loinc.org"/>
<code value="11526-1"/>
<display value="Pathology study"/>
</code>
<text value="Pathology Report"/>
<type value="reference"/>
<required value="false"/>
<repeats value="true"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="SupportingInformation/pathologyReport-designNote"/>
<text
value="Target: a reference to the pathology report as a clinical document
shared by the NHS England Single Patient Record (SPR), either a
DocumentReference or a FHIR Document Bundle. Interim: an attached PDF -
a DocumentReference whose content.attachment.url points at a Binary
(HL7 v2 OBX type ED)."/>
<type value="display"/>
</item>
</item>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile">
<valueCanonical
value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
</extension>
<linkId value="SupportingInformation/patientSummary"/>
<definition
value="http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.supportingInfo"/>
<code>
<system value="http://loinc.org"/>
<code value="60591-5"/>
<display value="Patient summary Document"/>
</code>
<text value="Patient Summary"/>
<type value="reference"/>
<required value="false"/>
<item>
<extension
url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/questionnaire-item-control"/>
<code value="help"/>
</coding>
</valueCodeableConcept>
</extension>
<linkId value="SupportingInformation/patientSummary-designNote"/>
<text
value="A clinical document - a DocumentReference or a FHIR Document Bundle,
implemented the same way as the Pathology Report. Not part of the NHS
England Genomics ServiceRequest specification."/>
<type value="display"/>
</item>
</item>
</item>
</Questionnaire>