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10.7 Resource Specimen - Content

Orders and Observations

Work Group

Maturity Level: 2

Trial Use

Security Category: Patient

Compartments: Device, Patient, Practitioner

A sample to be used for analysis.

10.7.1 Scope and Usage

Any material sample:

taken from a biological entity, living or dead
taken from a physical object or the environment

Some specimens are biological and can contain one or more components including but not limited to cellular molecules, cells, tissues, organs, body fluids, embryos, and body excretory products (source: NCI Thesaurus , modified).

The specimen resource covers substances used for diagnostic and environmental testing. The focus of the specimen resource is the process for gathering, maintaining and processing the specimen as well as where the specimen originated. This is distinct from the use of Substance which is only used when these other aspects are not relevant.

10.7.2 Background and Context

The current definition of the specimen resource contains only basic information about specimen containers. It does not address the recursive nature of containers or the tracking of the location of a container within its parent container (for instance: a tube in a tray in a rack in a freezer). The frequency with which these elements are tracked may depend on the context of use; general lab, bio-banking, etc. Comments from reviewers on the appropriate scope for this resource, and the need for tracking related specimen management attributes, are welcomed.

This resource is referenced by DiagnosticReport, ImagingStudy, Media, MolecularSequence, Observation, ServiceRequest and itself

Structure

Name	Flags	Card.	Type	Description & Constraints
Specimen	TU		DomainResource	Sample for analysis Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Identifier
accessionIdentifier	Σ	0..1	Identifier	Identifier assigned by the lab
status	?!Σ	0..1	code	available \| unavailable \| unsatisfactory \| entered-in-error SpecimenStatus (Required)
type	Σ	0..1	CodeableConcept	Kind of material that forms the specimen v2 Specimen Type (Example)
subject	Σ	0..1	Reference(Patient \| Group \| Device \| Substance \| Location)	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
receivedTime	Σ	0..1	dateTime	The time when specimen was received for processing
parent		0..*	Reference(Specimen)	Specimen from which this specimen originated
request		0..*	Reference(ServiceRequest)	Why the specimen was collected
collection		0..1	BackboneElement	Collection details
collector	Σ	0..1	Reference(Practitioner \| PractitionerRole)	Who collected the specimen
collected[x]	Σ	0..1		Collection time
collectedDateTime			dateTime
collectedPeriod			Period
duration	Σ	0..1	Duration	How long it took to collect specimen
quantity		0..1	SimpleQuantity	The quantity of specimen collected
method		0..1	CodeableConcept	Technique used to perform collection FHIR Specimen Collection Method (Example)
bodySite		0..1	CodeableConcept	Anatomical collection site SNOMED CT Body Structures (Example)
fastingStatus[x]	Σ	0..1		Whether or how long patient abstained from food and/or drink v2 Relevant Clincial Information (Extensible)
fastingStatusCodeableConcept			CodeableConcept
fastingStatusDuration			Duration
processing		0..*	BackboneElement	Processing and processing step details
description		0..1	string	Textual description of procedure
procedure		0..1	CodeableConcept	Indicates the treatment step applied to the specimen Specimen processing procedure (Example)
additive		0..*	Reference(Substance)	Material used in the processing step
time[x]		0..1		Date and time of specimen processing
timeDateTime			dateTime
timePeriod			Period
container		0..*	BackboneElement	Direct container of specimen (tube/slide, etc.)
identifier	Σ	0..*	Identifier	Id for the container
description		0..1	string	Textual description of the container
type		0..1	CodeableConcept	Kind of container directly associated with specimen Specimen container (Example)
capacity		0..1	SimpleQuantity	Container volume or size
specimenQuantity		0..1	SimpleQuantity	Quantity of specimen within container
additive[x]		0..1		Additive associated with container v2 Additive (Example)
additiveCodeableConcept			CodeableConcept
additiveReference			Reference(Substance)
condition	Σ	0..*	CodeableConcept	State of the specimen v2 Specimen Condition (Extensible)
note		0..*	Annotation	Comments
Documentation for this format

UML Diagram (Legend)

