CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG
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CDC National Healthcare Safety Network (NHSN) Digital Quality Measures (dQM) Content Package IG - Local Development build (v2.0.0-cibuild) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: LongTermCareMonthlyEventSpecimen - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the ltc-monthly-specimen resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Specimen
Definition

-


A sample to be used for analysis.

Short Sample for analysis
Comments

-

Control 0..*
Is Modifier false
Must Support false
Summary false
Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Specimen.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Short (NHSN-MS) Logical id of this artifactLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control 10..1
Type idstring
Is Modifier false
Summary true
4. Specimen.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short A set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1
Type uri
Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Specimen.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control 0..*
Type Extension
Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary false
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Names extensions, user content
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Specimen.identifier
Definition

Id for specimen.

Short External Identifier
Note This is a business identifier, not a resource identifier (see discussion)
Control 0..*
Type Identifier
Is Modifier false
Must Support true
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Specimen.accessionIdentifier
Definition

The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.

Short Identifier assigned by the lab
Control 0..1
Type Identifier
Is Modifier false
Must Support true
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Specimen.status
Definition

The availability of the specimen.

Short available | unavailable | unsatisfactory | entered-in-error
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control 0..1
Binding The codes SHALL be taken from SpecimenStatushttp://hl7.org/fhir/ValueSet/specimen-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/specimen-status|4.0.1)

Codes providing the status/availability of a specimen.

Type code
Is Modifier true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Must Support true
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Specimen.type
Definition

The kind of material that forms the specimen.

Short (USCDI) Kind of material that forms the specimenKind of material that forms the specimen
Comments

The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.

Control 10..1
Binding The codes SHALL be taken from For example codes, see SpecimenType (20240606) .http://terminology.hl7.org/ValueSet/v2-0487
(required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54|20240606)
Type CodeableConcept
Is Modifier false
Must Support true
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Specimen.subject
Definition

Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.

Short (USCDI) The patient where the specimen came from.Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device
Control 0..1
Type Reference(US Core Patient Profile, Patient, Group, Device, Substance, Location)
Is Modifier false
Must Support true
Summary true
Requirements

Must know the subject context.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Specimen.collection
Definition

Details concerning the specimen collection.

Short Collection details
Control 10..1
Type BackboneElement
Is Modifier false
Summary false
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Specimen.collection.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control 0..*
Type Extension
Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary true
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Names extensions, user content, modifiers
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. Specimen.collection.collected[x]
Definition

Time when specimen was collected from subject - the physiologically relevant time.

Short Collection time
Control 10..1
Type Choice of: dateTime, Period
[x] Note SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier false
Primitive Value This primitive element may be present, or absent, or replaced by an extension
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Specimen.collection.bodySite
Definition

Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.

Short Anatomical collection site
Comments

If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension bodySite.

Control 10..1
Binding Unless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/body-site)
Type CodeableConcept
Is Modifier false
Summary false
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Specimen
2. Specimen.id
Short (NHSN-MS) Logical id of this artifact
Control 1..?
4. Specimen.meta
6. Specimen.meta.extension:link-received-date-extension
Slice Name link-received-date-extension
Control 0..1
Type Extension(Received Date) (Extension Type: dateTime)
8. Specimen.identifier
Note This is a business identifier, not a resource identifier (see discussion)
Must Support true
10. Specimen.accessionIdentifier
Must Support true
12. Specimen.status
Must Support true
14. Specimen.type
Binding The codes SHALL be taken from SpecimenType (20240606) .
(required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54|20240606)
16. Specimen.collection
Control 1..?
18. Specimen.collection.collected[x]
Control 1..?
[x] Note SeeChoice of Data Typesfor further information about how to use [x]
20. Specimen.collection.bodySite
Control 1..?
Binding Unless not suitable, these codes SHALL be taken from SNOMEDCTBodyStructures
(extensible to http://hl7.org/fhir/ValueSet/body-site)

