NHS North West Genomics
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Questionnaire: NW Genomic General Ask At Order Questions

Official URL: https://fhir.nwgenomics.nhs.uk/Questionnaire/GenomicGeneralAskAtOrderEntry Version: 2.2.0
Active as of 2026-09-20 Computable Name:

Ask At Order Entry Questions Common - the default set used alongside the common core order form for order/test types that do not have their own dedicated Ask At Order Entry Questionnaire - see Order Entry Questions. These questions were originally part of GenomicTestOrder and have been extracted here so the core form stays generic to every order/test type.

Covers Cancer, Whole Genome Sequencing (WGS) and Rare and Inherited Disease orders generally - see Guidance by Order Type below for which questions actually apply to which. Questions only relevant to WGS specifically (Related Individual (NK1), Record of Discussion attached or to follow) have moved to WGS Test Additional Ask At Order Entry Questions, used alongside this Questionnaire for WGS orders, not instead of it.

Order Entry Questions

Diagnostic Genomics

Name Code System Answer ValueSet Cardinality HL7 v2 OML_O21 Message OBX-2 Value Type HL7 FHIR Resource (Message + RESTful)
High Infection Risk? SNOMED 281269004 Yes/No 0..1 OBX CE Observation.valueCodeableConcept
High infection Risk Details NWGMSA InfectionRiskDetails   0..1 OBX ST Observation.valueString
Consent            
- Has consent has been obtained for tests (Y/N) LOINC 19826-7 Yes/No 0..1 OBX CE Observation.valueCodeableConcept
- Has consent has been obtained for DNA storage (Y/N) LOINC 75520-7 Yes/No 0..1 OBX CE Observation.valueCodeableConcept
G Number (Pedigree Number) LOINC 74027-4   0..1 OBX ST Observation.valueString
Patient is from consanguineous union? SNOMED 842009 YesNoUnknown 0..1 OBX CE Observation.valueCodeableConcept
Confirm that a pathology report will be provided alongside the sample. SNOMED 74996004 YesNoUnknown 0..1 OBX CE Observation.valueCodeableConcept
Neonatal/Prenatal/Neither? SNOMED 118185001 Pregnancy 0..1 OBX CE Observation.valueCodeableConcept
Pregnant            
- Does this test relate to a pregnancy with > 1 fetus? SNOMED 370386005 YesNoUnknown 0..1 OBX CE Observation.valueCodeableConcept
- Patient expected delivery date SNOMED 161714006   0..1 OBX DT Observation.valueDateTime
- Patient gestation SNOMED 598151000005105   0..1 OBX NM Observation.valueQuantity
Is this test for a pregnancy loss? SNOMED 17369002 YesNoUnknown 0..1 OBX CE Observation.valueCodeableConcept
Is this test for a deceased infant? SNOMED 419099009 YesNoUnknown 0..1 OBX CE Observation.valueCodeableConcept
Reason For Variant Re-Interpretation Request NWGMSA VariantReinterpretationReason   0..1 OBX ST Observation.valueString

Related Individual (NK1) and Record of Discussion attached or to follow used to live here, but have moved to WGS Test Additional Ask At Order Entry Questions - they are only genuinely relevant to Whole Genome Sequencing orders, not every order/test type this Questionnaire covers.

Guidance by Order Type

Today, this Generic Ask At Order Entry Questionnaire is the one actually used for Cancer, Whole Genome Sequencing (WGS) and Rare and Inherited Disease orders placed through the generic order path (see Order Entry Questions) - Chimerism (and Histocompatibility and Immunogenetics generally) instead uses its own dedicated Ask At Order Entry Questionnaires - Chimerism Test Additional Ask At Order Entry Questions, HLA Tests - Transplant - so almost none of the items below normally apply to it. WGS orders also combine in WGS Test Additional Ask At Order Entry Questions alongside this Questionnaire - see that Questionnaire's own guidance for the items specific to it.

