- NHS North West Genomics v2.2.5

1..1

1..1

NK1

0..*

For a fetus, this shall be the mother.

PV1

0..1

PV1 should be populated if PV1-19 Visit Number is known

ORDER

1..*

- ORC

1..*

- OBSERVATION REQUEST

1..*

– OBR

1..*

– NTE

0..*

– DG1

0..*

– OBSERVATION

0..*

— OBX

0..*

- SPECIMEN

0..*

Conditional - required for complete order

– SPM

0..1

ORU_R01 Unsolicited transmission of an observation message

References

Diagnostic Workflow

Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
- See Appendix A – Using ORU to Publish PDF Reports
The Royal College of Radiologists Reporting networks - understanding the technical options

Genomics

HL7 Version 2.5.1 Implementation Guide: Lab Results Interface (LRI), Release 1 from May 2017 includes Data Standards
EPIC HL7 v2 See Discrete Genomic Results (RIE to EPIC EPR)
CodeX HL7 FHIR Accelerator - GenomeX Data Exchange - Transport - suggests sending a genomic FHIR Bundle via ORU_R01, either embedded or via OBX-2 = RP (Reference Pointer) pointing to a URL - see the design discussion under MDM_T02 below for how this differs from this guide's own approach

Message

Segment HL7	Optionality	Notes
MSH	1..1
PID	1..1
PV1	0..1	PV1 should be populated if PV1-19 Visit Number is known
NK1	0..*	For a fetus, this shall be the mother.
ORDER OBSERVATION	1..*
- ORC	1..*
- OBR	1..*
– OBSERVATION	1..*
– OBX	1..*

Segment HL7

Optionality

Notes

1..1

1..1

PV1

0..1

PV1 should be populated if PV1-19 Visit Number is known

NK1

0..*

For a fetus, this shall be the mother.

ORDER OBSERVATION

1..*

- ORC

1..*

- OBR

1..*

– OBSERVATION

1..*

– OBX

1..*

MDM_T02 Original document notification and content

This is currently being elaborated and subject to change.

See also which are functionally equivalent and have a similar data model:

IHE XDS Cross-Enterprise Document Sharing (XDS.b) or Cross-Enterprise Document Reliable Interchange (XDR) - Provide and Register Document Set-b [ITI-41]
IHE MHD Mobile access to Health Documents (MHD) - Simplified Publish [ITI-105]

Design Decision: ORU_R01 vs MDM_T02/ITI-105 for the Laboratory Report (Composition)

This has not yet been decided.

CodeX HL7 FHIR Accelerator - GenomeX Data Exchange - Transport suggests sending a genomic FHIR Bundle - the equivalent of this guide's own Laboratory Report (Composition), see Diagnostic Model Overview - Closed-Loop Referrals - embedded in, or referenced from, an ORU_R01 message: either the whole Bundle base64-encoded in an OBX, or an OBX-2 = RP (Reference Pointer) OBX whose OBX-5 is a URL the receiver retrieves the FHIR resource from - see OBX-2 Value Type below. This guide instead suggests MDM_T02 or IHE MHD Simplified Publish [ITI-105] for that same content, treating it as a document rather than a discrete result.

By the same logic, the RP pattern above is really a document notification - telling the receiver a document/resource exists at a URL, without embedding it - which is what HL7 v2 MDM^T01 (Document Notification, without content) or IHE Document Metadata Subscription (DSUBm) are for, rather than ORU_R01/OBX. Both remain live options for how a Laboratory Report (Composition) is signalled/delivered in this guide.

This decision is only about how the document (the Laboratory Report (Composition)) is packaged and delivered - it does not affect ORU_R01's existing use for discrete, structured results (the OBX conventions described throughout this page). For that content this guide already follows the HL7 Version 2.5.1 Implementation Guide: Lab Results Interface (LRI)

e.g. the same LOINC codes and panel/battery conventions - rather than inventing its own.

References

EPIC Incoming Scanned Document Link Interface Technical Specification

Message

Segment HL7	Optionality	Notes
MSH	1..1
EVN	1..1
PID	1..1
PV1	1..1	PV1 should be populated if PV1-19 Visit Number is known
ORDER	0..*
- ORC	1..1
- OBR	1..1
TXA	1..1
OBXNTE	1..*
- OBX	1..1

Segment HL7

Optionality

Notes

1..1

EVN

1..1

1..1

PV1

1..1

PV1 should be populated if PV1-19 Visit Number is known

ORDER

0..*

- ORC

1..1

- OBR

1..1

TXA

1..1

OBXNTE

1..*

- OBX

1..1

OMG_O19 General Clinical Order

Laboratory orders: OMG^O19 MAY be used instead of OML_O21 for a laboratory (genomic test) order. The segments, including SPM, and their field rules are the same as OML_O21, and the FHIR equivalent is the same Laboratory Order FHIR Message.

Referrals - for future use. OMG^O19 is also the IHE 360X referral order for a Genetic Clinical Referral - see Referral Request [PCC-55]. Not used by any interface in this guide today.

References

Diagnostic Workflow Referral Workflow

IHE PCC 360X Closed Loop Referral PCC TF-2 3.55
HL7 Version 2 to FHIR - ORC to ServiceRequest

OMG^O19^OMG_O19 has the same ORC/OBR/SPM shape as OML_O21, so it can carry either:

a laboratory order - a specific test (e.g. a Genomic Test Directory code in OBR-4), with its specimens in the SPECIMEN group; FHIR equivalent Laboratory Order (O21); or
a referral (IHE 360X, ORC-1 NW) - a clinical service (e.g. a clinical genetics assessment) in OBR-4, normally with no specimen; FHIR equivalent Referral Order (O19).

Message

Segment HL7 Optionality Notes

MSH 1..1 For a referral, MSH-5 / MSH-6 identify the referred-to service

PID 1..1

NK1 0..* For a fetus, this shall be the mother; for a referral, a named consultand (at-risk relative)

PV1 0..1 PV1 should be populated if PV1-19 Visit Number is known

ORDER 1..* A referral has one ORDER

- ORC 1..1 ORC-2 Placer Order Number / Referral ID; ORC-12 and ORC-21 the orderer / referrer

- TQ1 0..1 TQ1-8 expected by date, TQ1-9 priority

- OBR 1..1 OBR-4 Genomic Test Directory code, or for a clinical genetics referral 306119003^^SCT; OBR-31 reason for referral

- NTE 0..* Clinical details

- DG1 0..* Suspected/confirmed condition

- OBSERVATION 0..*

– OBX 0..* Ask At Order Entry answers; for a referral, the referral question (OBX-11 O, OBX-29 QST), forms and documents as RP or ED

- SPECIMEN 0..* Conditional - required for a complete laboratory order; normally absent for a referral

– SPM 1..1

– OBX 0..* Observations about the specimen

Segment HL7	Optionality	Notes
MSH	1..1	For a referral, MSH-5 / MSH-6 identify the referred-to service
PID	1..1
NK1	0..*	For a fetus, this shall be the mother; for a referral, a named consultand (at-risk relative)
PV1	0..1	PV1 should be populated if PV1-19 Visit Number is known
ORDER	1..*	A referral has one ORDER
- ORC	1..1	ORC-2 Placer Order Number / Referral ID; ORC-12 and ORC-21 the orderer / referrer
- TQ1	0..1	TQ1-8 expected by date, TQ1-9 priority
- OBR	1..1	OBR-4 Genomic Test Directory code, or for a clinical genetics referral `306119003^^SCT`; OBR-31 reason for referral
- NTE	0..*	Clinical details
- DG1	0..*	Suspected/confirmed condition
- OBSERVATION	0..*
– OBX	0..*	Ask At Order Entry answers; for a referral, the referral question (OBX-11 `O`, OBX-29 `QST`), forms and documents as `RP` or ED
- SPECIMEN	0..*	Conditional - required for a complete laboratory order; normally absent for a referral
– SPM	1..1
– OBX	0..*	Observations about the specimen

Example

A laboratory order sent as OMG^O19 instead of OML_O21 - see Referral Request [PCC-55]. For a referral, OBR-4 is 306119003^^SCT and there is normally no SPM.

