Blood Spot Test Outcome

The FHIR profiles used for the Blood Spot Test Outcome Event Message Bundle

Event Message Content

The Blood Spot Test Outcome event message represents a record of a blood spot test outcome in relation to a patient. Either creation, an update or deletion of the record.

All “Blood Spot Test Outcome” event messages that are published to the NEMS MUST be created inline with guidance and requirements specified on this page and on the Generic Event Message Requirements page. Where requirements on this page contradict the requirements on the Generic Event Message Requirements page, then the requirements on this page take precedence.

Bundle Structure

The event message will contain a mandatory MessageHeader resource as the first element within the event message bundle as per FHIR messaging requirements. The MessageHeader resource references a Encounter resource as the focus of the event message. The bloodspot test procedures, results and comment are linked to this encounter focus resource within the event message.

The diagram below shows the referencing between FHIR resources within the event message bundle:

Event Life Cycle

The MessageHeader resource contains the messageEventType extension which represents the action the event message represents at a resource level, for example the Blood Spot Test Outcome being shared is new or has been updated, or the Blood Spot Test Outcome has been deleted. The messageEventType extension shall contain a values as per the table below:

Value	Description
new	The `new` value must be used when the `Blood Spot Test Outcome` is being shared for the first time, or is being shared because of an `update` to the information.
update	A value of `update` will not be used for this type of event due to the way the Blood Spot Tests are recorded and managed within the current National Screening Service, a value of new shall be used instead.
delete	The `delete` value must be used when the Blood Spot Test Outcome record has been deleted and the record no longer exists.

Identifying Information

To support the event life cycle outlined above the following requirements MUST be followed:

For new and update type event messages, all procedures, results and other information MUST be included within each of the event messages.
The information included in the Blood Spot Test Outcome event message should be treated as atomic and stored under the identifier included within focus CareConnect-Encounter-1 resource. Where a new type event message is received with the same identifier the previous information should be overwritten with the information in the later event message as identified by the MessageHeader.meta.lastUpdated element within the event message.
In a delete type event message the event message should be populated with the payload of the original new (or update) message where possible, to allow for additional validation of the information being removed. Where this is not possible the event message SHALL including, as a minimum, the MessageHeader resource and the focus CareConnect-Encounter-1 resource. It is important that the CareConnect-Encounter-1 resource includes the relevant identifier element, as included in new (or update) event messages so the subscriber can identify the Blood Spot Test Outcome that the delete relates to.

Message Sequencing

As the Blood Spot Test Outcome may change in the source system, this would be represented by multiple new, new (update) and delete type event messages being published. To allow a subscribers to perform message sequencing, the event MUST include the meta.lastUpdated element within the MessageHeader resource allowing the consumer to identify the latest and most up to date information.

Onward Delivery

The delivery of the Blood Spot Test Outcome event messages to subscribers via MESH will use the following WorkflowID within the MESH control file. This WorkflowID will need to be added to the receiving MESH mailbox configuration before event messages can be received.

MESH WorkflowID BLOODSPOTTESTOUTCOME_1

Resource Population Requirements and Guidance

The following requirements and resource population guidance must be followed in addition to the requirements and guidance outlined in the Generic Requirements page.

Resource Mapping Overview

Element Name	FHIR resource element	Description
Date of Blood Test Outcome Received	CareConnect-DiagnosticReport-1.issued	The date that a Blood Spot Test outcome (status) was received by a Health Care Provider from the testing laboratory.
Outcome - PHENYLKETONURIA	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for PKU
Outcome - SICKLE CELL DISEASE	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for SCD
Outcome - CYSTIC FIBROSIS	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for CF
Outcome - CONGENITAL HYPOTHYROIDISM	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for CHT
Outcome - MEDIUM CHAIN ACYL-COA DEHYDROGENASE DEFICIENCY	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for MCADD
Outcome - HOMOCYSTINURIA	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for HCU
Outcome - MAPLE SYRUP URINE DISEASE	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for MSUD
Outcome - GLUTARIC ACIDURIA TYPE 1	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for GA1
Outcome - ISOVALERIC ACIDAEMIA	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for IVA
Outcome - SEVERE COMBINED IMMUNODEFICIENCY	CareConnect-Procedure-1.Procedure.outcome	Outcome of screening for SCID
Comments	CareConnect-Communication-1.Communication.category.coding.system	Supporting text may be given covering regarding the screening test, outcome and actions taken.

