CH LAB-Order (R4)
2.0.0 - trial-use Switzerland flag

This page is part of the CH LAB-Order (R4) (v2.0.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Example Bundle: CH LAB-Order 1-tvt with ServiceRequest

Case study 1

Suspicion of deep vein thrombosis

A patient, Tobias Timmermann, presents to Dr. med. Marc Mustermann at the Olten group practice on 09.03.2016. He verbally identifies himself via his master data as Tobias Timmermann, 01.01.1984. He reports unclear leg pain in the left lower leg as well as simultaneously occurring respiratory pain and cough. The doctor carries out the anamnesis and physical examination and prescribes the following laboratory parameters:

  • Blood cell count incl. differentiation
  • CRP
  • D-dimer

The doctor carries out the Blood count and the CRP determination himself by means of point of care diagnostics, the D-dimer diagnostics is prescribed as quantitative diagnostics in an external sending laboratory. To obtain the sample, a Blood sample is taken lying down (1 EDTA tube, 2 citrate tubes of 5 ml). The order is transmitted to the external laboratory and the sample is sent to the external dispatch laboratory by courier ordered by telephone. The results of the internal point of care diagnostics (Blood count and CRP) are entered in the patient`s laboratory sheet in the doctor`s office software (manually or via locally installed electronic interfaces). A prescription is therefore issued by the doctor to the patient for self-administration of an anti-thrombotic agent. The results of the sending-in laboratory arrive electronically at the GP`s on the same evening and are also entered in the patient`s laboratory sheet. By using the present exchange format, this process can be fully automated. After a telephone enquiry by the doctor at the sending laboratory due to a borderline D-dimer result, the information is given that a deep vein thrombosis cannot be ruled out in this situation by means of D-dimer and the patient is therefore called back the next day for a sonography of the legs.

As it is probably a primary leg vein thrombosis, Dr Eva Erlenmeier from the Pipette laboratory sends feedback to Dr Mustermann with the recommendation to carry out a thrombophilia screening, which includes the following analyses: Quick, aPTT, fibrinogen, antithrombin (funct.), thrombin time I 2.5 NIH/ml, APC resistance, D-dimers, protein C, (aPTT method), protein S antigen. The analyses can be carried out directly from the samples of the citrate tubes sent along.

Laboratory Order with Service Request 1-tvt

Laboratory Order with Service Request 1-tvt

Additional Document Content

2. http://example.com/fhir/Patient/TobiasTimmermann (Patient/TobiasTimmermann)

id: TobiasTimmermann

meta:

identifier: 012/08.111111

name: Tobias Timmermann

gender: MALE

birthDate: Jan 01, 1981

maritalStatus: unverheiratet (Details : {$ech-11-maritalstatus code '5' = '5', given as 'unverheiratet'})

Communications

-LanguagePreferred
*Deutsch (Schweiz) (Details : {urn:ietf:bcp:47 code 'de-CH' = 'German (Region=Schweiz))true

3. http://example.com/fhir/Practitioner/MarcMustermann (Practitioner/MarcMustermann)

Generated Narrative: Practitioner

ResourcePractitioner "MarcMustermann"

Profile: CH Core Practitioner

identifier: GLN/7601000050700, urn:oid:2.16.756.5.30.1.123.100.2.1.1/A123309

name: Marc Mustermann (Official)

telecom: ph: 033 444 22 11(WORK), marc.mustermann@gruppenpraxis.ch

4. http://example.com/fhir/Organization/Gruppenpraxis (Organization/Gruppenpraxis)

Generated Narrative: Organization

ResourceOrganization "Gruppenpraxis"

Profile: CH Core Organization EPR

identifier: GLN/7601000241115

name: Gruppenpraxis Olten

Contacts

-TelecomAddress
*+41555556677, info@gruppenpraxis.ch, http://www.gruppenpraxis.chGerbergasse 12 Olten 4600 CH

5. http://example.com/fhir/PractitionerRole/MarcMustermannGruppenpraxis (PractitionerRole/MarcMustermannGruppenpraxis)

Generated Narrative: PractitionerRole

ResourcePractitionerRole "MarcMustermannGruppenpraxis"

Profile: CH Core PractitionerRole

practitioner: See on this page: Practitioner/MarcMustermann

organization: See on this page: Organization/Gruppenpraxis

6. http://example.com/fhir/Practitioner/EvaErlenmeyer (Practitioner/EvaErlenmeyer)

Generated Narrative: Practitioner

ResourcePractitioner "EvaErlenmeyer"