MSH|^~\&|EPIC|R0A|RIE|699X0|20250129103726+0000||OMG^O19^OMG_O19|MSG001601737|P|2.5.1|||AL|NE
PID|1||633^^^R0A^MR~9449305552^^^^NH||CHISLETT^Octavia||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST
PV1|1|I|^^^R0A09^^^^^^^R0A||||C3456789^Darwin^Samuel^^^Dr^^^GMC|||892761000000102^Clinical haematology service^SNM3|||||||||1001166717^^^R0A^AN
ORC|NW|1601737^R0A|||||||20250129103726+0000|||C3456789^Darwin^Samuel^^^Dr^^^GMC|||||||||MANCHESTER UNIVERSITY NHS FOUNDATION TRUST^^R0A^^^ODS
OBR|1|1601737^R0A||R240.1^^England-GenomicTestDirectory||20250129||||||||||C3456789^Darwin^Samuel^^^Dr^^^GMC
SPM|1|25GEN-029GN00001&R0A||258580003^Whole blood specimen^SNM3|||||||||||||20250129103726+0000|||Y

FHIR Message Example: Bundle 'Message' - Genomics Order with Coded Entries

OSU_O51 Order Status Update

For future use. Not used by any interface in this guide today. Used for Genetic Clinical Referral status updates - see [PCC-55], [PCC-56] and [PCC-57].

References

Referral Workflow

IHE PCC 360X Closed Loop Referral PCC TF-2 3.55 to 3.59
NHS England Multicast Notification Service - Genomic Order Event

Note: OSU^O51 is an HL7 v2.8 message - it is not in HL7 v2.5.1, the version used by IHE PaLM (LTW, ILW) and the other messages in this guide. The IHE laboratory equivalents report order status with ORL^O22 / OML^O21 (ORC-1 and ORC-5) instead.

OSU^O51^OSU_O51 reports a change in the status of an order - accept, decline, interim note, outcome, cancellation. The FHIR equivalent is the Referral Order Status (O51) FHIR Message, whose focus is a Task.

Where the referral or order is managed by the NHS England Genomic Order Management Service (GOMS), the Regional Integration Engine (RIE) receives a genomic-order-event-1 notification from the NHS England Multicast Notification Service (MNS), retrieves the Task from GOMS, and converts it to OSU^O51 (or the FHIR Message) - see Status Updates from GOMS via MNS.

Message

Segment HL7	Optionality	Notes
MSH	1..1
PID	1..1	Required in this guide
ORC	1..*	ORC-1 / ORC-5 the status; ORC-2 the Referral ID; ORC-12 and ORC-21 the referrer (required in this guide); ORC-16 the reason

Segment HL7

Optionality

Notes

1..1

UKCorePersonRelationshipType

1..1

Required in this guide

ORC

1..*

ORC-1 / ORC-5 the status; ORC-2 the Referral ID; ORC-12 and ORC-21 the referrer (required in this guide); ORC-16 the reason

Order Control and Status

Status update ORC-1 ORC-5 FHIR Task.status Task.businessStatus (Referral Workflow Status)

Accept [PCC-55] OK IP accepted accepted

Decline [PCC-55, PCC-56] UA CA rejected declined

Interim Consultation Note [PCC-59] SC A in-progress interim-report

Referral Outcome [PCC-57] SC CM completed completed

Cancel Request [PCC-58] CA CA cancelled cancel-requested

Cancel Confirmation [PCC-58] CR CA cancelled cancelled

Status update	ORC-1	ORC-5	FHIR `Task.status`	`Task.businessStatus` (Referral Workflow Status)
Accept [PCC-55]	`OK`	`IP`	`accepted`	`accepted`
Decline [PCC-55, PCC-56]	`UA`	`CA`	`rejected`	`declined`
Interim Consultation Note [PCC-59]	`SC`	`A`	`in-progress`	`interim-report`
Referral Outcome [PCC-57]	`SC`	`CM`	`completed`	`completed`
Cancel Request [PCC-58]	`CA`	`CA`	`cancelled`	`cancel-requested`
Cancel Confirmation [PCC-58]	`CR`	`CA`	`cancelled`	`cancelled`

Example

MSH|^~\&|RIE|699X0|EPIC|R0A|20250130093000+0000||OSU^O51^OSU_O51|GLH-MSG-250130001|P|2.8|||AL|NE
PID|1||633^^^R0A^MR~9449305552^^^^NH||CHISLETT^Octavia||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST
ORC|OK|1601737^R0A|R25012345^699X0||IP||||20250130093000+0000|||C3456789^Darwin^Samuel^^^Dr^^^GMC|||||||||MANCHESTER UNIVERSITY NHS FOUNDATION TRUST^^R0A^^^ODS

FHIR Message Example: Bundle Message - Order Status (O51), accepted

Segments

MSH

This is based on the definition of MSH from NHS England HL7 v2 ADT Message Specification.

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
MSH-1	Field Separator		R			The character separating fields in the message - always a tab here.
MSH-2	Encoding Characters		R		^~\&	The component/repetition/escape/sub-component separators used throughout the message.
MSH-3	Sending Application		R		iGene	The sending system's own name (ubiquitous term: Sending System).
MSH-4	Sending Facility	HD	R	ODS Code	699X0	The sending organisation (ubiquitous terms: ODS Code, Trust Code).
MSH-5	Receiving Application	HD	R		EPIC	The receiving system's own name (ubiquitous term: Receiving System).
MSH-6	Receiving Facility		R	ODS Code	R0A	The receiving organisation (ubiquitous terms: ODS Code, Trust Code).
MSH-7	Date/Time Of Message		R		20170126143602	When the message was created (ubiquitous term: Message Timestamp).
MSH-9	Message Type		R		ORU^R01^ORU_R01	What kind of message this is, e.g. a lab report vs. an order (ubiquitous term: Message Type).
MSH-10	Message Control ID		R		2017012614360280000	Uniquely identifies this message instance, used to correlate an acknowledgement back to it (ubiquitous terms: Message ID, Message Control ID).
MSH-11	Processing ID		R		P	Whether this is Production, Training or Debugging data (ubiquitous term: Processing Mode).
MSH-12	Version ID		R		2.5.1	The HL7 v2 version this message conforms to (ubiquitous term: HL7 Version).
MSH-13	Accept AcknowledgmentType		R		AL	When the receiver should send an acknowledgement (ubiquitous term: Ack Type).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

MSH-1

Field Separator

The character separating fields in the message - always a tab here.

MSH-2

Encoding Characters

^~\&

The component/repetition/escape/sub-component separators used throughout the message.

MSH-3

Sending Application

iGene

The sending system's own name (ubiquitous term: Sending System).

MSH-4

Sending Facility

ODS Code

699X0

The sending organisation (ubiquitous terms: ODS Code, Trust Code).

MSH-5

Receiving Application

EPIC

The receiving system's own name (ubiquitous term: Receiving System).