XML Template

<Specimen xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Identifier --></identifier>
 <accessionIdentifier><!-- 0..1 Identifier Identifier assigned by the lab --></accessionIdentifier>
 <status value="[code]"/><!-- 0..1 available | unavailable | unsatisfactory | entered-in-error -->
 <type><!-- 0..1 CodeableConcept Kind of material that forms the specimen --></type>
 <subject><!-- 0..1 Reference(Patient|Group|Device|Substance|Location) 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 --></subject>
 <receivedTime value="[dateTime]"/><!-- 0..1 The time when specimen was received for processing -->
 <parent><!-- 0..* Reference(Specimen) Specimen from which this specimen originated --></parent>
 <request><!-- 0..* Reference(ServiceRequest) Why the specimen was collected --></request>
 <collection>  <!-- 0..1 Collection details -->
  <collector><!-- 0..1 Reference(Practitioner|PractitionerRole) Who collected the specimen --></collector>
  <collected[x]><!-- 0..1 dateTime|Period Collection time --></collected[x]>
  <duration><!-- 0..1 Duration How long it took to collect specimen --></duration>
  <quantity><!-- 0..1 Quantity(SimpleQuantity) The quantity of specimen collected --></quantity>
  <method><!-- 0..1 CodeableConcept Technique used to perform collection --></method>
  <bodySite><!-- 0..1 CodeableConcept Anatomical collection site --></bodySite>
  <fastingStatus[x]><!-- 0..1 CodeableConcept|Duration Whether or how long patient abstained from food and/or drink --></fastingStatus[x]>
 </collection>
 <processing>  <!-- 0..* Processing and processing step details -->
  <description value="[string]"/><!-- 0..1 Textual description of procedure -->
  <procedure><!-- 0..1 CodeableConcept Indicates the treatment step  applied to the specimen --></procedure>
  <additive><!-- 0..* Reference(Substance) Material used in the processing step --></additive>
  <time[x]><!-- 0..1 dateTime|Period Date and time of specimen processing --></time[x]>
 </processing>
 <container>  <!-- 0..* Direct container of specimen (tube/slide, etc.) -->
  <identifier><!-- 0..* Identifier Id for the container --></identifier>
  <description value="[string]"/><!-- 0..1 Textual description of the container -->
  <type><!-- 0..1 CodeableConcept Kind of container directly associated with specimen --></type>
  <capacity><!-- 0..1 Quantity(SimpleQuantity) Container volume or size --></capacity>
  <specimenQuantity><!-- 0..1 Quantity(SimpleQuantity) Quantity of specimen within container --></specimenQuantity>
  <additive[x]><!-- 0..1 CodeableConcept|Reference(Substance) Additive associated with container --></additive[x]>
 </container>
 <condition><!-- 0..* CodeableConcept State of the specimen --></condition>
 <note><!-- 0..* Annotation Comments --></note>
</Specimen>