Bundle

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 (new)

1..1 (delete)

Element	Cardinality	Additional Guidance
type	1..1	Fixed value: message

Event-MessageHeader-1

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 (new)

1..1 (delete)

Element	Cardinality `new`	Cardinality `delete`	Additional Guidance
extension(routingDemographics)	1..1	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	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	0..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	0..1	The extension MUST contain the patient’s Date Of Birth which matches the NHS number in the routingDemographics extension.
meta.lastUpdated	1..1	1..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	1..1	See the “Event Life Cycle” section above.
event	1..1	1..1	Fixed Value: blood-spot-test-outcome-1 (Blood Spot Test Outcome)
focus	1..1	1..1	The focus element will reference the CareConnect-Encounter-1 resource which contains information relating to the event message.

CareConnect-Encounter-1

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 (new)

1..1 (delete)

Element	Cardinality `new`	Cardinality `delete`	Additional Guidance
identifier	1..1	1..1	A publisher defined unique identifier for the Blood Spot Test Outcome which will be maintained across different event messages to allow subscribers to identify the information within subsequent new (i.e. updated) or delete event messages.
Encounter.type.coding(childHealthEncounterType)	1..1	0..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	0..1	Encounter.reason.coding(snomedCT) SHOULD use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-AdmissionReason-1
serviceProvider	1..1	0..1	This will reference the Organisation resource hosting the Encounter
location	0..1	0..1	This will reference the Encounter’s Location
subject	1..1	0..1	This will reference the patient resource representing the subject of this event

CareConnect-Organization-1

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..1 (new)

0..1 (delete)

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

CareConnect-Patient-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 (new)

0..1 (delete)

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

CareConnect-HealthcareService-1

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 (new)

0..1 (delete)

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

CareConnect-Location-1

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 (new)

0..1 (delete)

CareConnect-DiagnosticReport-1

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 (new)

0..1 (delete)

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

CareConnect-Procedure-1

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..10 (new)

0..10 (delete)

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

CareConnect-Procedure-1 (Blood Spot Screening, Severe Combined Immunodeficiency)

Element	Cardinality	Additional Guidance
Procedure.code.coding.system	1..1	Fixed Value: http://snomed.info/sct
Procedure.code.coding.code	1..1	Fixed Value: 1239891000000106
Procedure.code.coding.display	1..1	Fixed Value: Severe combined immunodeficiency 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-Communication-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 (new)

0..1 (delete)