MSH-6

Receiving Facility

ODS Code

R0A

The receiving organisation (ubiquitous terms: ODS Code, Trust Code).

MSH-7

Date/Time Of Message

20170126143602

When the message was created (ubiquitous term: Message Timestamp).

MSH-9

Message Type

ORU^R01^ORU_R01

What kind of message this is, e.g. a lab report vs. an order (ubiquitous term: Message Type).

MSH-10

Message Control ID

2017012614360280000

Uniquely identifies this message instance, used to correlate an acknowledgement back to it (ubiquitous terms: Message ID, Message Control ID).

MSH-11

Processing ID

Whether this is Production, Training or Debugging data (ubiquitous term: Processing Mode).

MSH-12

Version ID

2.5.1

The HL7 v2 version this message conforms to (ubiquitous term: HL7 Version).

MSH-13

Accept AcknowledgmentType

When the receiver should send an acknowledgement (ubiquitous term: Ack Type).

v2 to FHIR Conversion: MSH to FHIR MessageHeader
v2 to FHIR Conversion: MSH to FHIR Bundle (message)
FHIR Profile: MessageHeader

PID

This is based on the definition of PID from NHS England HL7 v2 ADT Message Specification and Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
PID-1	Set ID-PID		R		1	Sequence number of this PID segment within the message (ubiquitous term: Set ID).
PID-3	Patient Identifier List	CX	R S	NHS Number Medical Record Number.	633^^^R0A^MR~9449305552^^^NHS^NH	The patient's identifiers, repeating - ubiquitous terms: NHS Number (national) and Hospital Number/MRN (local).
PID-5	Patient Name		R S		CHISLETT^Octavia^^Miss	The patient's name (ubiquitous term: Patient Name).
PID-7	Date/Time of Birth		R S		20080920	The patient's date of birth (ubiquitous terms: DOB, Date of Birth).
PID-8	Administrative Sex		O		F	The patient's administrative/recorded sex (ubiquitous term: Sex).
PID-11	Patient Address		R		1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST	The patient's home address (ubiquitous term: Address).
PID-13	Phone Number - Home		R		01656 123123^PRN^PH~07927655295^ORN^CP^NET^X.400^abc@home.com~01656 123123~01656123123^PRN^PH^^^abc@home.com~01656123123^PRN^PH	The patient's contact details, repeating - phone, mobile and/or email (ubiquitous term: Contact Number).
PID-32	Identity Reliability Code		O	Mandatory if the the NHS Number tracing status is not known.	01	Flags a known data-quality issue with the patient's identity, e.g. an untraced NHS Number (ubiquitous term: Identity Reliability).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

PID-1

Set ID-PID

Sequence number of this PID segment within the message (ubiquitous term: Set ID).

PID-3

Patient Identifier List

R S

NHS Number
Medical Record Number.

633^^^R0A^MR~9449305552^^^NHS^NH

The patient's identifiers, repeating - ubiquitous terms: NHS Number (national) and Hospital Number/MRN (local).

PID-5

Patient Name

R S

CHISLETT^Octavia^^Miss

The patient's name (ubiquitous term: Patient Name).

PID-7

Date/Time of Birth

R S

20080920

The patient's date of birth (ubiquitous terms: DOB, Date of Birth).

PID-8

Administrative Sex

The patient's administrative/recorded sex (ubiquitous term: Sex).

PID-11

Patient Address

1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST

The patient's home address (ubiquitous term: Address).

PID-13

Phone Number - Home

01656 123123^PRN^PH~07927655295^ORN^CP^NET^X.400^abc@home.com~01656 123123~01656123123^PRN^PH^^^abc@home.com~01656123123^PRN^PH

The patient's contact details, repeating - phone, mobile and/or email (ubiquitous term: Contact Number).

PID-32

Identity Reliability Code

Mandatory if the the NHS Number tracing status is not known.

Flags a known data-quality issue with the patient's identity, e.g. an untraced NHS Number (ubiquitous term: Identity Reliability).

v2 to FHIR Conversion: PID to FHIR Patient
FHIR Profile: Patient

Examples

PID|1||633^^^R0A^MR~9449305552^^^^NH||CHISLETT^Octavia||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST

FHIR Resource Example: Patient - Octavia CHISLETT NHS Number: 9449305552

PD1

v2 to FHIR Conversion: PD1 to FHIR Patient
FHIR Profile: Patient

NK1

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
NK1-2	Name	XPN	O		London^Cersei	The next of kin/relative's name (ubiquitous term: NOK Name).
NK1-3	Relationship	CWE	R	UKCorePersonRelationshipType	MTH	How this person relates to the patient, e.g. mother, father (ubiquitous term: Relationship).
NK1.15	Administrative Sex	IS	O		F	The relative's administrative sex (ubiquitous term: Sex).
NK1-16	Date/Time of Birth	TS	O		19731003	The relative's date of birth (ubiquitous term: DOB).
NK1-33	Next of Kin/Associated Party's Identifiers	CX	R		9737383230^^^NHS^NH~1234567^^^RPY^MR	The relative's own identifiers, e.g. their own NHS Number/MRN if they are also a patient (ubiquitous term: NOK Identifiers).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

NK1-2

Name

XPN

London^Cersei

The next of kin/relative's name (ubiquitous term: NOK Name).

NK1-3

Relationship

CWE

MTH

How this person relates to the patient, e.g. mother, father (ubiquitous term: Relationship).

NK1.15

Administrative Sex

The relative's administrative sex (ubiquitous term: Sex).

NK1-16

Date/Time of Birth

19731003

The relative's date of birth (ubiquitous term: DOB).

NK1-33

Next of Kin/Associated Party's Identifiers

9737383230^^^NHS^NH~1234567^^^RPY^MR

The relative's own identifiers, e.g. their own NHS Number/MRN if they are also a patient (ubiquitous term: NOK Identifiers).

v2 to FHIR Conversion: NK1 to FHIR RelatedPerson
FHIR Profile: RelatedPerson

PV1

The PV1 segment should represent the episode/stay/visit number, not a consultant episode.

This is based on the definition of PV1 from NHS England HL7 v2 ADT Message Specification

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
PV1-1	Set ID - PV1	SI	R		1	Sequence number of this PV1 segment within the message (ubiquitous term: Set ID).
PV1-2	Patient Class				I	Inpatient, outpatient, emergency, etc. (ubiquitous term: Patient Class).
PV1-3	Assigned Patient Location	PL	R		^^^R0A09^^^^^^^R0A ^^^P1S8J^^^^^^^699X0	The ward/clinic/bed the patient is assigned to (ubiquitous terms: Location, Ward, Bed).
PV1-8	Referring Doctor	XCN	O	Practitioner Identifier	C3456789^Darwin^Samuel^^^Dr^^^GMC	The doctor who referred the patient (ubiquitous terms: Referring Doctor, Referrer).
PV1-9	Consulting Doctor	XCN	O	Practitioner Identifier	C3456789^Darwin^Samuel^^^Dr^^^GMC	A doctor consulted on this visit (ubiquitous term: Consultant).
PV1-10	Hospital Service		R S	Service	892761000000102^Clinical haematology service^SNM3 810^Radiology^2.16.840.1.113883.2.1.6.8	The clinical service/specialty responsible for the visit (ubiquitous term: Specialty).
PV1-17	Admitting Doctor	XCN	R	Practitioner Identifier	C3456789^Darwin^Samuel^^^Dr^^^GMC	The doctor formally admitting the patient (ubiquitous term: Admitting Doctor).
PV1-19	Visit Number	CX	O S	Hospital Provider Spell Identifier	12345^^^R0A	The identifier for this spell/stay (ubiquitous terms: Visit Number, Spell Number, Account Number).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

PV1-1

Set ID - PV1

Sequence number of this PV1 segment within the message (ubiquitous term: Set ID).