Guidance on how to interpret the contents of this table can be foundhere

0. Specimen
Definition

-

Short Sample for analysis
Comments

-

Control 0..*
Is Modifier false
Must Support false
Summary false
Invariants dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Specimen.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Short (NHSN-MS) Logical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control 1..1
Type id
Is Modifier false
Summary true
4. Specimen.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Short Metadata about the resource
Control 0..1
Type Meta
Is Modifier false
Summary true
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Specimen.meta.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing
Control 0..1
Type string
Is Modifier false
XML Format In the XML format, this property is represented as an attribute.
Summary false
8. Specimen.meta.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Short Additional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control 0..*
Type Extension
Is Modifier false
Summary false
Alternate Names extensions, user content
Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing This element introduces a set of slices on Specimen.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. Specimen.meta.extension:link-received-date-extension
    Slice Name link-received-date-extension
    Definition

    This extension stores the date and time a Resource was received by the processing system (e.g. NHSNLink).

    Short Received Date
    Control 0..1
    Type Extension(Received Date) (Extension Type: dateTime)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Specimen.meta.versionId
    Definition

    The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

    Short Version specific identifier
    Comments

    The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

    Control 0..1
    Type id
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Specimen.meta.lastUpdated
    Definition

    When the resource last changed - e.g. when the version changed.

    Short When the resource version last changed
    Comments

    This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

    Control 0..1
    Type instant
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Specimen.meta.source
    Definition

    A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

    Short Identifies where the resource comes from
    Comments

    In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

    This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

    Control 0..1
    Type uri
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Specimen.meta.profile
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    Short Profiles this resource claims to conform to
    Comments

    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

    Control 0..*
    Type canonical(StructureDefinition)
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Specimen.meta.security
    Definition

    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

    Short Security Labels applied to this resource
    Comments

    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control 0..*
    Binding Unless not suitable, these codes SHALL be taken from All Security Labels
    (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

    Security Labels from the Healthcare Privacy and Security Classification System.

    Type Coding
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Specimen.meta.tag
    Definition

    Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

    Short Tags applied to this resource
    Comments

    The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control 0..*
    Binding For example codes, see CommonTags
    (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

    Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

    Type Coding
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Specimen.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    Short A set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control 0..1
    Type uri
    Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Specimen.language
    Definition

    The base language in which the resource is written.

    Short Language of the resource content
    Comments

    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

    Control 0..1
    Binding The codes SHOULD be taken from CommonLanguages
    (preferred to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional Bindings Purpose
    AllLanguages Max Binding
    Type code
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Specimen.text
    Definition

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    Short Text summary of the resource, for human interpretation
    Comments

    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

    Control 0..1
    Type Narrative
    Is Modifier false
    Summary false
    Alternate Names narrative, html, xhtml, display
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Specimen.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

    Short Contained, inline Resources
    Comments

    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

    Control 0..*
    Type Resource
    Is Modifier false
    Summary false
    Alternate Names inline resources, anonymous resources, contained resources
    32. Specimen.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    Short Additional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier false
    Summary false
    Alternate Names extensions, user content
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    34. Specimen.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    Short Extensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summary false
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Names extensions, user content
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    36. Specimen.identifier
    Definition

    Id for specimen.

    Short External Identifier
    Note This is a business identifier, not a resource identifier (see discussion)
    Control 0..*
    Type Identifier
    Is Modifier false
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Specimen.accessionIdentifier
    Definition

    The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.

    Short Identifier assigned by the lab
    Control 0..1
    Type Identifier
    Is Modifier false
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Specimen.status
    Definition

    The availability of the specimen.

    Short available | unavailable | unsatisfactory | entered-in-error
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control 0..1
    Binding The codes SHALL be taken from SpecimenStatus
    (required to http://hl7.org/fhir/ValueSet/specimen-status|4.0.1)

    Codes providing the status/availability of a specimen.

    Type code
    Is Modifier true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Specimen.type
    Definition

    The kind of material that forms the specimen.

    Short (USCDI) Kind of material that forms the specimen
    Comments

    The type can change the way that a specimen is handled and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.

    Control 1..1
    Binding The codes SHALL be taken from SpecimenType (20240606) .
    (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.54|20240606)
    Type CodeableConcept
    Is Modifier false
    Must Support true
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Specimen.subject
    Definition

    Where the specimen came from. This may be from patient(s), from a location (e.g., the source of an environmental sample), or a sampling of a substance or a device.

