The FHIR profiles used for the Blood Spot Test Outcome Event Message Bundle
Important: Blood Spot Test Outcome message revised after review and supplier feedback.
FHIR Profiles
The following FHIR profiles are used to form the Blood Spot Test Outcome Event Message Bundle:
Bundle Structure
Specifies referencing within the Event Message Bundle.
Blood Spot Test Outcome Event data item mapping to FHIR profiles
The Child Health Event data items are fulfilled by elements within the FHIR resources listed below.
| DCH Data Item |
FHIR resource element |
Mandatory/Required/Optional |
| Date of Blood Test Outcome Received |
CareConnect-DiagnosticReport-1.issued |
Mandatory |
Procedure Outcome
for each Procedure |
CareConnect-Procedure-1.outcome |
Mandatory |
| Comment |
CareConnect-Communication-1 |
Optional |
Resource Population Requirements and Guidance
The following requirements and resource population guidance should be followed in addition to the requirements and guidance outlined in the data item mapping above and in the Event Header requirements page.
The Bundle resource included as part of the event message SHALL conform to the Bundle constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 Mandatory |
| Element |
Cardinality |
Additional Guidance |
| type |
1..1 |
Fixed value: message |
The Event-MessageHeader-1 resource included as part of the event message SHALL conform to the Event-MessageHeader-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 Mandatory |
| Element |
Cardinality |
Additional Guidance |
| id |
1..1 |
An originator/publisher unique publication reference, which will use a UUID format |
| extension(routingDemographics) |
1..1 |
The extension MUST contain the details of the patient who is the focus of this event message. |
extension(routingDemographics)
.extension(nhsNumber) |
1..1 |
The extension MUST contain the patient’s NHS Number identifier and is used by the NEMS for routing event messages to subscribers. |
extension(routingDemographics)
.extension(name) |
1..1 |
The extension MUST contain the human name element containing the patient’s official given and family names as recognised by PDS, and match the NHS number in the routingDemographics extension. |
extension(routingDemographics)
.extension(birthDateTime) |
1..1 |
The extension MUST contain the patient’s Date Of Birth which matches the NHS number in the routingDemographics extension. |
| meta.versionId |
0..1 |
Message Sequencing - A sequence number for the purpose of ordering messages for processing. The sequence number must be an integer which is patient and event-type specific and the publisher must increment the sequence number each time a new event of the same type is issued by the same system for the same patient. |
| meta.lastUpdated |
0..1 |
Message Sequencing - A FHIR instant (time stamp with sub-second accuracy) which represents the point in time that the change occurred which should be used for ordering messages for processing. |
| extension(messageEventType) |
1..1 |
|
| event |
1..1 |
Fixed Value: blood-spot-test-outcome-1 (Blood Spot Test Outcome) |
| source |
1..1 |
The IT system which holds the information that originated the event |
| source.name |
1..1 |
A human readable name for the IT system which holds the information that originated the event |
| source.contact |
1..1 |
The email address or telephone number to be used by subscribers to contact the publisher for any issues with event message. Additional requirements and information available on the Event Feedback Mechanism page |
| source.contact.system |
1..1 |
Must contain a value of phone or email matching the included contact method within the value element |
| source.contact.value |
1..1 |
A phone number or email address |
| responsible |
1..1 |
A reference to the organization resource which represents the organization responsible for the event. |
| focus |
1..1 |
The focus element will reference the CareConnect-Encounter-1 resource which contains information relating to the event message. |
The CareConnect-Organization-1 resource included as part of the event message SHALL conform to the CareConnect-Organization-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..* Mandatory |
| Element |
Cardinality |
Additional Guidance |
| identifier.system |
1..1 |
Fixed value: https://fhir.nhs.uk/Id/ods-organization-code |
| identifier.value |
1..1 |
Organisation’s ODS Organization Code |
| name |
1..1 |
Organisation’s Name |
The CareConnect-HealthcareService-1 resource included as part of the event message SHALL conform to the CareConnect-HealthcareService-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
0..1 Required |
| Element |
Cardinality |
Additional Guidance |
| providedBy |
1..1 |
This will reference the ‘sender’ organization of the event message. |
| type |
1..1 |
This will represent the type of service responsible for the event message. This will have a fixed value from the ValueSet CareConnect-CareSettingType-1 |
| specialty |
1..1 |
HealthcareService.specialty SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-Specialty-1 |
The CareConnect-Patient-1 resource included as part of the event message SHALL conform to the CareConnect-Patient-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 Mandatory |
| Element |
Cardinality |
Additional Guidance |
| identifier |
1..1 |
Patient NHS Number SHALL be included within the nhsNumber identifier slice |
| name (official) |
1..1 |
Patients name as registered on PDS, included within the resource as the official name element slice |
| birthDate |
1..1 |
The patient birth date shall be included in the patient resource |
The CareConnect-Encounter-1 resource included as part of the event message SHALL conform to the CareConnect-Encounter-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 Mandatory |
| Element |
Cardinality |
Additional Guidance |
| Encounter.type.coding(childHealthEncounterType) |
1..1 |
Encounter.type.coding(childHealthEncounterType) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-ChildHealthEncounterType-1 |