PV1-2

Patient Class

Inpatient, outpatient, emergency, etc. (ubiquitous term: Patient Class).

PV1-3

Assigned Patient Location

^^^R0A09^^^^^^^R0A
^^^P1S8J^^^^^^^699X0

The ward/clinic/bed the patient is assigned to (ubiquitous terms: Location, Ward, Bed).

PV1-8

Referring Doctor

XCN

C3456789^Darwin^Samuel^^^Dr^^^GMC

The doctor who referred the patient (ubiquitous terms: Referring Doctor, Referrer).

PV1-9

Consulting Doctor

XCN

C3456789^Darwin^Samuel^^^Dr^^^GMC

A doctor consulted on this visit (ubiquitous term: Consultant).

PV1-10

Hospital Service

R S

Service

892761000000102^Clinical haematology service^SNM3
810^Radiology^2.16.840.1.113883.2.1.6.8

The clinical service/specialty responsible for the visit (ubiquitous term: Specialty).

PV1-17

Admitting Doctor

XCN

Hospital Provider Spell Identifier

C3456789^Darwin^Samuel^^^Dr^^^GMC

The doctor formally admitting the patient (ubiquitous term: Admitting Doctor).

PV1-19

Visit Number

O S

12345^^^R0A

The identifier for this spell/stay (ubiquitous terms: Visit Number, Spell Number, Account Number).

v2 to FHIR Conversion: PV1 to FHIR Encounter
FHIR Profile: HospitalSpell FHIR Profile: Visit

Examples

PV1|1|I|^^^R0A09^^^^^^^R0A||||C3456789^Darwin^Samuel^^^Dr^^^GMC|||892761000000102^Clinical haematology service^SNM3|||||||||1001166717^^^R0A^AN|||||||||||||||||||||||||20250129103726+0000

FHIR Resource Example: Encounter 'episode/stay' Example

ORC

This is based on the definition of ORC from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide.

Field HL7 Fieldname Data Type Optionality Identifier Type or ValueSet Example Values Description

ORC-2 Placer Order Number EI R S Order Identifier (type PLAC) 1601737^R0A^150^L The referring system's own order number. Maps to ServiceRequest.identifier (ubiquitous terms: Order Number, Placer Order Number).

ORC-3 Filler Order Number EI O Order Identifier (type FILL) R25012345^699X0 The receiving laboratory's own number for the order, e.g. the iGene R-Number. Maps to ServiceRequest.identifier (ubiquitous terms: Filler Order Number, Lab Order Number).

ORC-4 Placer Group Number EI O S Order Group Number r25012345678^8J834 Assigned by the ordering system to link several orders placed together, e.g. the NGIS Referral Id or a panel (ubiquitous terms: Order Group Number, Panel Number).

ORC-5 Order Status O The current status of the order (ubiquitous term: Order Status).

ORC-8 Parent EIP O Order Group Number (provisional) ^R25012345&699X0 The parent order's Placer and/or Filler Order Number, e.g. the pathology order a genomic reflex order follows on from. Provisionally maps to ServiceRequest.requisition - see Linking Related Orders (ubiquitous term: Parent Order Number).

ORC-9 Date/Time of Transaction TS O When this order message was created/transacted (ubiquitous term: Transaction Date/Time).

ORC-12 Ordering Provider XCN O Practitioner Identifier C3456789^Darwin^Samuel^^^Dr^^^GMC The clinician who placed the order (ubiquitous terms: Ordering Provider, Requesting Clinician). Intended to become R (required), see note below.

ORC-21 Ordering Facility Name XON R S Organisation Code MANCHESTER UNIVERSITY NHS FOUNDATION TRUST^^R0A^^^ODS The organisation the order was placed on behalf of (ubiquitous terms: Ordering Facility, Trust).

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
ORC-2	Placer Order Number	EI	R S	Order Identifier (type `PLAC`)	1601737^R0A^150^L	The referring system's own order number. Maps to `ServiceRequest.identifier` (ubiquitous terms: Order Number, Placer Order Number).
ORC-3	Filler Order Number	EI	O	Order Identifier (type `FILL`)	R25012345^699X0	The receiving laboratory's own number for the order, e.g. the iGene R-Number. Maps to `ServiceRequest.identifier` (ubiquitous terms: Filler Order Number, Lab Order Number).
ORC-4	Placer Group Number	EI	O S	Order Group Number	r25012345678^8J834	Assigned by the ordering system to link several orders placed together, e.g. the NGIS Referral Id or a panel (ubiquitous terms: Order Group Number, Panel Number).
ORC-5	Order Status		O			The current status of the order (ubiquitous term: Order Status).
ORC-8	Parent	EIP	O	Order Group Number (provisional)	^R25012345&699X0	The parent order's Placer and/or Filler Order Number, e.g. the pathology order a genomic reflex order follows on from. Provisionally maps to `ServiceRequest.requisition` - see Linking Related Orders (ubiquitous term: Parent Order Number).
ORC-9	Date/Time of Transaction	TS	O			When this order message was created/transacted (ubiquitous term: Transaction Date/Time).
ORC-12	Ordering Provider	XCN	O	Practitioner Identifier	C3456789^Darwin^Samuel^^^Dr^^^GMC	The clinician who placed the order (ubiquitous terms: Ordering Provider, Requesting Clinician). Intended to become R (required), see note below.
ORC-21	Ordering Facility Name	XON	R S	Organisation Code	MANCHESTER UNIVERSITY NHS FOUNDATION TRUST^^R0A^^^ODS	The organisation the order was placed on behalf of (ubiquitous terms: Ordering Facility, Trust).

ORC-12 Ordering Provider: ORC-12 is currently optional, but it is intended that it will be made mandatory (R) in a future version of this guide. Senders SHOULD populate ORC-12 now in preparation for this change.

v2 to FHIR Conversion: ORC to FHIR ServiceRequest
FHIR Profile: ServiceRequest

Examples

ORC|NW|1601737^R0A|R25012345^699X0||||||20250129|||C3456789^Darwin^Samuel^^^Dr^^^GMC|||||||||^^R0A^^^ODS

FHIR Resource Example: ServiceRequest Coded Entries Example

OBR

This is based on the definition of OBR from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide

Field HL7 Fieldname Data Type Optionality Identifier Type or ValueSet Example Values Description

OBR-1 Set ID - OBR R 1 Sequence number of this order/observation-request group within the message (ubiquitous term: Set ID).

OBR-2 Placer Order Number EI O S Order Identifier 1601737^ R0A^150^L The referring system's own order number, repeated from ORC-2 (ubiquitous terms: Order Number, Placer Order Number).

OBR-3 Filler Order Number EI R S Report Identifier T25067890^699X0 The receiving laboratory's own number for this test/report, e.g. the iGene T-Number. Maps to DiagnosticReport.identifier. This may differ from ORC-3 (the order), see note below (ubiquitous terms: Report Number, Test Number, Filler Order Number).

OBR-4 Universal Service Identifier R S Genomic Test Directory R240.1^Diagnostic testing for known variant(s)^England-GenomicTestDirectory The test/panel being requested or reported on (ubiquitous term: Test Code).

OBR-6 Requested Date/Time TS R for OML_O21 20170126135745 When the order was requested (ubiquitous term: Requested Date/Time).