    Short (USCDI) The patient where the specimen came from.
    Control 0..1
    Type Reference(US Core Patient Profile)
    Is Modifier false
    Must Support true
    Summary true
    Requirements

    Must know the subject context.

    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Specimen.receivedTime
    Definition

    Time when specimen was received for processing or testing.

    Short The time when specimen was received for processing
    Control 0..1
    Type dateTime
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Specimen.parent
    Definition

    Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen.

    Short Specimen from which this specimen originated
    Comments

    The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.

    Control 0..*
    Type Reference(Specimen)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Specimen.request
    Definition

    Details concerning a service request that required a specimen to be collected.

    Short Why the specimen was collected
    Comments

    The request may be explicit or implied such with a ServiceRequest that requires a blood draw.

    Control 0..*
    Type Reference(ServiceRequest)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. Specimen.collection
    Definition

    Details concerning the specimen collection.

    Short Collection details
    Control 1..1
    Type BackboneElement
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. Specimen.collection.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    Short Unique id for inter-element referencing
    Control 0..1
    Type string
    Is Modifier false
    XML Format In the XML format, this property is represented as an attribute.
    Summary false
    56. Specimen.collection.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    Short Additional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier false
    Summary false
    Alternate Names extensions, user content
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    58. Specimen.collection.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    Short Extensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summary true
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Names extensions, user content, modifiers
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    60. Specimen.collection.collector
    Definition

    Person who collected the specimen.

    Short Who collected the specimen
    Control 0..1
    Type Reference(Practitioner, PractitionerRole)
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. Specimen.collection.collected[x]
    Definition

    Time when specimen was collected from subject - the physiologically relevant time.

    Short Collection time
    Control 1..1
    Type Choice of: dateTime, Period
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    64. Specimen.collection.duration
    Definition

    The span of time over which the collection of a specimen occurred.

    Short How long it took to collect specimen
    Control 0..1
    Type Duration
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    66. Specimen.collection.quantity
    Definition

    The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.

    Short The quantity of specimen collected
    Control 0..1
    Type Quantity(SimpleQuantity)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. Specimen.collection.method
    Definition

    A coded value specifying the technique that is used to perform the procedure.

    Short Technique used to perform collection
    Control 0..1
    Binding For example codes, see FHIRSpecimenCollectionMethod
    (example to http://hl7.org/fhir/ValueSet/specimen-collection-method)

    The technique that is used to perform the procedure.

    Type CodeableConcept
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. Specimen.collection.bodySite
    Definition

    Anatomical location from which the specimen was collected (if subject is a patient). This is the target site. This element is not used for environmental specimens.

    Short Anatomical collection site
    Comments

    If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension bodySite.

    Control 1..1
    Binding Unless not suitable, these codes SHALL be taken from SNOMEDCTBodyStructures
    (extensible to http://hl7.org/fhir/ValueSet/body-site)
    Type CodeableConcept
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. Specimen.collection.fastingStatus[x]
    Definition

    Abstinence or reduction from some or all food, drink, or both, for a period of time prior to sample collection.

    Short Whether or how long patient abstained from food and/or drink
    Comments

    Representing fasting status using this element is preferred to representing it with an observation using a 'pre-coordinated code' such as LOINC 2005-7 (Calcium [Moles/​time] in 2 hour Urine --12 hours fasting), or using a component observation such asObservation.component code` = LOINC 49541-6 (Fasting status - Reported).

    Control 0..1
    Binding Unless not suitable, these codes SHALL be taken from hl7VS-relevantClincialInformation
    (extensible to http://terminology.hl7.org/ValueSet/v2-0916)

    Codes describing the fasting status of the patient.

    Type Choice of: CodeableConcept, Duration
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Summary true
    Requirements

    Many diagnostic tests require fasting to facilitate accurate interpretation.

    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. Specimen.processing
    Definition

    Details concerning processing and processing steps for the specimen.