Profile: CH Core Practitioner

identifier: GLN/7601000050717, urn:oid:2.16.756.5.30.1.123.100.2.1.1/A123315

name: Eva Erlenmeyer (Official)

telecom: ph: 033 444 55 66(WORK), eva.erlenmeyer@labor-pipette.ch

7. http://example.com/fhir/Organization/LaborPipette (Organization/LaborPipette)

Generated Narrative: Organization

ResourceOrganization "LaborPipette"

Profile: CH Core Organization

identifier: GLN/7601000234407

name: Labor Pipette

Contacts

-TelecomAddress
*+41223345566, info@labor-pipette.ch, http://www.labor-pipette.chLaborstrasse 23 Olten 4600 CH

8. http://example.com/fhir/PractitionerRole/EvaErlenmeyerLaborPipette (PractitionerRole/EvaErlenmeyerLaborPipette)

Generated Narrative: PractitionerRole

ResourcePractitionerRole "EvaErlenmeyerLaborPipette"

Profile: CH Core PractitionerRole

identifier: urn:oid:2.16.756.5.30.1.123.100.2.1.1/A123444

practitioner: See on this page: Practitioner/EvaErlenmeyer

organization: See on this page: Organization/LaborPipette

9. http://example.com/fhir/Coverage/HealthInsuranceCardTobiasTimmermann (Coverage/HealthInsuranceCardTobiasTimmermann)

Generated Narrative: Coverage

ResourceCoverage "HealthInsuranceCardTobiasTimmermann"

Profile: CH ORF Coverage

identifier: Insurance Card Number/A123456780-1

status: ACTIVE

type: According to KVG (Coverage Type#KVG)

subscriber: See on this page: Patient/TobiasTimmermann

beneficiary: See on this page: Patient/TobiasTimmermann

period: ?? --> 2024-12-31

10. http://example.com/fhir/Condition/ConditionRenalInsufficiency (Condition/ConditionRenalInsufficiency)

Generated Narrative: Condition

ResourceCondition "ConditionRenalInsufficiency"

clinicalStatus: Active (Condition Clinical Status Codes#active)

verificationStatus: Confirmed (ConditionVerificationStatus#confirmed)

category: diagnosis (SNOMED CT#439401001)

severity: Mild to moderate (qualifier value) (SNOMED CT#371923003)

code: Chronic renal insufficiency (disorder) (SNOMED CT#723190009)

subject: See on this page: Patient/TobiasTimmermann: Tobias Timmermann

onset: 2023-08-05

recordedDate: 2023-10-05

11. http://example.com/fhir/Specimen/Serum-1-tvt (Specimen/Serum-1-tvt)

Generated Narrative: Specimen

ResourceSpecimen "Serum-1-tvt"

identifier: 48736-12345-75465

accessionIdentifier: 4e88a-12345-dd888

status: AVAILABLE

type: Serum specimen (specimen) (SNOMED CT#119364003)

subject: See on this page: Patient/TobiasTimmermann

Collections

-CollectorCollected[x]BodySiteFastingStatus[x]
*See on this page: Practitioner/MarcMustermann2015-08-16 06:40:17+0000Structure of median cubital vein (body structure) (SNOMED CT#49852007)Patient was fasting prior to the procedure. (relevantClincialInformation#F)

container

12. http://example.com/fhir/Specimen/Blood-coag-1-tvt (Specimen/Blood-coag-1-tvt)

Generated Narrative: Specimen

ResourceSpecimen "Blood-coag-1-tvt"

identifier: 48736-55555-75465

accessionIdentifier: 4e88a-66666-dd888

status: AVAILABLE

type: Blood sample (SNOMED CT#119297000)

subject: See on this page: Patient/TobiasTimmermann

receivedTime: 2023-12-01 16:40:17+0000

Collections

-CollectorCollected[x]
*See on this page: Practitioner/MarcMustermann2023-12-01 17:00:17+0000

Processings

-Time[x]
*2023-12-01 17:00:17+0000 --> 2023-12-01 17:30:17+0000

container

13. http://example.com/fhir/Specimen/Blood-1-tvt (Specimen/Blood-1-tvt)

Generated Narrative: Specimen

ResourceSpecimen "Blood-1-tvt"

status: AVAILABLE

type: Blood sample (SNOMED CT#119297000)

subject: See on this page: Patient/TobiasTimmermann

Collections

-CollectorCollected[x]BodySite
*See on this page: Practitioner/MarcMustermann2015-08-16 06:40:17+0000Structure of superficial vein of left upper limb (body structure) (SNOMED CT#721029009)

container

note: Specimen is grossly lipemic

14. http://example.com/fhir/ServiceRequest/1-tvt-service-request-0 (ServiceRequest/1-tvt-service-request-0)