OBR-7 Observation Date/Time TS R for ORU_R01 S 20170126135745 When the specimen/observation was taken (ubiquitous term: Observation Date/Time).

OBR-16 Ordering Provider R Organisation Code The organisation that placed the order (ubiquitous terms: Ordering Facility, Trust).

OBR-22 Results Rpt/Status Chng -Date/Time TS R for ORU_R01 S 20170126135745 When the report's status last changed, e.g. when finalised (ubiquitous term: Report Status Date/Time).

OBR-25 Result Status Whether the result is preliminary, final, corrected, etc. (ubiquitous term: Result Status).

OBR-31 Reason for Study CWE O Genomic Clinical Indication Codes R210^Lynch syndrome^GenomicClinicalIndication The clinical reason the test was requested (ubiquitous terms: Clinical Indication, Reason for Referral).

OBR-32 Principal Result Interpreter NDL O - SHOULD Practitioner Identifier C3456789^Darwin^Samuel^^^Dr^^^GMC The clinician who interpreted/authorised the result (ubiquitous terms: Reporting Clinician, Authoriser).

OBR-33 Assistant Result Interpreter NDL O - SHOULD Practitioner Identifier A second clinician who assisted in interpreting the result (ubiquitous term: Assistant Reporter).

OBR-34 Technician NDL O - SHOULD Practitioner Identifier The laboratory staff member who performed the test (ubiquitous term: Technician).

OBR-46 Placer Supplemental Service Information CWE O Further coded qualifier(s) on the requested service, supplementing OBR-4 rather than replacing it - maps to FHIR ServiceRequest.orderDetail (ubiquitous term: Supplemental Service Information).

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
OBR-1	Set ID - OBR		R		1	Sequence number of this order/observation-request group within the message (ubiquitous term: Set ID).
OBR-2	Placer Order Number	EI	O S	Order Identifier	1601737^ R0A^150^L	The referring system's own order number, repeated from ORC-2 (ubiquitous terms: Order Number, Placer Order Number).
OBR-3	Filler Order Number	EI	R S	Report Identifier	T25067890^699X0	The receiving laboratory's own number for this test/report, e.g. the iGene T-Number. Maps to `DiagnosticReport.identifier`. This may differ from ORC-3 (the order), see note below (ubiquitous terms: Report Number, Test Number, Filler Order Number).
OBR-4	Universal Service Identifier		R S	Genomic Test Directory	R240.1^Diagnostic testing for known variant(s)^England-GenomicTestDirectory	The test/panel being requested or reported on (ubiquitous term: Test Code).
OBR-6	Requested Date/Time	TS	R for OML_O21		20170126135745	When the order was requested (ubiquitous term: Requested Date/Time).
OBR-7	Observation Date/Time	TS	R for ORU_R01 S		20170126135745	When the specimen/observation was taken (ubiquitous term: Observation Date/Time).
OBR-16	Ordering Provider		R	Organisation Code		The organisation that placed the order (ubiquitous terms: Ordering Facility, Trust).
OBR-22	Results Rpt/Status Chng -Date/Time	TS	R for ORU_R01 S		20170126135745	When the report's status last changed, e.g. when finalised (ubiquitous term: Report Status Date/Time).
OBR-25	Result Status					Whether the result is preliminary, final, corrected, etc. (ubiquitous term: Result Status).
OBR-31	Reason for Study	CWE	O	Genomic Clinical Indication Codes	R210^Lynch syndrome^GenomicClinicalIndication	The clinical reason the test was requested (ubiquitous terms: Clinical Indication, Reason for Referral).
OBR-32	Principal Result Interpreter	NDL	O - SHOULD	Practitioner Identifier	C3456789^Darwin^Samuel^^^Dr^^^GMC	The clinician who interpreted/authorised the result (ubiquitous terms: Reporting Clinician, Authoriser).
OBR-33	Assistant Result Interpreter	NDL	O - SHOULD	Practitioner Identifier		A second clinician who assisted in interpreting the result (ubiquitous term: Assistant Reporter).
OBR-34	Technician	NDL	O - SHOULD	Practitioner Identifier		The laboratory staff member who performed the test (ubiquitous term: Technician).
OBR-46	Placer Supplemental Service Information	CWE	O			Further coded qualifier(s) on the requested service, supplementing OBR-4 rather than replacing it - maps to FHIR `ServiceRequest.orderDetail` (ubiquitous term: Supplemental Service Information).

ORC-3 and OBR-3: HL7 v2.5.1 expects OBR-3 to repeat ORC-3. In this guide they can differ: ORC-3 is the laboratory's number for the order (e.g. iGene R-Number, ServiceRequest.identifier) and OBR-3 is its number for each test/report under that order (e.g. iGene T-Number, DiagnosticReport.identifier). This follows the v2 to FHIR ORU_R01 mapping. Receivers that check ORC-3 = OBR-3 need to allow for this.

v2 to FHIR Conversion OML_O21: OBR to FHIR ServiceRequest
v2 to FHIR Conversion ORU_R01: OBR to FHIR DiagnosticReport
FHIR Profile: DiagnosticReport

Examples

OBR|1|1601737^R0A|T25067890^699X0|R240.1^^England-GenomicTestDirectory||20250129||||||||||C3456789^Darwin^Samuel^^^Dr^^^GMC

FHIR Resource Example: Diagnostic Report Example

NTE

Multiple NTE should be converted to a single FHIR Annotation using markdown

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

NTE-1

Set ID - NTE

Sequence number of this note line (ubiquitous term: Set ID).

NTE-2

Source of Comment

Which segment/system this comment relates to (ubiquitous term: Comment Source).

NTE-3

Comment

The free-text comment itself (ubiquitous term: Comment, Note).

NTE-4

Comment Type

The kind of comment this is, e.g. clinical vs. administrative (ubiquitous term: Comment Type).

v2 to FHIR Conversion OML_O21: NTE to FHIR ServiceRequest
v2 to FHIR Conversion ORU_R01: NTE to FHIR Observation

Examples

NTE|1||Referral lab PLEASE do following tests:
NTE|2||
NTE|3||Test(s) required: WGS
NTE|4||Sample type: Blood
NTE|5||Transport used: Merlin Courier
NTE|6||Tracking Number: ABC123
NTE|7||Sample sent to: LWH Genetics
NTE|8||By: PDAY       on: 02/04/25
NTE|9||
NTE|10||.Speciality Requesting Clinician: PAEDS
NTE|11||Test Group: Neurology
NTE|12||Ethnic Group: White British
NTE|13||Patient is from consanguineous union? : Unknown
NTE|14||Specimen Collection Status: Collect & send with order
NTE|15||Infection Risk: No Specific Risk
NTE|16||Clinical details:
NTE|17||
NTE|18||TESTING
NTE|19||Contact/Bleep No: 123

FHIR Resource Example OML_O21: ServiceRequest Coded Entries Example

FHIR Resource Example ORU_R01: TODO

DG1

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
DG1-3	Diagnosis Code	CE				The coded diagnosis (ubiquitous terms: Diagnosis Code, Condition).
DG1-4	Diagnosis Description					The diagnosis in plain text (ubiquitous term: Diagnosis Description).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

DG1-3

Diagnosis Code

The coded diagnosis (ubiquitous terms: Diagnosis Code, Condition).