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

Examples

New Update Delete

<Bundle xmlns="http://hl7.org/fhir">
	<id value="443a4d20-4c32-4cef-944c-7a153896f6ac"/>
	<meta>
		<profile value="http://hl7.org/fhir/STU3/StructureDefinition/Bundle"/>
	</meta>
	<type value="message"/>
	<entry>
		<fullUrl value="urn:uuid:9d2e2cd9-ffe1-49c7-be43-f36e30564d3f"/>
		<resource>
			<MessageHeader>
				<id value="9d2e2cd9-ffe1-49c7-be43-f36e30564d3f"/>
				<meta>
					<lastUpdated value="2017-11-01T15:00:33+00:00"/>
					<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Event-MessageHeader-1"/>
				</meta>
				<extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RoutingDemographics-1">
					<extension url="nhsNumber">
						<valueIdentifier>
							<system value="https://fhir.nhs.uk/Id/nhs-number"/>
							<value value="9912003888"/>
						</valueIdentifier>
					</extension>
					<extension url="name">
						<valueHumanName>
							<use value="official"/>
							<family value="DAWKINS"/>
							<given value="Jack"/>
						</valueHumanName>
					</extension>
					<extension url="birthDateTime">
						<valueDateTime value="2017-10-02T12:00:00+00:00"/>
					</extension>
				</extension>
				<extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-MessageEventType-1">
					<valueCodeableConcept>
						<coding>
							<system value="https://fhir.nhs.uk/STU3/CodeSystem/MessageEventType-1"/>
							<code value="new"/>
							<display value="New event message"/>
						</coding>
					</valueCodeableConcept>
				</extension>
				<event>
					<system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1"/>
					<code value="blood-spot-test-outcome-1"/>
					<display value="Blood Spot Test Outcome"/>
				</event>
				<timestamp value="2017-11-01T15:00:00+00:00"/>
				<source>
					<name value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
					<contact>
						<system value="phone"/>
						<value value="0191 1231234"/>
					</contact>
					<endpoint value="urn:nhs:addressing:asid:300000000161"/>
				</source>
				<responsible>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
					<display value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				</responsible>
				<focus>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</focus>
			</MessageHeader>
		</resource>
	</entry>
	<!--Responsible Org Blood Spot-->
	<entry>
		<fullUrl value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
		<resource>
			<Organization>
				<id value="33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
					<value value="RR8"/>
				</identifier>
				<name value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				<address>
					<line value="NORTH ROAD"/>
					<city value="DURHAM"/>
					<district value="COUNTY DURHAM"/>
					<postalCode value="DH1 5TW"/>
				</address>
			</Organization>
		</resource>
	</entry>
	<!--Healthcare service used e.g GP, trust, etc..-->
	<entry>
		<fullUrl value="urn:uuid:5a293df7-b22f-41b6-8bf1-44248ea59edb"/>
		<resource>
			<HealthcareService>
				<id value="5a293df7-b22f-41b6-8bf1-44248ea59edb"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-HealthcareService-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/STU3/CodeSystem/EMS-HealthcareServiceType-1"/>
					<value value="PDS"/>
				</identifier>
				<providedBy>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
					<display value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				</providedBy>
				<type>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="708196005"/>
						<display value="Haematology service"/>
					</coding>
				</type>
				<specialty>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/CodeSystem/DCH-Specialty-1"/>
						<code value="253"/>
						<display value="PAEDIATRIC CLINICAL HAEMATOLOGY"/>
					</coding>
				</specialty>
				<location>
					<reference value="urn:uuid:02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
				</location>
				<telecom>
					<system value="phone"/>
					<value value="0191 1231234"/>
				</telecom>
			</HealthcareService>
		</resource>
	</entry>
	<!--Child Details (Jack Dawkins)-->
	<entry>
		<fullUrl value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
		<resource>
			<Patient>
				<id value="5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"/>
				</meta>
				<identifier>
					<extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1">
						<valueCodeableConcept>
							<coding>
								<system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1"/>
								<code value="01"/>
								<display value="Number present and verified"/>
							</coding>
						</valueCodeableConcept>
					</extension>
					<system value="https://fhir.nhs.uk/Id/nhs-number"/>
					<value value="9912003888"/>
				</identifier>
				<name>
					<use value="official"/>
					<family value="DAWKINS"/>
					<given value="Jack"/>
				</name>
				<gender value="male"/>
				<birthDate value="2013-10-12">
					<extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
						<valueDateTime value="2017-10-02T12:00:00+00:00"/>
					</extension>
				</birthDate>
				<address>
					<use value="home"/>
					<line value="4 Sandmoor Drive"/>
					<city value="DURHAM"/>
					<postalCode value="DH1 2TF"/>
				</address>
			</Patient>
		</resource>
	</entry>
	<!--Blood Spot Test PKU Procedure-->
	<entry>
		<fullUrl value="urn:uuid:796a220c-7888-46ac-962e-46c971e1dbdf"/>
		<resource>
			<Procedure>
				<id value="796a220c-7888-46ac-962e-46c971e1dbdf"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="314081000"/>
						<display value="Phenylketonuria screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="946431000000102"/>
						<display value="Phenylketonuria screening, unsuitable sample: date of sample missing/not accurately recorded (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test SCD Procedure-->
	<entry>
		<fullUrl value="urn:uuid:feeddff6-9eee-4856-8dc1-819bea6abbce"/>
		<resource>
			<Procedure>
				<id value="feeddff6-9eee-4856-8dc1-819bea6abbce"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="314090007"/>
						<display value="Sickle cell disease screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="947611000000105"/>
						<display value="Sickle cell screening declined, screened in United Kingdom (as reported by parents) with no evidence of result (situation)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test CF Procedure-->
