Specimen Lite - tabular view

This Specimen CMET is derived from the R_Specimen [Universal] in the HL7 v3 ballot. It is designed to be used for general Laboratory requests and reports without the overhead of the requirements of Automation or Specimen Tracking. It is constrained for use with Human subjects and excludes environmental, non-human and manufactured specimens. The 'Specimen' may play the role of a Specimen or an Isolate.

Indicates the role being played by the entity.

Entities in the Specimen CMET may play the role of either a 'Specimen' or an 'Isolate'. The RoleClass identifies the type of role being played by the entity in a particular message.

Valid role types are 'SPEC' or 'ISLT' according to the entity playing the role.

Where 'SPEC' is used, the code shall be taken from the Snomed National Specimen Type subset.

Where 'ISLT' is used, the code shall be taken from the Snomed National_Lab Isolate subset_UK20060401.  

The ID is the unique identifier for the Specimen/Isolate.

According to the use of the CMET, the ID may be a Placer or a Fulfiller identifier for the Specimen/Isolate. In Request interactions, it shall be the Placer identifier, in Event interactions, it shall be the Fulfiller identifier. In Event interactions, provision is made to carry the Placer Identifier in an associated role (SpecimenAlternatIdentifier) in addition to the Fulfiller identifier where one is available.  The ID is made up of two parts, a root and extension. The Root will be an OID allocated to the system that generates the extension and will be at such a level that the combination of the Root and Extension is universally unique. The extension will be a human readable string generated by the system and may not be unique across the whole system.

E.g. There are many systems that are configured on a departmental basis and the same range of human readable strings are used in multiple departments. In such cases, the Root OID shall be allocated at such a level that the human readable portion is unique within that Root OID.

< id root =" 9.99.999.99.10.2 " extension ="B05.00504885C "/>

Where 9.99.999.99.  identifies the Hospital organization and 9.99.999.99.10.2 identifies the ID scheme within the Laboratory system that generated the extension B05.00504885C

Fixed value of 'P' Indicates thet the role is a Patient related or derived specimen rather than a Q.A. or Pooled specimen

The only entity available is 'Natural'. This restriction is in place to exclude non-human and manufactured entities. The current scope of the CMET is specimens obtained from a human source.

This provides a mechanism for carying one or more process steps that are performed on the specimen. 

Allows for observations to be made about the specimen.

Identifies the 'Source' of the 'Specimen/Isolate'

This is the 'Specimen' Entity itself. This identifies the actual physical specimen.

Indicates that this is an entity.

• Fixed value: "ENT"

Indicates that this is an Instance.

• Fixed value "INSTANCE"

NOTE: This datatype is currently restricted by HL7 to CE. In order for Snomed to be able to apply post-coordination, the datatype will need to be changed to CD. An change request has been proposed to HL7 to enable this.

The type of specimen is identified. It may be EITHER:-

A Specimen conceptID taken from the

SNOMED lab specimen subset_UK_20060401

and optionally post-coordinated with

SNOMED lab topography subset_UK_20060401

SNOMED lab morphology subset_UK_20060401

SNOMED lab laterality subset_UK_20060401

according to the Principals laid down in " Principles for carrying Pathology Request and Result data as SnCT concepts"  (  NPFIT-FNT-TO-DPM-0378.01)

OR:-

An identified isolate taken from the SNOMED CT Concept  organism%
  Exc  domestic mammal -%
  Exc   Kingdom Animalia -%
  Exc   plant -%
  Exc   resistant organism -%
  Exc   trophic life form -%

(% = concept and all descendents; Exc = Excluding)

Resistant Organisms  (ESBL E.coli etc) will be carried as the Species with appropriate observations indicating the susceptibility pattern.

Isolates may be identified by Genus or to a Species level only. No post-coordination is allowed. All observations about the organism shall be carried as Observations off the SpecimenObservationCluster to which the Isolate is linked.

A textual additional description of the specimen to supplement the coded value. This shall only be used where codes are not available to describe the specimen. It shall not be used in place of appropriate codes.

Carries any risk associated with the specimen such as Biohazard.

Identifies any specific handling instructions for the specimen. (Keep refrigerated etc)

In reports, this shall be used to carry the Placer Specimen Number

May be used to identify the Parent specimen of the current specimen

This is used to carry the Placer Specimen number in reports. It is not used in Requesting as there is only one (Placer) identifier which is carried in the Specimen Role

Indicates that this is an entity.

• Fixed value: "IDENT"

The Placer ID for the specimen.

The ID is the unique identifier for the Specimen.

 It is made up of two parts, a root and extension. The Root will be an OID allocated to the system that generates the extension and will be at such a level that the combination of the Root and Extension is universally unique. The extension will be a human readable string generated by the system and may not be unique across the whole system.

E.g. There are many systems that are configured on a departmental basis and the same range of human readable strings are used in multiple departments. In such cases, the Root OID shall be allocated at such a level that the human readable portion is unique within that Root OID.