DG1-4

Diagnosis Description

The diagnosis in plain text (ubiquitous term: Diagnosis Description).

v2 to FHIR Conversion: DG1 to FHIR Condition Note: In orders this is likely to be a coded entry in ServiceRequest.reasonCode as only a code is present.
FHIR Profile: Condition

Examples

DG1|1||363349007^Malignant tumour of stomach^SNM3||20250129103726+0000

FHIR Resource Example ORU_R01: TODO

OBX

This is based on the definition of OBX from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
OBX-1	Set ID – OBX		R		1	Sequence number of this result line within the report (ubiquitous term: Set ID).
OBX-2	Value Type		R S	See next section for ED	CE	The data type of the result value that follows in OBX-5 (ubiquitous term: Value Type).
OBX-3	Observation Identifier	CE	R S		842009^Consanguinity^SNM3 97209-1^Shipment tracking number^LN 161714006^Estimated date of delivery^SNM3	What was measured/observed/tested (ubiquitous terms: Test Name, Observation Code).
OBX-5	Observation Value	Varies	R S		LN^Yes^LA33-6 (value type=CE) UK3096580215 (value type=ST) 20250512103726+0000 (value type=DT)	The actual result (ubiquitous terms: Result, Result Value).
OBX-6	Units	CE	O	ucum-units		The unit the result is expressed in, e.g. mmol/L (ubiquitous term: Units).
OBX-7	References Range	ST	O			The normal/expected range for this result (ubiquitous term: Reference Range, Normal Range).
OBX-8	Abnormal Flags	IS	O			Flags whether the result is high/low/abnormal (ubiquitous term: Abnormal Flag).
OBX-11	Observation Result Status	ID	R		F	Whether this result is preliminary, final, corrected, etc. (ubiquitous term: Result Status).
OBX-14	Date/Time of the Observation	TS	O - SHOULD		20190514102417+0000	When this specific observation was made (ubiquitous term: Observation Date/Time).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

OBX-1

Set ID – OBX

Sequence number of this result line within the report (ubiquitous term: Set ID).

OBX-2

Value Type

R S

See next section for ED

The data type of the result value that follows in OBX-5 (ubiquitous term: Value Type).

OBX-3

Observation Identifier

R S

842009^Consanguinity^SNM3
97209-1^Shipment tracking number^LN
161714006^Estimated date of delivery^SNM3

What was measured/observed/tested (ubiquitous terms: Test Name, Observation Code).

OBX-5

Observation Value

Varies

R S

LN^Yes^LA33-6 (value type=CE)
UK3096580215 (value type=ST)
20250512103726+0000 (value type=DT)

The actual result (ubiquitous terms: Result, Result Value).

OBX-6

Units

ucum-units

The unit the result is expressed in, e.g. mmol/L (ubiquitous term: Units).

OBX-7

References Range

The normal/expected range for this result (ubiquitous term: Reference Range, Normal Range).

OBX-8

Abnormal Flags

Flags whether the result is high/low/abnormal (ubiquitous term: Abnormal Flag).

OBX-11

Observation Result Status

Whether this result is preliminary, final, corrected, etc. (ubiquitous term: Result Status).

OBX-14

Date/Time of the Observation

O - SHOULD

20190514102417+0000

When this specific observation was made (ubiquitous term: Observation Date/Time).

OBX-2 Value Type

HL7 Value Type OBX-5 FHIR Observation Mapping FHIR DiagnosticReport

Coded Entry (CE, CWE and CNE ) Obsveration.valueCodeableConcept DiagnosticReport.result

Date (DT) Observation.valueDateTime DiagnosticReport.result

Embedded documents (ED) n/a, convert OBX-5 to Binary and the OBX to FHIR DocumentReference OBX (type = ED) DiagnosticReport.extension(supportingInfo) - for reports, the Binary should be referenced via DiagnosticReport.presentedForm.url

Formatted Text (FT) Observation.valueString, HL7 v2.x formatting should be converted to markdown DiagnosticReport.result

Numeric (NM) Observation.valueQuantity DiagnosticReport.result

Reference Pointer (RP) n/a, convert the OBX to FHIR DocumentReference OBX (type = ED) DiagnosticReport.extension(supportingInfo) - for reports, the value is mapped to DiagnosticReport.presentedForm.url

Structured Numeric (SN) Observation.valueQuantity DiagnosticReport.result

String Data (ST) Observation.valueString DiagnosticReport.result

Time (TM) Observation.valueTime DiagnosticReport.result

Text Data (TX) Observation.valueString, newline is represented as \n DiagnosticReport.result

HL7 Value Type	OBX-5 FHIR Observation Mapping	FHIR DiagnosticReport
Coded Entry (CE, CWE and CNE )	Obsveration.valueCodeableConcept	DiagnosticReport.result
Date (DT)	Observation.valueDateTime	DiagnosticReport.result
Embedded documents (ED)	n/a, convert OBX-5 to Binary and the OBX to FHIR DocumentReference OBX (type = ED)	DiagnosticReport.extension(supportingInfo) - for reports, the Binary should be referenced via DiagnosticReport.presentedForm.url
Formatted Text (FT)	Observation.valueString, HL7 v2.x formatting should be converted to markdown	DiagnosticReport.result
Numeric (NM)	Observation.valueQuantity	DiagnosticReport.result
Reference Pointer (RP)	n/a, convert the OBX to FHIR DocumentReference OBX (type = ED)	DiagnosticReport.extension(supportingInfo) - for reports, the value is mapped to DiagnosticReport.presentedForm.url
Structured Numeric (SN)	Observation.valueQuantity	DiagnosticReport.result
String Data (ST)	Observation.valueString	DiagnosticReport.result
Time (TM)	Observation.valueTime	DiagnosticReport.result
Text Data (TX)	Observation.valueString, newline is represented as `\n`	DiagnosticReport.result

For discussion:

Many reports will use FT or TX for the report (Genetic Report (1054161000000101) and Laboratort Report (4241000179101)), the preferred way to represent this is to use the DiagnosticReport.presentedForm with FT/TX text converted to PDF.
Only ED/RP documents which are reports should use the DiagnosticReport.presentedForm, others should use DiagnosticReport.extension(supportingInfo).

v2 to FHIR Conversion: OBX to FHIR Observation
FHIR Profile: Observation

Examples

OBX|1|CE|GENEAP^GENETICS TEST PERFORMABLE^https://fhir.nwgenomics.nhs.uk/CodeSystem/MFTQuestionIds|||||||||||20250129103726+0000
OBX|2|CE|230056^What Type of Referral Do You Require?^https://fhir.nwgenomics.nhs.uk/CodeSystem/MFTQuestionIds|||||||||||20250129103726+0000
OBX|3|CE|281269004^High infection risk sample^SNM3|||||||||||20250129103726+0000
OBX|4|ST|230016^Test Type^https://fhir.nwgenomics.nhs.uk/CodeSystem/MFTQuestionIds||Diagnostic Screen/Test|||||||||20250129103726+0000

Genomic Genomic Test Outcome Codes Example - this is mapped to DiagnosticReport.conclusionCode in FHIR.

OBX|2|CE|51968-6^^LN|1|432^NO TARGET DETECTED OR TARGET DETECTED BELOW A LEVEL REQUIRING CLINICAL ACTION|||||||||20260604200000+0000

FHIR Resource Example: Consanguinity (value type=CE)

FHIR Resource Example: Order Tracking Number (value type=ST)

FHIR Resource Example: Pregnancy Expected Delivery Date (value type=DT)

OBX (type = ED)

This is based on the definition of OBX from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide

Field HL7 Fieldname Data Type Optionality Identifier Type or ValueSet Example Values Description

OBX-1 Set ID – OBX R 1 Sequence number of this result line within the report (ubiquitous term: Set ID).