	<entry>
		<fullUrl value="urn:uuid:47ac4243-bda0-4988-adbb-afede243c226"/>
		<resource>
			<Procedure>
				<id value="47ac4243-bda0-4988-adbb-afede243c226"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="314080004"/>
						<display value="Cystic fibrosis screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="947511000000106"/>
						<display value="Cystic fibrosis not screened for or screening incomplete, not contactable, reasonable efforts made (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test CHT Procedure-->
	<entry>
		<fullUrl value="urn:uuid:78d24725-9964-4d28-bc01-ccbf946c3be6"/>
		<resource>
			<Procedure>
				<id value="78d24725-9964-4d28-bc01-ccbf946c3be6"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="400984005"/>
						<display value="Congenital hypothyroidism screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="948801000000106"/>
						<display value="Congenital hypothyroidism not screened for or screening incomplete, baby died (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test MCADD Procedure-->
	<entry>
		<fullUrl value="urn:uuid:036f2447-dd0f-499d-9f00-00b27edfb8d1"/>
		<resource>
			<Procedure>
				<id value="036f2447-dd0f-499d-9f00-00b27edfb8d1"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="428056008"/>
						<display value="Medium-chain acyl-coenzyme A dehydrogenase deficiency screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="949041000000108"/>
						<display value="Medium-chain acyl-coenzyme A dehydrogenase deficiency screening, unsuitable sample: expired card used (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test HCU Procedure-->
	<entry>
		<fullUrl value="urn:uuid:f14c5e57-c588-427b-9b39-c81b20541985"/>
		<resource>
			<Procedure>
				<id value="f14c5e57-c588-427b-9b39-c81b20541985"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940201000000107"/>
						<display value="Blood spot homocystinuria screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="950641000000105"/>
						<display value="Homocystinuria screening, unsuitable sample: more than 14 days in transit, too old for analysis (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test MSUD Procedure-->
	<entry>
		<fullUrl value="urn:uuid:f818d131-502a-4f80-bee7-ee3fd08d31e3"/>
		<resource>
			<Procedure>
				<id value="f818d131-502a-4f80-bee7-ee3fd08d31e3"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940221000000103"/>
						<display value="Blood spot MSUD (maple syrup urine disease) screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="949981000000104"/>
						<display value="Maple syrup urine disease not screened for or screening incomplete, not contactable, reasonable efforts made (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test GA1 Procedure-->
	<entry>
		<fullUrl value="urn:uuid:25f607d7-48ef-4b4e-a1bd-d9206b239df7"/>
		<resource>
			<Procedure>
				<id value="25f607d7-48ef-4b4e-a1bd-d9206b239df7"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940131000000109"/>
						<display value="Blood spot glutaric aciduria type 1 screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="952081000000108"/>
						<display value="Glutaric aciduria type 1 screening, unsuitable sample: National Health Service number missing/not accurately recorded (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test IVA Procedure-->
	<entry>
		<fullUrl value="urn:uuid:e3c6ae24-6601-413a-b4a3-4afb5a8337e8"/>
		<resource>
			<Procedure>
				<id value="e3c6ae24-6601-413a-b4a3-4afb5a8337e8"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940151000000102"/>
						<display value="Blood spot isovaleric acidaemia screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="951461000000103"/>
						<display value="Isovaleric acidaemia screening, unsuitable sample: date of birth not accurately matched (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test SCID Procedure-->
	<entry>
		<fullUrl value="urn:uuid:4b7e9298-9dbc-11eb-a8b3-0242ac130003"/>
		<resource>
			<Procedure>
				<id value="4b7e9298-9dbc-11eb-a8b3-0242ac130003"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="1239891000000106"/>
						<display value="Severe combined immunodeficiency screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="1239971000000104"/>
						<display value="Severe combined immunodeficiency screening related finding (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Diagnostic Report-->
	<entry>
		<fullUrl value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
		<resource>
			<DiagnosticReport>
				<id value="4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-DiagnosticReport-1"/>
				</meta>
				<status value="final"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="86637100000010"/>
						<display value="Child Screening Report (record artifact)"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<issued value="2017-10-02T20:12:00+00:00"/>
			</DiagnosticReport>
		</resource>
	</entry>
	<!--Blood Spot Encounter details-->
	<entry>
		<fullUrl value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
		<resource>
			<Encounter>
				<id value="1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1"/>
				</meta>
				<identifier>
					<system value="https://supplierABC/identifiers"/>
					<value value="abc1111"/>
				</identifier>
				<status value="finished"/>
				<type>
					<coding> 
						<system value="https://fhir.nhs.uk/STU3/CodeSystem/DCH-ChildHealthEncounterType-1"/> 
						<code value="008"/> 
						<display value="Newborn Blood Spot Screening"/> 
					</coding> 
				</type>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
					<display value="DAWKINS, Jack"/>
				</subject>
				<period>
					<start value="2018-01-29"/>
				</period>
				<location>
					<location>
						<reference value="urn:uuid:02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
					</location>
				</location>
				<serviceProvider>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
				</serviceProvider>
			</Encounter>
		</resource>
	</entry>
	<!--Location where event took place-->
	<entry>
		<fullUrl value="urn:uuid:02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
		<resource>
			<Location>
				<id value="02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Location-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/Id/ods-site-code"/>
					<value value="RX3EP"/>
				</identifier>
			</Location>
		</resource>
	</entry>
</Bundle>