| Encounter.reason.coding(snomedCT) |
0..1 |
Encounter.reason.coding(snomedCT) SHOULD use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-AdmissionReason-1 |
| serviceProvider |
1..1 |
This will reference the Organisation resource hosting the Encounter |
| location |
0..1 Required |
This will reference the Encounter’s Location |
| subject |
1..1 |
This will reference the patient resource representing the subject of this event |
The CareConnect-Location-1 resource included as part of the event message SHALL conform to the CareConnect-Location-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
0..1 Optional |
The CareConnect-DiagnosticReport-1 resource included as part of the event message SHALL conform to the CareConnect-DiagnosticReport-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 Mandatory |
| Element |
Cardinality |
Additional Guidance |
| subject |
1..1 |
This will reference the patient resource representing the subject of this event |
| issued |
1..1 |
This will hold Date/Time the Blood Spot Test Outcome is received |
The CareConnect-Procedure-1 resource included as part of the event message SHALL conform to the CareConnect-Procedure-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
0..9 Required |
| Element |
Cardinality |
Additional Guidance |
| subject |
1..1 |
This will reference the patient resource representing the subject of this event |
For each of the Procedure resources representing a Test Outcome:
CareConnect-Procedure-1 (Blood Spot Screening, Phenylketonuria)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 314081000 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Phenylketonuria screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Sickle Cell Disease)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 314090007 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Sickle cell disease screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Cystic Fibrosis)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 314080004 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Cystic fibrosis screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Congenital Hypothyroidism)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 400984005 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Congenital hypothyroidism screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Medium-chain Acyl-Coenzyme A Dehydrogenase Deficiency)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 428056008 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Medium-chain acyl-coenzyme A dehydrogenase deficiency screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Homocystinuria)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 940201000000107 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Blood spot homocystinuria screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Maple Syrup Urine Disease)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 940221000000103 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Blood spot MSUD (maple syrup urine disease) screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Glutaric Aciduria Type 1)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 940131000000109 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Blood spot glutaric aciduria type 1 screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
CareConnect-Procedure-1 (Blood Spot Screening, Isovaleric Acidaemia)
| Element |
Cardinality |
Additional Guidance |
| Procedure.code.coding.system |
1..1 |
Fixed Value: http://snomed.info/sct |
| Procedure.code.coding.code |
1..1 |
Fixed Value: 940151000000102 |
| Procedure.code.coding.display |
1..1 |
Fixed Value: Blood spot isovaleric acidaemia screening test |
| Procedure.outcome.coding(snomedCT) |
1..1 |
Procedure.outcome.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1 |
The CareConnect-Communication-1 resource included as part of the event message SHALL conform to the CareConnect-Communication-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
0..1 Optional |
| Element |
Cardinality |
Additional Guidance |
| status |
1..1 |
Fixed value: completed |
| sender |
1..1 |
This will reference the sending organization of the event message. |
| subject |
1..1 |
This will reference the patient resource representing the patient who is the subject of this event. |
| Communication.category.coding.system |
1..1 |
Fixed Value: https://fhir.nhs.uk/STU3/CodeSystem/DCH-ProfessionalCommentType-1 |
| Communication.category.coding.code |
1..1 |
Fixed Value: 007 |
| Communication.category.coding.display |
1..1 |
Fixed Value: Newborn Blood Spot Screening |
DCH Blood Spot Test Outcome Example
Profile Change Mappings for Blood Spot Test Outcome
Profiles used in Demographics Update Event Messages 1.2.1-Release Candidate are replaced with:
| Demographic-Event-Messages |
Demographic-Event-Messages-CareConnect |
| DCH-Bundle-1 |
Bundle |
| DCH-MessageHeader-1 |
Event-MessageHeader-1 |
| CareConnect-Organization-1 |
CareConnect-Organization-1 |
| DCH-HealthcareService-1 |
CareConnect-HealthcareService-1 |
| CareConnect-DCH-Patient-1 |
CareConnect-Patient-1 |
| CareConnect-DCH-Encounter-1 |
CareConnect-Encounter-1 |
| CareConnect-Location-1 |
CareConnect-Location-1 |
| DCH-NewbornBloodSpotScreening-DiagnosticReport-1 |
CareConnect-DiagnosticReport-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningPKU-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningSCD-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningCF-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningCHT-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningMCADD-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningHCU-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningMSUD-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningGA1-Procedure-1 |
CareConnect-Procedure-1 |
| CareConnect-DCH-NewbornBloodSpotScreeningIVA-Procedure-1 |
CareConnect-Procedure-1 |
| DCH-ProfessionalComment-Communication-1 |
CareConnect-Communication-1 |
