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Scenarios 5

Split Test Request, Different Sample Types


Susan Allen is a 25 year old woman with type 1 diabetes. Susan is seen for a review in a diabetes clinic at her local hospital, Oldhampton Royal Infirmary. The diabetes nurse, Mike Black, requests blood and urine tests: full blood count, electrolytes, glycated haemoglobin, cholesterol and triglycerides and urine albumin and urine for microbiology (Microscopy, Culture and Sensitivity – MC&S). Mike takes blood samples and sends them to the pathology laboratory based in the hospital.

The patient is given a paper request form for the urine samples. The following day she takes the samples and request form to her GP surgery, Newgate GP Practice. The samples are sent from the GP surgery to the laboratory.

The samples are received by the laboratory, checked and matched with the test requests. The details are recorded on the Laboratory Information Management System (LIMS).

The tests are performed, and the results are authorised for release. The following test results (and reference ranges) are sent electronically from the LIMS to the hospital’s EPR system:

Full Blood Count    
Haemoglobin 134 g/L (115 to 150)
White Blood Count 6.1 10^9/L (3.5 to 11.0)
Platelets 143 10^9/L (140 to 400)
Haematocrit (PCV) 0.372 Ratio (0.36 to 0.46)
Red Blood Count 4.23 10^12/L (3.80 to 5.00)
Mean Cell Volume 87.9 fL (80.0 to 99.0)
Mean Cell Haemoglobin 31.7 pg (27.5 to 32.5)
Mean Cell Haemoglobin Conc. 360 g/L (310 to 350)
Neutrophils 4.02 10^9/L (1.70 to 8.00)
Lymphocytes 1.45 10^9/L (1.00 to 4.00)
Monocytes 0.56 10^9/L (0.20 to 0.80)
Eosinophils 0.06 10^9/L (0.04 to 0.40)
Basophils 0.03 10^9/L (0.02 to 0.10)
Nucleated RBCs 0.0010^9/L  
Red Cell Distribution Width ^14 % (11.6 to 13.9)
Mean Platelet Volume ^13.0 fL (7.1 to 10.7)
Electrolytes and Creatinine Profile
Sodium 143 mmol/L (133 to 146)
Potassium 4.5 mmol/L (3.5 to 5.3)
Chloride 107 mmol/L (95 to 108)
Creatinine 58 umol/L (48 to 128)
EGFR >90 mL/min/1.73m*
Comments: The EGFR quoted above must be multiplied by 1.2 if the patient is of Afro-Caribbean origin.
Acute Kidney Injury 0
Glycated haemoglobin    
HbA1c (IFCC) 45 mmol/mol (18 to 41)
Liver function tests    
Total Bilirubin 13 umol/L (0 to 21)
Alkaline Phosphatase 83 IU/L (30 to 130)
Alanine Transaminase 27 IU/L (0 to 40)
Cholesterol and Triglycerides    
Cholesterol 7.7 mmol/L  
Triglycerides 6.9 mmol/L (0 to 1.7)
HDL Cholesterol 0.8 mmol/L  
TC/HDL ratio 9.6 (0 to 5)
Non-HDL Cholesterol 6.9 mmol/L  
Urine Albumin and Urine    
Urine Creatinine 4.2 mmol/L  
Urine Albumin <3 mg/L (3 to 20)
Albumin/creatinine ratio Not applicable  

Named participants

  • Patient: Patient: Susan Allen – FHIR Resource: Patient
  • Requesting HCP: Mike Black – FHIR Resource: Practitioner
  • Specimen Collecting HCP: Mike Black – FHIR Resource: Practitioner

Named Organisations

  • Requesting Organisation: Oldhampton Royal Infirmary (Diabetes Clinic) – FHIR Resource: Organization
  • Specimen Collecting Organisation: Newgate GP Practice – FHIR Resource: Organization
  • Performing Organisation: Oldhampton Royal Infirmary (Blood Sciences) – FHIR Resource: Organization


Required Tests


Test Report

Test Results

Tags: fhir

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