<Bundle xmlns="http://hl7.org/fhir">
	<id value="b6ec56de-f3e3-4392-84bc-8c04dbc2ca98"/>
	<meta>
		<profile value="http://hl7.org/fhir/STU3/StructureDefinition/Bundle"/>
	</meta>
	<type value="message"/>
	<entry>
		<fullUrl value="urn:uuid:36435ab7-231b-43c3-b9f1-df3d44da7af8"/>
		<resource>
			<MessageHeader>
				<id value="36435ab7-231b-43c3-b9f1-df3d44da7af8"/>
				<meta>
					<lastUpdated value="2017-11-01T15:25:21+00:00"/>
					<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Event-MessageHeader-1"/>
				</meta>
				<extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RoutingDemographics-1">
					<extension url="nhsNumber">
						<valueIdentifier>
							<system value="https://fhir.nhs.uk/Id/nhs-number"/>
							<value value="9912003888"/>
						</valueIdentifier>
					</extension>
					<extension url="name">
						<valueHumanName>
							<use value="official"/>
							<family value="DAWKINS"/>
							<given value="Jack"/>
						</valueHumanName>
					</extension>
					<extension url="birthDateTime">
						<valueDateTime value="2017-10-02T12:00:00+00:00"/>
					</extension>
				</extension>
				<extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-MessageEventType-1">
					<valueCodeableConcept>
						<coding>
							<system value="https://fhir.nhs.uk/STU3/CodeSystem/MessageEventType-1"/>
							<code value="new"/>
							<display value="New event message"/>
						</coding>
					</valueCodeableConcept>
				</extension>
				<event>
					<system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1"/>
					<code value="blood-spot-test-outcome-1"/>
					<display value="Blood Spot Test Outcome"/>
				</event>
				<timestamp value="2017-11-01T15:00:00+00:00"/>
				<source>
					<name value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
					<contact>
						<system value="phone"/>
						<value value="0191 1231234"/>
					</contact>
					<endpoint value="urn:nhs:addressing:asid:300000000161"/>
				</source>
				<responsible>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
					<display value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				</responsible>
				<focus>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</focus>
			</MessageHeader>
		</resource>
	</entry>
	<!--Responsible Org Blood Spot-->
	<entry>
		<fullUrl value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
		<resource>
			<Organization>
				<id value="33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
					<value value="RR8"/>
				</identifier>
				<name value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				<address>
					<line value="NORTH ROAD"/>
					<city value="DURHAM"/>
					<district value="COUNTY DURHAM"/>
					<postalCode value="DH1 5TW"/>
				</address>
			</Organization>
		</resource>
	</entry>
	<!--Healthcare service used e.g GP, trust, etc..-->
	<entry>
		<fullUrl value="urn:uuid:5a293df7-b22f-41b6-8bf1-44248ea59edb"/>
		<resource>
			<HealthcareService>
				<id value="5a293df7-b22f-41b6-8bf1-44248ea59edb"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-HealthcareService-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/STU3/CodeSystem/EMS-HealthcareServiceType-1"/>
					<value value="PDS"/>
				</identifier>
				<providedBy>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
					<display value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				</providedBy>
				<type>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="708196005"/>
						<display value="Haematology service"/>
					</coding>
				</type>
				<specialty>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/CodeSystem/DCH-Specialty-1"/>
						<code value="253"/>
						<display value="PAEDIATRIC CLINICAL HAEMATOLOGY"/>
					</coding>
				</specialty>
				<location>
					<reference value="urn:uuid:02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
				</location>
				<telecom>
					<system value="phone"/>
					<value value="0191 1231234"/>
				</telecom>
			</HealthcareService>
		</resource>
	</entry>
	<!--Child Details (Jack Dawkins)-->
	<entry>
		<fullUrl value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
		<resource>
			<Patient>
				<id value="5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"/>
				</meta>
				<identifier>
					<extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1">
						<valueCodeableConcept>
							<coding>
								<system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1"/>
								<code value="01"/>
								<display value="Number present and verified"/>
							</coding>
						</valueCodeableConcept>
					</extension>
					<system value="https://fhir.nhs.uk/Id/nhs-number"/>
					<value value="9912003888"/>
				</identifier>
				<name>
					<use value="official"/>
					<family value="DAWKINS"/>
					<given value="Jack"/>
				</name>
				<gender value="male"/>
				<birthDate value="2013-10-12">
					<extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
						<valueDateTime value="2017-10-02T12:00:00+00:00"/>
					</extension>
				</birthDate>
				<address>
					<use value="home"/>
					<line value="4 Sandmoor Drive"/>
					<city value="DURHAM"/>
					<postalCode value="DH1 2TF"/>
				</address>
			</Patient>
		</resource>
	</entry>
	<!--Blood Spot Test PKU Procedure-->
	<entry>
		<fullUrl value="urn:uuid:796a220c-7888-46ac-962e-46c971e1dbdf"/>
		<resource>
			<Procedure>
				<id value="796a220c-7888-46ac-962e-46c971e1dbdf"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="314081000"/>
						<display value="Phenylketonuria screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="946431000000102"/>
						<display value="Phenylketonuria screening, unsuitable sample: date of sample missing/not accurately recorded (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test SCD Procedure-->
	<entry>
		<fullUrl value="urn:uuid:feeddff6-9eee-4856-8dc1-819bea6abbce"/>
		<resource>
			<Procedure>
				<id value="feeddff6-9eee-4856-8dc1-819bea6abbce"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="314090007"/>
						<display value="Sickle cell disease screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="947611000000105"/>
						<display value="Sickle cell screening declined, screened in United Kingdom (as reported by parents) with no evidence of result (situation)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test CF Procedure-->
	<entry>
		<fullUrl value="urn:uuid:47ac4243-bda0-4988-adbb-afede243c226"/>
		<resource>
			<Procedure>
				<id value="47ac4243-bda0-4988-adbb-afede243c226"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="314080004"/>
						<display value="Cystic fibrosis screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="947511000000106"/>