    Short Processing and processing step details
    Control 0..*
    Type BackboneElement
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    76. Specimen.processing.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    Short Unique id for inter-element referencing
    Control 0..1
    Type string
    Is Modifier false
    XML Format In the XML format, this property is represented as an attribute.
    Summary false
    78. Specimen.processing.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    Short Additional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier false
    Summary false
    Alternate Names extensions, user content
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    80. Specimen.processing.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    Short Extensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summary true
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Names extensions, user content, modifiers
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    82. Specimen.processing.description
    Definition

    Textual description of procedure.

    Short Textual description of procedure
    Control 0..1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    84. Specimen.processing.procedure
    Definition

    A coded value specifying the procedure used to process the specimen.

    Short Indicates the treatment step applied to the specimen
    Control 0..1
    Binding For example codes, see SpecimenProcessingProcedure
    (example to http://hl7.org/fhir/ValueSet/specimen-processing-procedure)

    Type indicating the technique used to process the specimen.

    Type CodeableConcept
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    86. Specimen.processing.additive
    Definition

    Material used in the processing step.

    Short Material used in the processing step
    Control 0..*
    Type Reference(Substance)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    88. Specimen.processing.time[x]
    Definition

    A record of the time or period when the specimen processing occurred. For example the time of sample fixation or the period of time the sample was in formalin.

    Short Date and time of specimen processing
    Control 0..1
    Type Choice of: dateTime, Period
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. Specimen.container
    Definition

    The container holding the specimen. The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here.

    Short Direct container of specimen (tube/slide, etc.)
    Control 0..*
    Type BackboneElement
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    92. Specimen.container.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    Short Unique id for inter-element referencing
    Control 0..1
    Type string
    Is Modifier false
    XML Format In the XML format, this property is represented as an attribute.
    Summary false
    94. Specimen.container.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    Short Additional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier false
    Summary false
    Alternate Names extensions, user content
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    96. Specimen.container.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    Short Extensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control 0..*
    Type Extension
    Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summary true
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Names extensions, user content, modifiers
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    98. Specimen.container.identifier
    Definition

    Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.

    Short Id for the container
    Note This is a business identifier, not a resource identifier (see discussion)
    Control 0..*
    Type Identifier
    Is Modifier false
    Summary true
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    100. Specimen.container.description
    Definition

    Textual description of the container.

    Short Textual description of the container
    Control 0..1
    Type string
    Is Modifier false
    Primitive Value This primitive element may be present, or absent, or replaced by an extension
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    102. Specimen.container.type
    Definition

    The type of container associated with the specimen (e.g. slide, aliquot, etc.).

    Short Kind of container directly associated with specimen
    Control 0..1
    Binding For example codes, see SpecimenContainerType
    (example to http://hl7.org/fhir/ValueSet/specimen-container-type)

    Type of specimen container.

    Type CodeableConcept
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    104. Specimen.container.capacity
    Definition

    The capacity (volume or other measure) the container may contain.

    Short Container volume or size
    Control 0..1
    Type Quantity(SimpleQuantity)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    106. Specimen.container.specimenQuantity
    Definition

    The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.

    Short Quantity of specimen within container
    Control 0..1
    Type Quantity(SimpleQuantity)
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    108. Specimen.container.additive[x]
    Definition

    Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.

    Short Additive associated with container
    Control 0..1
    Binding For example codes, see hl7VS-additivePreservative
    (example to http://terminology.hl7.org/ValueSet/v2-0371)

    Substance added to specimen container.

    Type Choice of: CodeableConcept, Reference(Substance)
    [x] Note SeeChoice of Data Typesfor further information about how to use [x]
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    110. Specimen.condition
    Definition

    A mode or state of being that describes the nature of the specimen.

    Short State of the specimen
    Comments

    Specimen condition is an observation made about the specimen. It's a point-in-time assessment. It can be used to assess its quality or appropriateness for a specific test.

    Control 0..*
    Binding Unless not suitable, these codes SHALL be taken from hl7VS-specimenCondition
    (extensible to http://terminology.hl7.org/ValueSet/v2-0493)

    Codes describing the state of the specimen.

    Type CodeableConcept
    Is Modifier false
    Summary true
    Requirements

    The specimen condition can be used to assess its quality or appropriateness for a specific test.

    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    112. Specimen.note
    Definition

    To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).

    Short Comments
    Control 0..*
    Type Annotation
    Is Modifier false
    Summary false
    Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))