OBX-2 Value Type R S ED The data type of the value that follows - ED for an embedded document (ubiquitous term: Value Type).

OBX-3 Observation Identifier CE R S Document Entry Type 1054161000000101^Genetic report^SNM3 What kind of document this is, e.g. a genetics report (ubiquitous terms: Document Type, Report Type).

OBX-5 Observation Value ED R S MOL^IM^PDF^Base64^JVBERI0X… The embedded document itself, base64-encoded (ubiquitous terms: Attachment, Report PDF).

OBX-11 Observation Result Status R F Whether this document is preliminary, final, corrected, etc. (ubiquitous term: Result Status).

OBX-14 Date/Time of the Observation O - SHOULD 20190514102417+0000 When this document was produced (ubiquitous term: Observation Date/Time).

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
OBX-1	Set ID – OBX		R		1	Sequence number of this result line within the report (ubiquitous term: Set ID).
OBX-2	Value Type		R S		ED	The data type of the value that follows - `ED` for an embedded document (ubiquitous term: Value Type).
OBX-3	Observation Identifier	CE	R S	Document Entry Type	1054161000000101^Genetic report^SNM3	What kind of document this is, e.g. a genetics report (ubiquitous terms: Document Type, Report Type).
OBX-5	Observation Value	ED	R S		MOL^IM^PDF^Base64^JVBERI0X…	The embedded document itself, base64-encoded (ubiquitous terms: Attachment, Report PDF).
OBX-11	Observation Result Status		R		F	Whether this document is preliminary, final, corrected, etc. (ubiquitous term: Result Status).
OBX-14	Date/Time of the Observation		O - SHOULD		20190514102417+0000	When this document was produced (ubiquitous term: Observation Date/Time).

v2 to FHIR Conversion: OBX to FHIR DocumentReference
FHIR Profile: DocumentReference

Examples

OBX|1|ED|1054161000000101^Genetic report^SNM3||MOL^IM^PDF^Base64^JVBERi0x...||||||F

FHIR Resource Example: Document Reference Laboratory Report

SPM

This is based on the definition of SPM from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide

Specimen Type is SNOMED CT, not HL7 v2 Table 0487, for conversion to SNOMED see HL7 Terminology - hl7VS-specimenType

Field HL7 Fieldname Data Type Optionality Identifier Type or ValueSet Example Values Description

SPM-2 Specimen ID O Placer Specimen Number^Specimen Accession Number 25GEN-029GN00001&R0A^S25034567&699X0 The specimen's own identifier. SPM-2.1 is the requester's number; SPM-2.2 (Filler Assigned Identifier) is the laboratory's own number, e.g. the iGene S-Number, which maps to Specimen.accessionIdentifier (ubiquitous terms: Specimen Number, Specimen ID, Accession Number, Lab Number).

SPM-3 Specimen Parent IDs O S ^R25012345&699X0 Identifiers of the order(s) this specimen relates to, i.e. the Filler Order Number in ORC-3 (ubiquitous term: Order Number).

SPM-4 Specimen Type CWE R S Specimen Type 119325001^Skin specimen^SNM3 What kind of specimen this is, e.g. blood, tissue (ubiquitous term: Specimen Type).

SPM-8 Specimen Source Site CWE O S Specimen Body Site 299706009^Bone structure of wrist and/or hand^SNM3 Where on/in the body the specimen was taken from (ubiquitous term: Body Site).

SPM-9 Specimen Source Site Modifier O 7771000^Left^SNM3 A qualifier on the body site, e.g. left/right (ubiquitous term: Body Site Modifier, Laterality).

SPM-17 Specimen Collection Date/Time TS O When the specimen was taken from the patient (ubiquitous term: Collection Date/Time).

SPM-18 Specimen Received Date/Time TS O When the specimen arrived at the laboratory (ubiquitous term: Received Date/Time).

SPM-20 Specimen Availability O Whether the specimen is available for further testing (ubiquitous term: Specimen Availability).

SPM-30 Accession ID Not used Specimen Accession Number HL7 v2.7 and later only - not part of HL7 v2.5.1, which ends at SPM-29. For v2.5.1 feeds the laboratory's specimen number goes in SPM-2.2 (ubiquitous terms: Accession Number, Lab Number).

SPM-32 Shipment Tracking Number O Shipment Tracking Number The courier/logistics tracking number for the specimen's shipment (ubiquitous terms: Tracking Number, Consignment Number).

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
SPM-2	Specimen ID		O	Placer Specimen Number^Specimen Accession Number	25GEN-029GN00001&R0A^S25034567&699X0	The specimen's own identifier. SPM-2.1 is the requester's number; SPM-2.2 (Filler Assigned Identifier) is the laboratory's own number, e.g. the iGene S-Number, which maps to `Specimen.accessionIdentifier` (ubiquitous terms: Specimen Number, Specimen ID, Accession Number, Lab Number).
SPM-3	Specimen Parent IDs		O S		^R25012345&699X0	Identifiers of the order(s) this specimen relates to, i.e. the Filler Order Number in ORC-3 (ubiquitous term: Order Number).
SPM-4	Specimen Type	CWE	R S	Specimen Type	119325001^Skin specimen^SNM3	What kind of specimen this is, e.g. blood, tissue (ubiquitous term: Specimen Type).
SPM-8	Specimen Source Site	CWE	O S	Specimen Body Site	299706009^Bone structure of wrist and/or hand^SNM3	Where on/in the body the specimen was taken from (ubiquitous term: Body Site).
SPM-9	Specimen Source Site Modifier		O		7771000^Left^SNM3	A qualifier on the body site, e.g. left/right (ubiquitous term: Body Site Modifier, Laterality).
SPM-17	Specimen Collection Date/Time	TS	O			When the specimen was taken from the patient (ubiquitous term: Collection Date/Time).
SPM-18	Specimen Received Date/Time	TS	O			When the specimen arrived at the laboratory (ubiquitous term: Received Date/Time).
SPM-20	Specimen Availability		O			Whether the specimen is available for further testing (ubiquitous term: Specimen Availability).
SPM-30	Accession ID		Not used	Specimen Accession Number		HL7 v2.7 and later only - not part of HL7 v2.5.1, which ends at SPM-29. For v2.5.1 feeds the laboratory's specimen number goes in SPM-2.2 (ubiquitous terms: Accession Number, Lab Number).
SPM-32	Shipment Tracking Number		O	Shipment Tracking Number		The courier/logistics tracking number for the specimen's shipment (ubiquitous terms: Tracking Number, Consignment Number).

Container Identifier: Where a specimen container (e.g. a tube or pot) needs to be identified separately from the specimen itself, use an identifier with Identifier Type Code ZCID "Container Identifier". This is a local (Z) code, as HL7 v2 Table 0203 has no equivalent concept. In FHIR this maps directly to the dedicated Specimen.container.identifier element, so no identifier type code is needed on the FHIR side.

v2 to FHIR Conversion: SPM to FHIR Specimen
FHIR Profile: Specimen

Examples

SPM|1|25GEN-029GN00001&R0A^S25034567&699X0|^R25012345&699X0|258580003^Whole blood specimen^SNM3|||||||||||||20250129103726+0000|||Y

FHIR Resource Example: Specimen Example

TXA

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
TXA-1	Set ID - TXA		R		1	Sequence number of this document notification (ubiquitous term: Set ID).
TXA-2	Document Type	CWE	R	Document Entry Type	1054161000000101^Genetic report^SNM3	What kind of document this is, e.g. a genetics report (ubiquitous terms: Document Type, Report Type).
TXA-4	Activity Date/Time	TS	R			When the document was produced/activity occurred (ubiquitous term: Activity Date/Time).
TXA-5	Primary Activity Provider Code/Name	XCN				The person/system that produced the document (ubiquitous term: Author).
TXA-12	Unique Document Number	EI	R		1001166717^699X0	The document's own unique identifier (ubiquitous terms: Document Number, Report Number).
TXA-17	Document Completion Status		R		F	Whether the document is final, in progress, etc. (ubiquitous term: Document Status).
TXA-24	Folder Assignment	CWE		DocumentEntry Class		The clinical folder/category the document is filed under (ubiquitous term: Document Folder, Category).
TXA-25	Document Title	ST				The document's display title (ubiquitous term: Document Title).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

TXA-1

Set ID - TXA

Sequence number of this document notification (ubiquitous term: Set ID).