JSON Template

{
  "resourceType" : "Specimen",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Identifier
  "accessionIdentifier" : { Identifier }, // Identifier assigned by the lab
  "status" : "<code>", // available | unavailable | unsatisfactory | entered-in-error
  "type" : { CodeableConcept }, // Kind of material that forms the specimen
  "subject" : { Reference(Patient|Group|Device|Substance|Location) }, // 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
  "receivedTime" : "<dateTime>", // The time when specimen was received for processing
  "parent" : [{ Reference(Specimen) }], // Specimen from which this specimen originated
  "request" : [{ Reference(ServiceRequest) }], // Why the specimen was collected
  "collection" : { // Collection details
    "collector" : { Reference(Practitioner|PractitionerRole) }, // Who collected the specimen
    // collected[x]: Collection time. One of these 2:
    "collectedDateTime" : "<dateTime>",
    "collectedPeriod" : { Period },
    "duration" : { Duration }, // How long it took to collect specimen
    "quantity" : { Quantity(SimpleQuantity) }, // The quantity of specimen collected
    "method" : { CodeableConcept }, // Technique used to perform collection
    "bodySite" : { CodeableConcept }, // Anatomical collection site
    // fastingStatus[x]: Whether or how long patient abstained from food and/or drink. One of these 2:
    "fastingStatusCodeableConcept" : { CodeableConcept }
    "fastingStatusDuration" : { Duration }
  },
  "processing" : [{ // Processing and processing step details
    "description" : "<string>", // Textual description of procedure
    "procedure" : { CodeableConcept }, // Indicates the treatment step  applied to the specimen
    "additive" : [{ Reference(Substance) }], // Material used in the processing step
    // time[x]: Date and time of specimen processing. One of these 2:
    "timeDateTime" : "<dateTime>"
    "timePeriod" : { Period }
  }],
  "container" : [{ // Direct container of specimen (tube/slide, etc.)
    "identifier" : [{ Identifier }], // Id for the container
    "description" : "<string>", // Textual description of the container
    "type" : { CodeableConcept }, // Kind of container directly associated with specimen
    "capacity" : { Quantity(SimpleQuantity) }, // Container volume or size
    "specimenQuantity" : { Quantity(SimpleQuantity) }, // Quantity of specimen within container
    // additive[x]: Additive associated with container. One of these 2:
    "additiveCodeableConcept" : { CodeableConcept }
    "additiveReference" : { Reference(Substance) }
  }],
  "condition" : [{ CodeableConcept }], // State of the specimen
  "note" : [{ Annotation }] // Comments
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Specimen;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Specimen.identifier [ Identifier ], ... ; # 0..* External Identifier
  fhir:Specimen.accessionIdentifier [ Identifier ]; # 0..1 Identifier assigned by the lab
  fhir:Specimen.status [ code ]; # 0..1 available | unavailable | unsatisfactory | entered-in-error
  fhir:Specimen.type [ CodeableConcept ]; # 0..1 Kind of material that forms the specimen
  fhir:Specimen.subject [ Reference(Patient|Group|Device|Substance|Location) ]; # 0..1 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
  fhir:Specimen.receivedTime [ dateTime ]; # 0..1 The time when specimen was received for processing
  fhir:Specimen.parent [ Reference(Specimen) ], ... ; # 0..* Specimen from which this specimen originated
  fhir:Specimen.request [ Reference(ServiceRequest) ], ... ; # 0..* Why the specimen was collected
  fhir:Specimen.collection [ # 0..1 Collection details
    fhir:Specimen.collection.collector [ Reference(Practitioner|PractitionerRole) ]; # 0..1 Who collected the specimen
    # Specimen.collection.collected[x] : 0..1 Collection time. One of these 2
      fhir:Specimen.collection.collectedDateTime [ dateTime ]
      fhir:Specimen.collection.collectedPeriod [ Period ]
    fhir:Specimen.collection.duration [ Duration ]; # 0..1 How long it took to collect specimen
    fhir:Specimen.collection.quantity [ Quantity(SimpleQuantity) ]; # 0..1 The quantity of specimen collected
    fhir:Specimen.collection.method [ CodeableConcept ]; # 0..1 Technique used to perform collection
    fhir:Specimen.collection.bodySite [ CodeableConcept ]; # 0..1 Anatomical collection site
    # Specimen.collection.fastingStatus[x] : 0..1 Whether or how long patient abstained from food and/or drink. One of these 2
      fhir:Specimen.collection.fastingStatusCodeableConcept [ CodeableConcept ]
      fhir:Specimen.collection.fastingStatusDuration [ Duration ]
  ];
  fhir:Specimen.processing [ # 0..* Processing and processing step details
    fhir:Specimen.processing.description [ string ]; # 0..1 Textual description of procedure
    fhir:Specimen.processing.procedure [ CodeableConcept ]; # 0..1 Indicates the treatment step  applied to the specimen
    fhir:Specimen.processing.additive [ Reference(Substance) ], ... ; # 0..* Material used in the processing step
    # Specimen.processing.time[x] : 0..1 Date and time of specimen processing. One of these 2
      fhir:Specimen.processing.timeDateTime [ dateTime ]
      fhir:Specimen.processing.timePeriod [ Period ]
  ], ...;
  fhir:Specimen.container [ # 0..* Direct container of specimen (tube/slide, etc.)
    fhir:Specimen.container.identifier [ Identifier ], ... ; # 0..* Id for the container
    fhir:Specimen.container.description [ string ]; # 0..1 Textual description of the container
    fhir:Specimen.container.type [ CodeableConcept ]; # 0..1 Kind of container directly associated with specimen
    fhir:Specimen.container.capacity [ Quantity(SimpleQuantity) ]; # 0..1 Container volume or size
    fhir:Specimen.container.specimenQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Quantity of specimen within container
    # Specimen.container.additive[x] : 0..1 Additive associated with container. One of these 2
      fhir:Specimen.container.additiveCodeableConcept [ CodeableConcept ]
      fhir:Specimen.container.additiveReference [ Reference(Substance) ]
  ], ...;
  fhir:Specimen.condition [ CodeableConcept ], ... ; # 0..* State of the specimen
  fhir:Specimen.note [ Annotation ], ... ; # 0..* Comments
]