Item/Group Cancer WGS Rare and Inherited Disease Chimerism
G Number (Pedigree Number) - ✓ (Rare and Inherited Disease WGS only) ✓ -
Patient is from consanguineous union? - ✓ ✓ -
Confirm that a pathology report will be provided alongside the sample ✓ - - -
Neonatal/Prenatal/Neither? (and the Pregnant sub-group) - ✓ (where prenatal) ✓ (where prenatal) -
Is this test for a pregnancy loss? / a deceased infant? - ✓ (where prenatal) ✓ (where prenatal) -
Consent group ✓ ✓ ✓ -
Reason For Variant Re-Interpretation Request ✓ ✓ ✓ -
High Infection Risk? / High infection Risk Details ✓ ✓ ✓ -

G Number (Pedigree Number)

G Number (Pedigree Number) is only applicable to Rare and Inherited Disease WGS orders - see Whole Genome Sequencing (WGS) - The Reverse Direction for how it relates to (and is distinct from) a genuine Order Group Number (ServiceRequest.requisition). See WGS Test Additional Ask At Order Entry Questions for Related Individual and the Consultand/Proband/mother-baby-fetus guidance that goes with it, now that both have moved there.

Known Gaps (from a Live WGS Order-Entry Screen)

A real NHS Trust EPR order-entry screen for Rare and Inherited Disease WGS orders surfaces several fields with no equivalent anywhere in this Questionnaire, WGS Test Additional Ask At Order Entry Questions or Genomic Test Order - consistent with, and extending, the same gap analysis in Whole Genome Sequencing (WGS):

  • Family/test structure (Singleton/Duo/Trio/Tumour/Germline) - a required field selecting which WGS family structure or sample type the order is for. This Questionnaire has no equivalent; Distributed WGS (dWGS) is the only place in this IG with a comparable concept (FamilyStructure/ParticipantType on dWGSAskAtOrderEntry), and that is a different Questionnaire for a different pathway.
  • Previously stored DNA ID number - a reference to an existing stored DNA sample from a prior test, as an alternative to submitting a fresh specimen. No equivalent field exists on this Questionnaire or the common core's own Specimen group.
  • Specialist Test Group, used on this live screen as a required selector alongside the Test Code itself (e.g. "WGS" for a WGS order) - this is the same Genomic Test Code specialist-test-group property already modelled as CodeSystem metadata in this IG, but not yet as its own submitted Ask At Order Entry answer.

Profile: Questionnaire

Structure
LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. **Ask At Order Entry Questions Common** - the default set used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) for order/test types that do not have their own dedicated Ask At Order Entry Questionnaire - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions). These questions were originally part of [GenomicTestOrder](Questionnaire-GenomicTestOrder.html) and have been extracted here so the core form stays generic to every order/test type. Covers Cancer, Whole Genome Sequencing (WGS) and Rare and Inherited Disease orders generally - see [Guidance by Order Type](#guidance-by-order-type) below for which questions actually apply to which. Questions only relevant to WGS specifically (`Related Individual (NK1)`, `Record of Discussion attached or to follow`) have moved to [WGS Test Additional Ask At Order Entry Questions](Questionnaire-WGSTestAdditionalAskAtOrderQuestions.html), used *alongside* this Questionnaire for WGS orders, not instead of it. Questionnaire https://fhir.nwgenomics.nhs.uk/Questionnaire/GenomicGeneralAskAtOrderEntry#2.2.0
... AskAtOrderEntry Ask At Order Entry Questions 0..1 group Value Set:
.... SNM/281269004 High Infection Risk? 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
.... NOS/InfectionRiskDetails High infection Risk Details 0..1 string Definition: Observation.valueString
Value Set:
.... Consent Consent 0..1 group Value Set:
..... LN/19826-7 Has consent has been obtained for tests (Y/N) 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
..... LN/75520-7 Has consent has been obtained for DNA storage (Y/N) 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
.... pedigreeNumber G Number (Pedigree Number) 0..1 string Definition: Observation.valueString
Value Set:
..... pedigreeNumber-designNote Useful for Duo/Trio orders, to record the shared pedigree/family group these related orders belong to. Moved here from Genomic Test Order (where it was wrongly mapped to Patient.identifier:PedigreeNumber, implying it was a formal Patient identifier) - NHS England's own Genomics Pedigree Number naming system (https://fhir.nhs.uk/Id/genomics-pedigree-number) describes this as a patient's genetic/pedigree number which links their family, and their own FHIR Genomics Implementation Guide has since moved its own equivalent mapping to a Group resource. Not an Order Group Number (ServiceRequest.requisition) - see WholeGenomicSequence.html for that distinction. Modelled here simply as an Observation.valueString pending a decision on whether a more structured representation (e.g. Group) is needed. 0..1 display Value Set:
.... SNM/842009 Patient is from consanguineous union? 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
.... SNM/74996004-pathology-report Confirm that a pathology report will be provided alongside the sample. 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
.... SNM/118185001 Neonatal/Prenatal/Neither? 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
..... pregnant Pregnant 0..1 group Enable When: SNM/118185001 = Pregnancy (SNOMED CT#77386006)
Value Set:
...... SNM/370386005 Does this test relate to a pregnancy with > 1 fetus? 0..1 string Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
...... SNM/161714006 Patient expected delivery date 0..1 date Definition: Observation.valueDateTime
Value Set:
...... SNM/598151000005105 Patient gestation 0..1 integer Definition: Observation.valueQuantity
Value Set:
.... SNM/17369002 Is this test for a pregnancy loss? 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
.... SNM/419099009 Is this test for a deceased infant? 0..1 choice Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
.... NOS/VariantReinterpretationReason Reason For Variant Re-Interpretation Request 0..1 string Definition: Observation.valueString
Value Set:

doco Documentation for this format

Options Sets

Answer options for SNM/281269004

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")

Answer options for LN/19826-7

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")

Answer options for LN/75520-7

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")

Answer options for SNM/842009

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")
  • http://loinc.org#LA4489-6 ("Unknown")

Answer options for SNM/74996004-pathology-report

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")
  • http://loinc.org#LA4489-6 ("Unknown")

Answer options for SNM/118185001

  • http://snomed.info/sct#77386006 ("Pregnancy")
  • http://snomed.info/sct#255407002 ("Neonatal")
  • http://loinc.org#LA32-8 ("No")

Answer options for SNM/370386005

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")
  • http://loinc.org#LA4489-6 ("Unknown")

Answer options for SNM/17369002

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")
  • http://loinc.org#LA4489-6 ("Unknown")

Answer options for SNM/419099009

  • http://loinc.org#LA33-6 ("Yes")
  • http://loinc.org#LA32-8 ("No")
  • http://loinc.org#LA4489-6 ("Unknown")

Profile: Questionnaire

Ask At Order Entry Questions

  • linkId: AskAtOrderEntry
  • Answers:

High Infection Risk?

High infection Risk Details

Consent

  • linkId: Consent
  • Answers:

Has consent has been obtained for tests (Y/N)

Has consent has been obtained for DNA storage (Y/N)

G Number (Pedigree Number)

Useful for Duo/Trio orders, to record the shared pedigree/family group these related orders belong to. Moved here from Genomic Test Order (where it was wrongly mapped to Patient.identifier:PedigreeNumber, implying it was a formal Patient identifier) - NHS England's own Genomics Pedigree Number naming system (https://fhir.nhs.uk/Id/genomics-pedigree-number) describes this as a patient's genetic/pedigree number which links their family, and their own FHIR Genomics Implementation Guide has since moved its own equivalent mapping to a Group resource. Not an Order Group Number (ServiceRequest.requisition) - see WholeGenomicSequence.html for that distinction. Modelled here simply as an Observation.valueString pending a decision on whether a more structured representation (e.g. Group) is needed.

  • linkId: pedigreeNumber-designNote
  • Answers:

Patient is from consanguineous union?

Confirm that a pathology report will be provided alongside the sample.

Neonatal/Prenatal/Neither?

Pregnant

  • linkId: pregnant
  • Enable When: todo
  • Answers:

Does this test relate to a pregnancy with > 1 fetus?

Patient expected delivery date

Patient gestation

Is this test for a pregnancy loss?

Is this test for a deceased infant?

Reason For Variant Re-Interpretation Request

Profile: Questionnaire

LinkIDDescription & Constraintsdoco
.. AskAtOrderEntry Value Set:
... SNM/281269004 Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
... NOS/InfectionRiskDetails Definition: Observation.valueString
Value Set:
... Consent Value Set:
.... LN/19826-7 Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
.... LN/75520-7 Definition: Observation.valueCodeableConcept
Value Set:
Options: 2 options
... pedigreeNumber Definition: Observation.valueString
Value Set:
.... pedigreeNumber-designNote Value Set:
... SNM/842009 Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
... SNM/74996004-pathology-report Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
... SNM/118185001 Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
.... pregnant Enable When: Not done yet
Value Set:
..... SNM/370386005 Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
..... SNM/161714006 Definition: Observation.valueDateTime
Value Set:
..... SNM/598151000005105 Definition: Observation.valueQuantity
Value Set:
... SNM/17369002 Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
... SNM/419099009 Definition: Observation.valueCodeableConcept
Value Set:
Options: 3 options
... NOS/VariantReinterpretationReason Definition: Observation.valueString
Value Set:

doco Documentation for this format

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