NHS North West Genomics
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NHS North West Genomics - Local Development build (v2.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Questionnaire: Haemato-Oncology Ask At Order Entry Questions

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

For analysis purposes only - not an active or planned project.

Ask At Order Entry Questions for the NW GLH paper Molecular Genomic Testing Request Form - Haemato-Oncology (DOC5775), used alongside the common core order form - see Order Entry Questions. Unlike the Genomic Test Directory R-code panels used elsewhere, this form selects a named laboratory test panel directly (e.g. Myeloid NGS panel, BCR::ABL, MRD panels) rather than a coded test-directory indication.

This Questionnaire is compared against Genomic Test Order - see NW GLH Paper Test Request Forms - but does not yet declare derivedFrom/extends it: unlike the Ask At Order Entry Questionnaires that originated from an existing digital order-entry screen (see Order Entry Questions), this one hasn't yet been processed into the specific electronic Ask At Order Entry shape that relationship implies for use in an actual order. It structures the NW GLH paper Molecular Genomic Testing Request Form - Haemato-Oncology (DOC5775) - see NW Genomics paper test request forms for how this compares to the other paper forms.

Source form: Molecular Genomic Testing Request Form - Haemato-Oncology (DOCX)

Summary

Item Paper Form Field FHIR
Surname/Forename Free text Patient.name
D.O.B./Biological Sex/Gender Identity Free text Patient.birthDate / Patient.gender / not yet mapped
Patient's Address/Postcode Free text Patient.address
Ethnicity Coded Patient.extension:ethnicCategory
NHS No/Hospital No Free text Patient.identifier:nhsNumber / Patient.identifier:MedicalRecordNumber
Referring Clinician/Healthcare Professional (Consultant/GP, Hospital/Surgery, Department, E-mail/Tel, Requested by/Cc. Report to) Free text PractitionerRole
Test panel(s) ~25 named panel tick-boxes (Myeloid NGS, Lymphoid NGS, BCR::ABL, MRD panels, SNP array, etc.) ServiceRequest.code, repeating
Differential diagnosis Free text (used when "Other" panel selected) ServiceRequest.note

The form's Test Code is implied by which panel is ticked, not a Genomic Test Directory R-code - the named panels don't yet have a 1:1 mapping onto a local CodeSystem in this IG, so NOS/HaemOncPanelRequested is left open rather than guessing lab-internal panel codes. Specimen detail (Sample Type, High Infection Risk, Sample Date, Taken by) beyond the common core's own Specimen group is not restored here - see Genomic Test Order for that. No Order Placer Number, Account Number/Hospital Spell Identifier, or clinician professional identifier (GMC/GMP) field is present on the paper form.

Profile: Questionnaire

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. **For analysis purposes only - not an active or planned project.** **Ask At Order Entry Questions** for the NW GLH paper **Molecular Genomic Testing Request Form - Haemato-Oncology** (DOC5775), used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions). Unlike the Genomic Test Directory R-code panels used elsewhere, this form selects a **named laboratory test panel** directly (e.g. Myeloid NGS panel, BCR::ABL, MRD panels) rather than a coded test-directory indication. Questionnaire https://fhir.nwgenomics.nhs.uk/Questionnaire/HaematoOncologyAskAtOrderEntry#2.2.0
... Patient Patient Details 0..1 group Definition: Patient
Value Set:
.... LN/45394-4 Surname 0..1 string Definition: Patient.name.family
Value Set:
.... LN/45392-8 Forename 0..1 string Definition: Patient.name.given
Value Set:
.... LN/21112-8 D.O.B. 0..1 date Definition: Patient.birthDate
Value Set:
.... LN/46098-0 Biological Sex 0..1 choice Definition: Patient.gender
Value Set: AdministrativeGender
.... NOS/GenderIdentity Gender Identity 0..1 string Value Set:
..... NOS/GenderIdentity-designNote No clean FHIR field identified - distinct from Biological Sex on this form's own layout, same pattern as Genomic Variant Review's and CYP2C19 Mavacamten's own Gender Identity item. 0..1 display Value Set:
.... LN/56799-0 Patient's Address 0..* string Definition: Patient.address.line
Value Set:
.... LN/45401-7 Postcode 0..1 string Definition: Patient.address.postalCode
Value Set:
.... LN/32624-9 Ethnicity 0..1 choice Definition: Patient.extension:ethnicCategory
Value Set: Ethnicity
.... LN/89061-6 NHS No 0..1 string Definition: Patient.identifier:nhsNumber
Value Set:
.... LN/76435-7 Hospital No 0..1 string Definition: Patient.identifier:MedicalRecordNumber
Value Set:
... HealthcareProfessional Referring Clinician/Healthcare Professional 0..1 group Definition: PractitionerRole
Value Set:
.... LN/18705-4 Consultant/GP (in full) 0..1 string Definition: PractitionerRole.practitioner.display
Value Set:
.... HL7/ORC-21 Hospital/Surgery (in full) 0..1 string Definition: PractitionerRole.organization.identifier.value
Value Set:
.... LN/18707-0 Department 0..1 choice Definition: PractitionerRole.specialty.coding.code
Value Set: UK Core Practice Setting Code
.... LN/89058-2 E-mail/Tel 0..1 string Definition: PractitionerRole.telecom.value
Value Set:
.... NOS/RequestedByCcReportTo Requested by/Cc. Report to 0..1 string Value Set:
..... NOS/RequestedByCcReportTo-designNote Same genuinely-additional-person gap identified on Genomic Variant Review and the GMS WGS national forms' own Main Contact group - see Genomic Test Order - Common Fields We May Have Missed (Copy Report To). 0..1 display Value Set:
... AskAtOrderEntry Ask At Order Entry Questions 0..1 group Value Set:
.... NOS/HaemOncPanelRequested Test panel(s) requested 1..* choice Definition: ServiceRequest.code
Value Set:
..... NOS/HaemOncPanelRequested-designNote The paper form lists ~25 named panels (Myeloid NGS, Lymphoid NGS, MRD fusion panels, SNP array, etc.) as tick-boxes, not Genomic Test Directory R-codes. This item is left as free-choice pending a local test-panel CodeSystem rather than guessing lab-internal panel codes. 0..1 display Value Set:
.... NOS/DifferentialDiagnosis Differential diagnosis/clinical question (if 'Other' panel selected) 0..1 string Definition: ServiceRequest.note
Value Set:

doco Documentation for this format

Profile: Questionnaire

Patient Details

  • linkId: Patient
  • Definition:: Patient
  • Answers:

Surname

Forename

D.O.B.

Biological Sex

Gender Identity

  • linkId: NOS/GenderIdentity
  • Answers:

No clean FHIR field identified - distinct from Biological Sex on this form's own layout, same pattern as Genomic Variant Review's and CYP2C19 Mavacamten's own Gender Identity item.

  • linkId: NOS/GenderIdentity-designNote
  • Answers:

Patient's Address

Postcode

Ethnicity

NHS No

Hospital No

Referring Clinician/Healthcare Professional

Consultant/GP (in full)

Hospital/Surgery (in full)

Department

E-mail/Tel

Requested by/Cc. Report to

  • linkId: NOS/RequestedByCcReportTo
  • Answers:

Same genuinely-additional-person gap identified on Genomic Variant Review and the GMS WGS national forms' own Main Contact group - see Genomic Test Order - Common Fields We May Have Missed (Copy Report To).

  • linkId: NOS/RequestedByCcReportTo-designNote
  • Answers:

Ask At Order Entry Questions

  • linkId: AskAtOrderEntry
  • Answers:

Test panel(s) requested*

The paper form lists ~25 named panels (Myeloid NGS, Lymphoid NGS, MRD fusion panels, SNP array, etc.) as tick-boxes, not Genomic Test Directory R-codes. This item is left as free-choice pending a local test-panel CodeSystem rather than guessing lab-internal panel codes.

  • linkId: NOS/HaemOncPanelRequested-designNote
  • Answers:

Differential diagnosis/clinical question (if 'Other' panel selected)

Profile: Questionnaire

LinkIDDescription & Constraintsdoco
.. Patient Definition: Patient
Value Set:
... LN/45394-4 Definition: Patient.name.family
Value Set:
... LN/45392-8 Definition: Patient.name.given
Value Set:
... LN/21112-8 Definition: Patient.birthDate
Value Set:
... LN/46098-0 Definition: Patient.gender
Value Set: AdministrativeGender
... NOS/GenderIdentity Value Set:
.... NOS/GenderIdentity-designNote Value Set:
... LN/56799-0 Definition: Patient.address.line
Value Set:
... LN/45401-7 Definition: Patient.address.postalCode
Value Set:
... LN/32624-9 Definition: Patient.extension:ethnicCategory
Value Set: Ethnicity
... LN/89061-6 Definition: Patient.identifier:nhsNumber
Value Set:
... LN/76435-7 Definition: Patient.identifier:MedicalRecordNumber
Value Set:
.. HealthcareProfessional Definition: PractitionerRole
Value Set:
... LN/18705-4 Definition: PractitionerRole.practitioner.display
Value Set:
... HL7/ORC-21 Definition: PractitionerRole.organization.identifier.value
Value Set:
... LN/18707-0 Definition: PractitionerRole.specialty.coding.code
Value Set: UK Core Practice Setting Code
... LN/89058-2 Definition: PractitionerRole.telecom.value
Value Set:
... NOS/RequestedByCcReportTo Value Set:
.... NOS/RequestedByCcReportTo-designNote Value Set:
.. AskAtOrderEntry Value Set:
... NOS/HaemOncPanelRequested Definition: ServiceRequest.code
Value Set:
.... NOS/HaemOncPanelRequested-designNote Value Set:
... NOS/DifferentialDiagnosis Definition: ServiceRequest.note
Value Set:

doco Documentation for this format

Test this Questionnaire

Try this questionnaire out:

Responses for this Questionnaire

There are currently no QuestionnaireResponse instances for this Questionnaire defined in this IG.