						<display value="Cystic fibrosis not screened for or screening incomplete, not contactable, reasonable efforts made (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test CHT Procedure-->
	<entry>
		<fullUrl value="urn:uuid:78d24725-9964-4d28-bc01-ccbf946c3be6"/>
		<resource>
			<Procedure>
				<id value="78d24725-9964-4d28-bc01-ccbf946c3be6"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="400984005"/>
						<display value="Congenital hypothyroidism screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="948801000000106"/>
						<display value="Congenital hypothyroidism not screened for or screening incomplete, baby died (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test MCADD Procedure-->
	<entry>
		<fullUrl value="urn:uuid:036f2447-dd0f-499d-9f00-00b27edfb8d1"/>
		<resource>
			<Procedure>
				<id value="036f2447-dd0f-499d-9f00-00b27edfb8d1"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="428056008"/>
						<display value="Medium-chain acyl-coenzyme A dehydrogenase deficiency screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="949041000000108"/>
						<display value="Medium-chain acyl-coenzyme A dehydrogenase deficiency screening, unsuitable sample: expired card used (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test HCU Procedure-->
	<entry>
		<fullUrl value="urn:uuid:f14c5e57-c588-427b-9b39-c81b20541985"/>
		<resource>
			<Procedure>
				<id value="f14c5e57-c588-427b-9b39-c81b20541985"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940201000000107"/>
						<display value="Blood spot homocystinuria screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="950641000000105"/>
						<display value="Homocystinuria screening, unsuitable sample: more than 14 days in transit, too old for analysis (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test MSUD Procedure-->
	<entry>
		<fullUrl value="urn:uuid:f818d131-502a-4f80-bee7-ee3fd08d31e3"/>
		<resource>
			<Procedure>
				<id value="f818d131-502a-4f80-bee7-ee3fd08d31e3"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940221000000103"/>
						<display value="Blood spot MSUD (maple syrup urine disease) screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="949981000000104"/>
						<display value="Maple syrup urine disease not screened for or screening incomplete, not contactable, reasonable efforts made (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test GA1 Procedure-->
	<entry>
		<fullUrl value="urn:uuid:25f607d7-48ef-4b4e-a1bd-d9206b239df7"/>
		<resource>
			<Procedure>
				<id value="25f607d7-48ef-4b4e-a1bd-d9206b239df7"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940131000000109"/>
						<display value="Blood spot glutaric aciduria type 1 screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="952081000000108"/>
						<display value="Glutaric aciduria type 1 screening, unsuitable sample: National Health Service number missing/not accurately recorded (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test IVA Procedure-->
	<entry>
		<fullUrl value="urn:uuid:e3c6ae24-6601-413a-b4a3-4afb5a8337e8"/>
		<resource>
			<Procedure>
				<id value="e3c6ae24-6601-413a-b4a3-4afb5a8337e8"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="940151000000102"/>
						<display value="Blood spot isovaleric acidaemia screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="951461000000103"/>
						<display value="Isovaleric acidaemia screening, unsuitable sample: date of birth not accurately matched (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Test SCID Procedure-->
	<entry>
		<fullUrl value="urn:uuid:4b7e9298-9dbc-11eb-a8b3-0242ac130003"/>
		<resource>
			<Procedure>
				<id value="4b7e9298-9dbc-11eb-a8b3-0242ac130003"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Procedure-1"/>
				</meta>
				<status value="completed"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="1239891000000106"/>
						<display value="Severe combined immunodeficiency screening test"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<outcome>
					<coding>
						<system value="https://fhir.nhs.uk/STU3/ValueSet/DCH-BloodSpotOutcome-1"/>
						<code value="1239971000000104"/>
						<display value="Severe combined immunodeficiency screening related finding (finding)"/>
					</coding>
				</outcome>
				<report>
					<reference value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				</report>
			</Procedure>
		</resource>
	</entry>
	<!--Blood Spot Diagnostic Report-->
	<entry>
		<fullUrl value="urn:uuid:4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
		<resource>
			<DiagnosticReport>
				<id value="4ae3b640-a32b-4879-8c6c-3896ac19da74"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-DiagnosticReport-1"/>
				</meta>
				<status value="final"/>
				<code>
					<coding>
						<system value="http://snomed.info/sct"/>
						<code value="86637100000010"/>
						<display value="Child Screening Report (record artifact)"/>
					</coding>
				</code>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
				</subject>
				<context>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</context>
				<issued value="2017-10-02T20:12:00+00:00"/>
			</DiagnosticReport>
		</resource>
	</entry>
	<!--Blood Spot Encounter details-->
	<entry>
		<fullUrl value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
		<resource>
			<Encounter>
				<id value="1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1"/>
				</meta>
				<identifier>
					<system value="https://supplierABC/identifiers"/>
					<value value="abc1111"/>
				</identifier>
				<status value="finished"/>
				<type>
					<coding> 
						<system value="https://fhir.nhs.uk/STU3/CodeSystem/DCH-ChildHealthEncounterType-1"/> 
						<code value="008"/> 
						<display value="Newborn Blood Spot Screening"/> 
					</coding> 
				</type>
				<subject>
					<reference value="urn:uuid:5d5845f3-398f-474b-af59-14882fc7b0ca"/>
					<display value="DAWKINS, Jack"/>
				</subject>
				<period>
					<start value="2018-01-30"/>
				</period>
				<location>
					<location>
						<reference value="urn:uuid:02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
					</location>
				</location>
				<serviceProvider>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
				</serviceProvider>
			</Encounter>
		</resource>
	</entry>
	<!--Location where event took place-->
	<entry>
		<fullUrl value="urn:uuid:02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
		<resource>
			<Location>
				<id value="02692f55-56cf-4dda-8ef5-e9ec13f6bd99"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Location-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/Id/ods-site-code"/>
					<value value="RX3EP"/>
				</identifier>
			</Location>
		</resource>
	</entry>
</Bundle>