Generated Narrative: ServiceRequest

ResourceServiceRequest "1-tvt-service-request-0"

Profile: CH LAB-Order-SR

identifier: Placer Identifier/123

basedOn: See on this page: ServiceRequest/1-tvt-service-request-5

status: ACTIVE

intent: ORIGINALORDER

priority: URGENT

subject: See on this page: Patient/TobiasTimmermann

requester: See on this page: PractitionerRole/MarcMustermannGruppenpraxis

insurance: See on this page: Coverage/HealthInsuranceCardTobiasTimmermann

15. http://example.com/fhir/ServiceRequest/1-tvt-service-request-1 (ServiceRequest/1-tvt-service-request-1)

Generated Narrative: ServiceRequest

ResourceServiceRequest "1-tvt-service-request-1"

Profile: CH LAB-Order-SR

identifier: Placer Identifier/123

status: ACTIVE

intent: ORIGINALORDER

priority: URGENT

code: CBC panel - Blood by Automated count (LOINC#58410-2)

subject: See on this page: Patient/TobiasTimmermann

requester: See on this page: PractitionerRole/MarcMustermannGruppenpraxis

insurance: See on this page: Coverage/HealthInsuranceCardTobiasTimmermann

specimen: See on this page: Specimen/Blood-1-tvt

16. http://example.com/fhir/ServiceRequest/1-tvt-service-request-2 (ServiceRequest/1-tvt-service-request-2)

Generated Narrative: ServiceRequest

ResourceServiceRequest "1-tvt-service-request-2"

Profile: CH LAB-Order-SR

identifier: Placer Identifier/123

status: ACTIVE

intent: ORIGINALORDER

priority: URGENT

code: CBC W Auto Differential panel - Blood (LOINC#57021-8)

subject: See on this page: Patient/TobiasTimmermann

requester: See on this page: PractitionerRole/MarcMustermannGruppenpraxis

insurance: See on this page: Coverage/HealthInsuranceCardTobiasTimmermann

specimen: See on this page: Specimen/Blood-1-tvt

17. http://example.com/fhir/ServiceRequest/1-tvt-service-request-3 (ServiceRequest/1-tvt-service-request-3)

Generated Narrative: ServiceRequest

ResourceServiceRequest "1-tvt-service-request-3"

Profile: CH LAB-Order-SR

identifier: Placer Identifier/123

status: ACTIVE

intent: ORIGINALORDER

priority: URGENT

code: Short Fibrin D-dimer FEU and DDU panel - Platelet poor plasma (LOINC#55398-2)

subject: See on this page: Patient/TobiasTimmermann

requester: See on this page: PractitionerRole/MarcMustermannGruppenpraxis

insurance: See on this page: Coverage/HealthInsuranceCardTobiasTimmermann

specimen: See on this page: Specimen/Blood-coag-1-tvt

18. http://example.com/fhir/ServiceRequest/1-tvt-service-request-4 (ServiceRequest/1-tvt-service-request-4)

Generated Narrative: ServiceRequest

ResourceServiceRequest "1-tvt-service-request-4"

Profile: CH LAB-Order-SR

identifier: Placer Identifier/123

status: ACTIVE

intent: ORIGINALORDER

priority: URGENT

code: C reactive protein [Mass/Volume] in Serum or Plasma (LOINC#1988-5)

subject: See on this page: Patient/TobiasTimmermann

requester: See on this page: PractitionerRole/MarcMustermannGruppenpraxis

insurance: See on this page: Coverage/HealthInsuranceCardTobiasTimmermann

specimen: See on this page: Specimen/Serum-1-tvt: Serum specimen

19. http://example.com/fhir/ServiceRequest/1-tvt-service-request-5 (ServiceRequest/1-tvt-service-request-5)

Generated Narrative: ServiceRequest

ResourceServiceRequest "1-tvt-service-request-5"

Profile: CH LAB-Order-SR

identifier: Placer Identifier/123

status: ACTIVE

intent: ORIGINALORDER

priority: URGENT

code: 25-Hydroxyvitamin D3+25-Hydroxyvitamin D2 [Mass/volume] in Serum or Plasma (LOINC#62292-8)

subject: See on this page: Patient/TobiasTimmermann

requester: See on this page: PractitionerRole/MarcMustermannGruppenpraxis

insurance: See on this page: Coverage/HealthInsuranceCardTobiasTimmermann

supportingInfo: Condition/ConditionRenalInsufficiency

specimen: See on this page: Specimen/Serum-1-tvt: Serum specimen