Changes since R3

Specimen

Specimen.status

Change value set from http://hl7.org/fhir/ValueSet/specimen-status to http://hl7.org/fhir/ValueSet/specimen-status|4.0.1

Specimen.subject

Min Cardinality changed from 1 to 0
Type Reference: Added Target Type Location

Specimen.request

Type Reference: Added Target Type ServiceRequest
Type Reference: Removed Target Type ProcedureRequest

Specimen.collection.collector

Type Reference: Added Target Type PractitionerRole

Specimen.collection.duration

Added Element

Specimen.collection.fastingStatus[x]

Added Element

Specimen.condition

Added Element

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 4 tests that all execute ok. All tests pass round-trip testing and 2 r3 resources are invalid (0 errors).)

Structure

Name	Flags	Card.	Type	Description & Constraints
Specimen	TU		DomainResource	Sample for analysis Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External Identifier
accessionIdentifier	Σ	0..1	Identifier	Identifier assigned by the lab
status	?!Σ	0..1	code	available \| unavailable \| unsatisfactory \| entered-in-error SpecimenStatus (Required)
type	Σ	0..1	CodeableConcept	Kind of material that forms the specimen v2 Specimen Type (Example)
subject	Σ	0..1	Reference(Patient \| Group \| Device \| Substance \| Location)	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
receivedTime	Σ	0..1	dateTime	The time when specimen was received for processing
parent		0..*	Reference(Specimen)	Specimen from which this specimen originated
request		0..*	Reference(ServiceRequest)	Why the specimen was collected
collection		0..1	BackboneElement	Collection details
collector	Σ	0..1	Reference(Practitioner \| PractitionerRole)	Who collected the specimen
collected[x]	Σ	0..1		Collection time
collectedDateTime			dateTime
collectedPeriod			Period
duration	Σ	0..1	Duration	How long it took to collect specimen
quantity		0..1	SimpleQuantity	The quantity of specimen collected
method		0..1	CodeableConcept	Technique used to perform collection FHIR Specimen Collection Method (Example)
bodySite		0..1	CodeableConcept	Anatomical collection site SNOMED CT Body Structures (Example)
fastingStatus[x]	Σ	0..1		Whether or how long patient abstained from food and/or drink v2 Relevant Clincial Information (Extensible)
fastingStatusCodeableConcept			CodeableConcept
fastingStatusDuration			Duration
processing		0..*	BackboneElement	Processing and processing step details
description		0..1	string	Textual description of procedure
procedure		0..1	CodeableConcept	Indicates the treatment step applied to the specimen Specimen processing procedure (Example)
additive		0..*	Reference(Substance)	Material used in the processing step
time[x]		0..1		Date and time of specimen processing
timeDateTime			dateTime
timePeriod			Period
container		0..*	BackboneElement	Direct container of specimen (tube/slide, etc.)
identifier	Σ	0..*	Identifier	Id for the container
description		0..1	string	Textual description of the container
type		0..1	CodeableConcept	Kind of container directly associated with specimen Specimen container (Example)
capacity		0..1	SimpleQuantity	Container volume or size
specimenQuantity		0..1	SimpleQuantity	Quantity of specimen within container
additive[x]		0..1		Additive associated with container v2 Additive (Example)
additiveCodeableConcept			CodeableConcept
additiveReference			Reference(Substance)
condition	Σ	0..*	CodeableConcept	State of the specimen v2 Specimen Condition (Extensible)
note		0..*	Annotation	Comments
Documentation for this format

UML Diagram (Legend)