<Bundle xmlns="http://hl7.org/fhir">
	<id value="0817373d-d299-496e-9465-0cc7ec36b125"/>
	<meta>
		<profile value="http://hl7.org/fhir/STU3/StructureDefinition/Bundle"/>
	</meta>
	<type value="message"/>
	<entry>
		<fullUrl value="urn:uuid:acdfd531-06da-4856-95e9-77182ee6d0ad"/>
		<resource>
			<MessageHeader>
				<id value="acdfd531-06da-4856-95e9-77182ee6d0ad"/>
				<meta>
					<lastUpdated value="2017-11-01T16:00:22+00:00"/>
					<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Event-MessageHeader-1"/>
				</meta>
				<extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RoutingDemographics-1">
					<extension url="nhsNumber">
						<valueIdentifier>
							<system value="https://fhir.nhs.uk/Id/nhs-number"/>
							<value value="9912003888"/>
						</valueIdentifier>
					</extension>
				</extension>
				<extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-MessageEventType-1">
					<valueCodeableConcept>
						<coding>
							<system value="https://fhir.nhs.uk/STU3/CodeSystem/MessageEventType-1"/>
							<code value="delete"/>
							<display value="Delete event message"/>
						</coding>
					</valueCodeableConcept>
				</extension>
				<event>
					<system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1"/>
					<code value="blood-spot-test-outcome-1"/>
					<display value="Blood Spot Test Outcome"/>
				</event>
				<timestamp value="2017-11-01T15:00:00+00:00"/>
				<source>
					<name value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
					<contact>
						<system value="phone"/>
						<value value="0191 1231234"/>
					</contact>
					<endpoint value="urn:nhs:addressing:asid:300000000161"/>
				</source>
				<responsible>
					<reference value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
					<display value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				</responsible>
				<focus>
					<reference value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				</focus>
			</MessageHeader>
		</resource>
	</entry>
	<!--Responsible Org Blood Spot-->
	<entry>
		<fullUrl value="urn:uuid:33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
		<resource>
			<Organization>
				<id value="33a33b58-648a-4453-b981-e21ea9ebc6ea"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"/>
				</meta>
				<identifier>
					<system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
					<value value="RR8"/>
				</identifier>
				<name value="UNIVERSITY HOSPITAL OF NORTH DURHAM"/>
				<address>
					<line value="NORTH ROAD"/>
					<city value="DURHAM"/>
					<district value="COUNTY DURHAM"/>
					<postalCode value="DH1 5TW"/>
				</address>
			</Organization>
		</resource>
	</entry>
	<entry>
		<fullUrl value="urn:uuid:1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
		<resource>
			<Encounter>
				<id value="1bcb0151-4ddf-4084-9c06-e8a31fdcf25b"/>
				<meta>
					<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Encounter-1"/>
				</meta>
				<identifier>
					<system value="https://supplierABC/identifiers"/>
					<value value="abc1111"/>
				</identifier>
				<status value="entered-in-error"/>
				<type>
					<coding> 
						<system value="https://fhir.nhs.uk/STU3/CodeSystem/DCH-ChildHealthEncounterType-1"/> 
						<code value="008"/> 
						<display value="Newborn Blood Spot Screening"/> 
					</coding> 
				</type>
			</Encounter>
		</resource>
	</entry>
</Bundle>