< id root =" 9.99.999.99.10.2 " extension ="GP00115085 "/>

Where 9.99.999.99.  identifies the organization and 9.99.999.99.10.2 identifies the ID scheme within the Placer system that generated the extension.

Fixed value of 'P' Indicates thet the role is a Patient related or derived specimen rather than a Q.A. or Pooled specimen

Identifies the Parent specimen for the current specimen. For an Isolate, this may be used to identify the specimen from which the isolate was cultured. It may not be used to link one isolate to another. For this reason, the classCode is fixed as 'SPEC'.

Indicates that this is a specimen.

• Fixed value: "SPEC"

The Specimen ID of the Parent specimen.

It is made up of two parts, a root and extension. The Root will be an OID allocated to the system that generates the extension and will be at such a level that the combination of the Root and Extension is universally unique. The extension will be a human readable string generated by the system and may not be unique across the whole system.

< id root =" 9.99.999.99.10.2 " extension ="B05.00504875C "/>

Where 9.99.999.99.  identifies the Hospital organization and 9.99.999.99.10.2 identifies the ID scheme within the Laboratory system that generated the extension B05.00504875C

An activity applied to the specimen.

Indicates that this is a Transport ProcessStep. This carries information about the transport of the specimen.

Indicates that this is an event.

• Fixed value: "EVN"

Code values are taken from HL7 A: x_LabProcessCodes  A: ActSpecimenTransportCode. These are process steps concerned with transport of specimens. This act is primarily used to carry the Date/Time of the receipt of the specimen in the laboratory.

(Values for this vocabulary are currently being authored)

This is the time at which the Process step took place. In the current scope, this is the time at which the specimen was received in the laboratory and will be a TS. Where the time is not accurate, the TS may be truncated from the right to an appropriate level of accuracy.

An observation made on the specimen.

Indicates that this is a specimen observation.

• Fixed value: "SPCOBS"

Indicates that this is an event.

• Fixed value: "EVN"

Values from SnCT Specimen Processing hierarchy relating to measurement e.g.

• specimen weight (observable entity)
• specimen volume (observable entity)
• length of specimen (observable entity)

Value according to the act.code. Units (UCUM) shall be specified where a numerical measurement is made.

Identifies the process by which the Specimen/Isolate was obtained

Indicates that this is an entity.

• Fixed value: "ENT"

Indicates that this is an Instance.

• Fixed value "INSTANCE"

This is the globally unique identifier (SDS value) for this Organization..

References an act in the message using a unique identifier.

This is used where the identified specimen/Isolate is the product of another act carried within the message. This may occur if it is required to identify an act (e.g. Anaerobic Culture) that gave rise to an identified isolate. Not used in Requests.

This may only be used within the message and may not refer to any previously identified act that is not carried in the message.

Indicates that this is an act.

• Fixed value: "ACT"

Indicates that this is an event.

• Fixed value: "EVN"

This is the Fulfiller Unique ID for the act in the message that gave rise to the identified specimen. It is a 'Real World' identifier for that act.

< id root =" 9.99.999.99.10.2 " extension ="1002044 "/>

Where 9.99.999.99.  identifies the Hospital organization and 9.99.999.99.10.2 identifies the ID scheme within the Laboratory system that generated the extension.

This is the process by which the 'specimen' was obtained

Indicates that this is a procedure.

• Fixed value: "PROC"

May be intent or Event. It is not used in Request mood in order to request that the Lab collect. Here it would be in Event mood as the decision that the lab shall collect has been made.

It may be in Intent mood where it has yet to be collected by the sender and they wish to indicate the time at which they intend to collect the specimen.

It is not intended that this is ever used to place an 'Order' for collection, merely to identify the collection process.

Not used by NPfIT

A value taken from SNOMED lab collection method subset_UK_20060401

For most specimens, this will be a generic concept of "17636008 specimen collection (procedure)". Where the collection method is specialised such as a 'Timed collection' or a method such as 'Clean Catch', 'Bag', 'Mid-stream' (applied to Urine collection), Biopsy etc, appropriate SnCT codes from the SNOMED lab collection method subset_UK_20060401 shall be used.

Set to 'completed' as the process has been defined.

The actual or intended time of collection of the specimen. This may be an interval in the case of timed collections such as 24 hour collection (Start time - End time). In some circumstances, the Snomed concept for the collection process and the actual interval in the effective time may differ. The effective time or time interval shall be the time used for any calculation.

These criteria apply to the collection process. They shall be fulfilled prior to the collection process.

Indicates that this is an observation.

• Fixed value: "OBS"

Indicates that this is a event criterion.

• Fixed value: "EVN.CRT"

Values from SNOMED lab pre-condition subset_UK_20060401 for appropriate criteria for collection e.g. fasting patient (182923009), acute phase(255251009), post-dose (255566006)

May be used where there is a need to carry a value for a criterion. E.g 20 mins (post dose)