XML Template

<Specimen xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Identifier --></identifier>
 <accessionIdentifier><!-- 0..1 Identifier Identifier assigned by the lab --></accessionIdentifier>
 <status value="[code]"/><!-- 0..1 available | unavailable | unsatisfactory | entered-in-error -->
 <type><!-- 0..1 CodeableConcept Kind of material that forms the specimen --></type>
 <subject><!-- 0..1 Reference(Patient|Group|Device|Substance|Location) 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 --></subject>
 <receivedTime value="[dateTime]"/><!-- 0..1 The time when specimen was received for processing -->
 <parent><!-- 0..* Reference(Specimen) Specimen from which this specimen originated --></parent>
 <request><!-- 0..* Reference(ServiceRequest) Why the specimen was collected --></request>
 <collection>  <!-- 0..1 Collection details -->
  <collector><!-- 0..1 Reference(Practitioner|PractitionerRole) Who collected the specimen --></collector>
  <collected[x]><!-- 0..1 dateTime|Period Collection time --></collected[x]>
  <duration><!-- 0..1 Duration How long it took to collect specimen --></duration>
  <quantity><!-- 0..1 Quantity(SimpleQuantity) The quantity of specimen collected --></quantity>
  <method><!-- 0..1 CodeableConcept Technique used to perform collection --></method>
  <bodySite><!-- 0..1 CodeableConcept Anatomical collection site --></bodySite>
  <fastingStatus[x]><!-- 0..1 CodeableConcept|Duration Whether or how long patient abstained from food and/or drink --></fastingStatus[x]>
 </collection>
 <processing>  <!-- 0..* Processing and processing step details -->
  <description value="[string]"/><!-- 0..1 Textual description of procedure -->
  <procedure><!-- 0..1 CodeableConcept Indicates the treatment step  applied to the specimen --></procedure>
  <additive><!-- 0..* Reference(Substance) Material used in the processing step --></additive>
  <time[x]><!-- 0..1 dateTime|Period Date and time of specimen processing --></time[x]>
 </processing>
 <container>  <!-- 0..* Direct container of specimen (tube/slide, etc.) -->
  <identifier><!-- 0..* Identifier Id for the container --></identifier>
  <description value="[string]"/><!-- 0..1 Textual description of the container -->
  <type><!-- 0..1 CodeableConcept Kind of container directly associated with specimen --></type>
  <capacity><!-- 0..1 Quantity(SimpleQuantity) Container volume or size --></capacity>
  <specimenQuantity><!-- 0..1 Quantity(SimpleQuantity) Quantity of specimen within container --></specimenQuantity>
  <additive[x]><!-- 0..1 CodeableConcept|Reference(Substance) Additive associated with container --></additive[x]>
 </container>
 <condition><!-- 0..* CodeableConcept State of the specimen --></condition>
 <note><!-- 0..* Annotation Comments --></note>
</Specimen>