TXA-2

Document Type

CWE

Document Entry Type

1054161000000101^Genetic report^SNM3

What kind of document this is, e.g. a genetics report (ubiquitous terms: Document Type, Report Type).

TXA-4

Activity Date/Time

When the document was produced/activity occurred (ubiquitous term: Activity Date/Time).

TXA-5

Primary Activity Provider Code/Name

XCN

The person/system that produced the document (ubiquitous term: Author).

TXA-12

Unique Document Number

1001166717^699X0

The document's own unique identifier (ubiquitous terms: Document Number, Report Number).

TXA-17

Document Completion Status

Whether the document is final, in progress, etc. (ubiquitous term: Document Status).

TXA-24

Folder Assignment

CWE

DocumentEntry Class

The clinical folder/category the document is filed under (ubiquitous term: Document Folder, Category).

TXA-25

Document Title

The document's display title (ubiquitous term: Document Title).

v2 to FHIR Conversion: TXA to DocumentReference
FHIR Profile: DocumentReference

Data Types

This applies to HL7 v2 ORU_R01 feeds to the RIE.

ORC-21 (XON) SHALL be populated. ORC-12 (XCN) SHOULD be populated, and is intended to become mandatory, see ORC.

CNE

v2 to FHIR Conversion: CNE to FHIR CodeableConcept

CWE

v2 to FHIR Conversion: CWE to FHIR Value[x]

CE

Coded Element. UK SNOMED CT is preferred and may be mandatory depending on use, for example for OXB Type ED, it will be required.

Example

SNOMED

1054161000000101^Genetic report^SNM3

LOINC (from HL7 International)

53577-3^Reason for study^LN 51967-8^Genetic disease assessed [ID]^LN 48018-6^Gene studied^LN

CX

Extended Composite ID with Check Digit CX.1 - Id Number, CX-4 - Assigning authority and CX.5 - Identifier Type Code are mandatory

Example

NHS Number

9449305552^^^NHS^NH

Medical Record Number

633^^^R0A^MR

v2 to FHIR Conversion: CE to FHIR CodeableConcept

ED

v2 to FHIR Conversion: ED to FHIR DocumentReference

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
ED.1	Source Application	HD	O			The system that originated the attached data (ubiquitous term: Source System).
ED.2	Type Of Data	ID	R	DocumentEntry mimeType	AP or application/pdf	The high-level MIME type of the attachment, e.g. application (ubiquitous term: File Type).
ED.3	Data Subtype	ID	R		PDF	The specific format of the attachment, e.g. PDF (ubiquitous term: File Format).
ED.4	Encoding	ID	R		Base64	How the data is encoded, e.g. Base64 (ubiquitous term: Encoding).
ED.5	Type Of Data	TX	R		JVBERI0X…	The encoded file content itself (ubiquitous terms: Attachment, File Content).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

ED.1

Source Application

The system that originated the attached data (ubiquitous term: Source System).

ED.2

Type Of Data

DocumentEntry mimeType

AP or application/pdf

The high-level MIME type of the attachment, e.g. application (ubiquitous term: File Type).

ED.3

Data Subtype

PDF

The specific format of the attachment, e.g. PDF (ubiquitous term: File Format).

ED.4

Encoding

Base64

How the data is encoded, e.g. Base64 (ubiquitous term: Encoding).

ED.5

Type Of Data

JVBERI0X…

The encoded file content itself (ubiquitous terms: Attachment, File Content).

EI

Entity Identifier. EI.1 - Entity Identifier and EI.2 - Namespace Id are mandatory

Example

Manchester University NHS Foundation Trust

1601737^R0A

North West GLH Hub

1001166717^699X0

PL

This is based on the definition of PL from NHS England HL7 v2 ADT Message Specification SHOULD be followed and SHALL be used in PV1-3. In addition, this includes of PL.11 to hold organisation ODS code.

The ODS Site Code SHALL belong to the ODS Code. This is to help avoid data issues in this codesystem.

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Example Values	Description
PL.4	Facility	HD	R	Organisation Site Code	R0A09	The specific site/building the patient/specimen is at (ubiquitous terms: Site Code, ODS Site Code).
PL.11	Assigning Authority For Location	HD	R	Organisation Code	R0A	The organisation the site belongs to (ubiquitous terms: ODS Code, Trust Code).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

PL.4

Facility

Organisation Site Code

R0A09

The specific site/building the patient/specimen is at (ubiquitous terms: Site Code, ODS Site Code).

PL.11

Assigning Authority For Location

Organisation Code

R0A

The organisation the site belongs to (ubiquitous terms: ODS Code, Trust Code).

NDL

This is based on the definitions of NDL from Royal College of Radiologists

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Description
NDL-1.CNN.1	Id Number	ST	O	Practitioner Identifier	The clinician's own professional identifier (ubiquitous terms: GMC Number, Professional Registration Number).
NDL-1.CNN.2	Family Name	ST	O		The clinician's family name (ubiquitous term: Surname).
NDL-1.CNN.3	Given Name	ST	O		The clinician's given name (ubiquitous term: First Name).
NDL-7	Facility	HD	O	Organisation Code	The organisation the clinician belongs to (ubiquitous terms: ODS Code, Trust Code).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

NDL-1.CNN.1

Id Number

The clinician's own professional identifier (ubiquitous terms: GMC Number, Professional Registration Number).

NDL-1.CNN.2

Family Name

The clinician's family name (ubiquitous term: Surname).

NDL-1.CNN.3

Given Name

The clinician's given name (ubiquitous term: First Name).

NDL-7

Facility

Organisation Code

The organisation the clinician belongs to (ubiquitous terms: ODS Code, Trust Code).

NM

v2 to FHIR Conversion: NM to FHIR Quantity

SN

v2 to FHIR Conversion: SN to FHIR Quantity

XCN

Extended Composite ID Number and Name for Persons. The definition of XCN from NHS England HL7 v2 ADT Message Specification SHOULD be followed and SHALL be used in ORC-12.

Field HL7	Fieldname	Data Type	Optionality	Identifier Type or ValueSet	Description
XCN-1	Id Number	ST	O	Practitioner Identifier	The person's own professional identifier (ubiquitous terms: GMC Number, Professional Registration Number).
XCN-2	Family Name	ST	O		The person's family name (ubiquitous term: Surname).
XCN-3	Given Name	ST	O		The person's given name (ubiquitous term: First Name).
XCN-8	Source Table	HD	O	See Practitioner Identifier	Which professional register/code system XCN-1 comes from, e.g. GMC (ubiquitous term: Identifier Type).

Field HL7

Fieldname

Data Type

Optionality

Identifier Type or ValueSet

Example Values

Description

XCN-1

Id Number