Tags:

API Hub

Explore and Make use of Nationally Defined Messaging APIs

Blood Spot Test Outcome

Event Message Content

Bundle Structure

Event Life Cycle

Identifying Information

Message Sequencing

Onward Delivery

Resource Population Requirements and Guidance

Resource Mapping Overview

Bundle

Event-MessageHeader-1

CareConnect-Encounter-1

CareConnect-Organization-1

CareConnect-Patient-1

CareConnect-HealthcareService-1

CareConnect-Location-1

CareConnect-DiagnosticReport-1

CareConnect-Procedure-1

CareConnect-Procedure-1 (Blood Spot Screening, Phenylketonuria)

CareConnect-Procedure-1 (Blood Spot Screening, Sickle Cell Disease)

CareConnect-Procedure-1 (Blood Spot Screening, Cystic Fibrosis)

CareConnect-Procedure-1 (Blood Spot Screening, Congenital Hypothyroidism)

CareConnect-Procedure-1 (Blood Spot Screening, Medium-chain Acyl-Coenzyme A Dehydrogenase Deficiency)

CareConnect-Procedure-1 (Blood Spot Screening, Homocystinuria)

CareConnect-Procedure-1 (Blood Spot Screening, Maple Syrup Urine Disease)

CareConnect-Procedure-1 (Blood Spot Screening, Glutaric Aciduria Type 1)

CareConnect-Procedure-1 (Blood Spot Screening, Isovaleric Acidaemia)

CareConnect-Procedure-1 (Blood Spot Screening, Severe Combined Immunodeficiency)

CareConnect-Communication-1

Examples