JSON Template

{
  "resourceType" : "Specimen",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Identifier
  "accessionIdentifier" : { Identifier }, // Identifier assigned by the lab
  "status" : "<code>", // available | unavailable | unsatisfactory | entered-in-error
  "type" : { CodeableConcept }, // Kind of material that forms the specimen
  "subject" : { Reference(Patient|Group|Device|Substance|Location) }, // 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
  "receivedTime" : "<dateTime>", // The time when specimen was received for processing
  "parent" : [{ Reference(Specimen) }], // Specimen from which this specimen originated
  "request" : [{ Reference(ServiceRequest) }], // Why the specimen was collected
  "collection" : { // Collection details
    "collector" : { Reference(Practitioner|PractitionerRole) }, // Who collected the specimen
    // collected[x]: Collection time. One of these 2:
    "collectedDateTime" : "<dateTime>",
    "collectedPeriod" : { Period },
    "duration" : { Duration }, // How long it took to collect specimen
    "quantity" : { Quantity(SimpleQuantity) }, // The quantity of specimen collected
    "method" : { CodeableConcept }, // Technique used to perform collection
    "bodySite" : { CodeableConcept }, // Anatomical collection site
    // fastingStatus[x]: Whether or how long patient abstained from food and/or drink. One of these 2:
    "fastingStatusCodeableConcept" : { CodeableConcept }
    "fastingStatusDuration" : { Duration }
  },
  "processing" : [{ // Processing and processing step details
    "description" : "<string>", // Textual description of procedure
    "procedure" : { CodeableConcept }, // Indicates the treatment step  applied to the specimen
    "additive" : [{ Reference(Substance) }], // Material used in the processing step
    // time[x]: Date and time of specimen processing. One of these 2:
    "timeDateTime" : "<dateTime>"
    "timePeriod" : { Period }
  }],
  "container" : [{ // Direct container of specimen (tube/slide, etc.)
    "identifier" : [{ Identifier }], // Id for the container
    "description" : "<string>", // Textual description of the container
    "type" : { CodeableConcept }, // Kind of container directly associated with specimen
    "capacity" : { Quantity(SimpleQuantity) }, // Container volume or size
    "specimenQuantity" : { Quantity(SimpleQuantity) }, // Quantity of specimen within container
    // additive[x]: Additive associated with container. One of these 2:
    "additiveCodeableConcept" : { CodeableConcept }
    "additiveReference" : { Reference(Substance) }
  }],
  "condition" : [{ CodeableConcept }], // State of the specimen
  "note" : [{ Annotation }] // Comments
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:Specimen;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Specimen.identifier [ Identifier ], ... ; # 0..* External Identifier
  fhir:Specimen.accessionIdentifier [ Identifier ]; # 0..1 Identifier assigned by the lab
  fhir:Specimen.status [ code ]; # 0..1 available | unavailable | unsatisfactory | entered-in-error
  fhir:Specimen.type [ CodeableConcept ]; # 0..1 Kind of material that forms the specimen
  fhir:Specimen.subject [ Reference(Patient|Group|Device|Substance|Location) ]; # 0..1 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
  fhir:Specimen.receivedTime [ dateTime ]; # 0..1 The time when specimen was received for processing
  fhir:Specimen.parent [ Reference(Specimen) ], ... ; # 0..* Specimen from which this specimen originated
  fhir:Specimen.request [ Reference(ServiceRequest) ], ... ; # 0..* Why the specimen was collected
  fhir:Specimen.collection [ # 0..1 Collection details
    fhir:Specimen.collection.collector [ Reference(Practitioner|PractitionerRole) ]; # 0..1 Who collected the specimen
    # Specimen.collection.collected[x] : 0..1 Collection time. One of these 2
      fhir:Specimen.collection.collectedDateTime [ dateTime ]
      fhir:Specimen.collection.collectedPeriod [ Period ]
    fhir:Specimen.collection.duration [ Duration ]; # 0..1 How long it took to collect specimen
    fhir:Specimen.collection.quantity [ Quantity(SimpleQuantity) ]; # 0..1 The quantity of specimen collected
    fhir:Specimen.collection.method [ CodeableConcept ]; # 0..1 Technique used to perform collection
    fhir:Specimen.collection.bodySite [ CodeableConcept ]; # 0..1 Anatomical collection site
    # Specimen.collection.fastingStatus[x] : 0..1 Whether or how long patient abstained from food and/or drink. One of these 2
      fhir:Specimen.collection.fastingStatusCodeableConcept [ CodeableConcept ]
      fhir:Specimen.collection.fastingStatusDuration [ Duration ]
  ];
  fhir:Specimen.processing [ # 0..* Processing and processing step details
    fhir:Specimen.processing.description [ string ]; # 0..1 Textual description of procedure
    fhir:Specimen.processing.procedure [ CodeableConcept ]; # 0..1 Indicates the treatment step  applied to the specimen
    fhir:Specimen.processing.additive [ Reference(Substance) ], ... ; # 0..* Material used in the processing step
    # Specimen.processing.time[x] : 0..1 Date and time of specimen processing. One of these 2
      fhir:Specimen.processing.timeDateTime [ dateTime ]
      fhir:Specimen.processing.timePeriod [ Period ]
  ], ...;
  fhir:Specimen.container [ # 0..* Direct container of specimen (tube/slide, etc.)
    fhir:Specimen.container.identifier [ Identifier ], ... ; # 0..* Id for the container
    fhir:Specimen.container.description [ string ]; # 0..1 Textual description of the container
    fhir:Specimen.container.type [ CodeableConcept ]; # 0..1 Kind of container directly associated with specimen
    fhir:Specimen.container.capacity [ Quantity(SimpleQuantity) ]; # 0..1 Container volume or size
    fhir:Specimen.container.specimenQuantity [ Quantity(SimpleQuantity) ]; # 0..1 Quantity of specimen within container
    # Specimen.container.additive[x] : 0..1 Additive associated with container. One of these 2
      fhir:Specimen.container.additiveCodeableConcept [ CodeableConcept ]
      fhir:Specimen.container.additiveReference [ Reference(Substance) ]
  ], ...;
  fhir:Specimen.condition [ CodeableConcept ], ... ; # 0..* State of the specimen
  fhir:Specimen.note [ Annotation ], ... ; # 0..* Comments
]

Changes since Release 3

Specimen

Specimen.status

Change value set from http://hl7.org/fhir/ValueSet/specimen-status to http://hl7.org/fhir/ValueSet/specimen-status|4.0.1

Specimen.subject

Min Cardinality changed from 1 to 0
Type Reference: Added Target Type Location

Specimen.request

Type Reference: Added Target Type ServiceRequest
Type Reference: Removed Target Type ProcedureRequest

Specimen.collection.collector

Type Reference: Added Target Type PractitionerRole

Specimen.collection.duration

Added Element

Specimen.collection.fastingStatus[x]

Added Element

Specimen.condition

Added Element

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 4 tests that all execute ok. All tests pass round-trip testing and 2 r3 resources are invalid (0 errors).)

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

10.7.3.1 Terminology Bindings

Path	Definition	Type	Reference
Specimen.status	Codes providing the status/availability of a specimen.	Required	SpecimenStatus
Specimen.type	The type of the specimen.	Example	v2.0487
Specimen.collection.method	The technique that is used to perform the procedure.	Example	FHIRSpecimenCollectionMethod
Specimen.collection.bodySite	Codes describing anatomical locations. May include laterality.	Example	SNOMEDCTBodyStructures
Specimen.collection.fastingStatus[x]	Codes describing the fasting status of the patient.	Extensible	v2.0916
Specimen.processing.procedure	Type indicating the technique used to process the specimen.	Example	SpecimenProcessingProcedure
Specimen.container.type	Type of specimen container.	Example	SpecimenContainer
Specimen.container.additive[x]	Substance added to specimen container.	Example	v2.0371
Specimen.condition	Codes describing the state of the specimen.	Extensible	v2.0493

Path

Definition

Type

Reference

Specimen.status

Codes providing the status/availability of a specimen.

Required

SpecimenStatus

Specimen.type

The type of the specimen.

Example

v2.0487

Specimen.collection.method

The technique that is used to perform the procedure.

Example

FHIRSpecimenCollectionMethod

Specimen.collection.bodySite

Codes describing anatomical locations. May include laterality.

Example

SNOMEDCTBodyStructures

Specimen.collection.fastingStatus[x]

Codes describing the fasting status of the patient.

Extensible

v2.0916

Specimen.processing.procedure

Type indicating the technique used to process the specimen.

Example

SpecimenProcessingProcedure

Specimen.container.type

Type of specimen container.

Example

SpecimenContainer

Specimen.container.additive[x]

Substance added to specimen container.

Example

v2.0371

Specimen.condition

Codes describing the state of the specimen.

Extensible

v2.0493

10.7.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
accession	token	The accession number associated with the specimen	Specimen.accessionIdentifier
bodysite	token	The code for the body site from where the specimen originated	Specimen.collection.bodySite
collected	date	The date the specimen was collected	Specimen.collection.collected
collector	reference	Who collected the specimen	Specimen.collection.collector (Practitioner, PractitionerRole)
container	token	The kind of specimen container	Specimen.container.type
container-id	token	The unique identifier associated with the specimen container	Specimen.container.identifier
identifier	token	The unique identifier associated with the specimen	Specimen.identifier
parent	reference	The parent of the specimen	Specimen.parent (Specimen)
patient	reference	The patient the specimen comes from	Specimen.subject.where(resolve() is Patient) (Patient)
status	token	available \| unavailable \| unsatisfactory \| entered-in-error	Specimen.status
subject	reference	The subject of the specimen	Specimen.subject (Group, Device, Patient, Substance, Location)
type	token	The specimen type	Specimen.type