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web github.com contact : https://github.com/KevinMayfield/PathologyAndLaboratory
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web www.datadictionary.nhs.uk General Medical Council Consultant Code. For more details see: NHS Data Model Dictionary
web www.datadictionary.nhs.uk General Practitioner (GMP) number. For more details see: NHS Data Model Dictionary
web www.datadictionary.nhs.uk NHS Number allocated to the patient in England and Wales. For more details see: NHS Data Model Dictionary
web github.com IG © 2026+ Kevin Mayfield . Package uk.org.examplesihe.palm#0.1.0 based on FHIR 4.0.1 . Generated 2026-11-04
Links: Table of Contents | QA Report
web nw-gmsa.github.io England/Wales NHS Number, Scotland CHI Number and Northern Ireland Health and Care Number. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io UK Professional License. Copied from the NW GMSA FHIR IG .
web hl7.eu HL7 Europe Laboratory Report
web nw-gmsa.github.io NW GMSA FHIR IG
web kevinmayfield.github.io Cancer Pathology Report
web www.ihe.net IHE PaLM TF-1 - Inter-Laboratory Workflow (ILW)
web www.ihe.net IHE PaLM TF-2 - transactions LAB-35, LAB-36
web nw-gmsa.github.io NW GMSA - Inter Laboratory Workflow (ILW) - the genomics equivalent
web nw-gmsa.github.io Genomics - a pathology laboratory sending a specimen to a Genomic Laboratory Hub (see the NW GMSA FHIR IG )
web www.ihe.net IHE PaLM TF-2 - Placer Order Management [LAB-1]
web nw-gmsa.github.io NW GMSA - OML_O21 Laboratory Order
web www.ihe.net IHE PaLM TF-2 - Filler Order Management [LAB-2]
web www.ihe.net IHE PaLM TF-2 - Order Results Management [LAB-3]
web nw-gmsa.github.io Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide - the source of most of the field rules on HL7 v2.5.1 Segments
web nw-gmsa.github.io NW GMSA - ORU_R01
web www.ihe.net IHE PaLM TF-2 - Sub-order Management [LAB-35]
web nw-gmsa.github.io NW GMSA - Inter Laboratory Workflow (ILW) - distributed WGS sub-orders use the same transaction
web www.ihe.net IHE PaLM TF-2 - Sub-order Results Delivery [LAB-36]
web www.ihe.net IHE PaLM TF-1 - Laboratory Testing Workflow (LTW)
web www.ihe.net IHE PaLM TF-2 - transactions LAB-1, LAB-2, LAB-3
web nw-gmsa.github.io NW GMSA - Laboratory Testing Workflow (LTW) - the genomics equivalent of this page
web github.com They were generated from the FHIR Documents in the fhir.r4.nhsengland.pathology package by scripts/nhse_document_to_oru.py , using the FHIR to HL7 v2 rules on Mapping HL7 v2 and FHIR . The notebooks convert them back: ORU^R01 to a FHIR Message, then the FHIR Message to a FHIR Document for the NHS England API.
web github.com They were generated from the FHIR Documents in the fhir.r4.nhsengland.pathology package by scripts/nhse_document_to_oru.py , using the FHIR to HL7 v2 rules on Mapping HL7 v2 and FHIR . The notebooks convert them back: ORU^R01 to a FHIR Message, then the FHIR Message to a FHIR Document for the NHS England API.
web nw-gmsa.github.io Patient - the NHS England examples identify the patient by NHS Number only, but PID-5 (name), PID-7 (date of birth) and PID-8 (sex) are required in HL7 v2. These messages use NHS England EDI test patients instead - the patients used by older versions of NHS England PaLM and by the NW GMSA IG . They exist in the NHS England INT environment (PDS), so developers can trace them:
web github.com PID-3 also carries a hospital number (MRN, type MR , assigned by York and Scarborough Teaching Hospitals RCB , the local acute trust for the requesting practice) and the laboratory's own patient number (type PI , assigned by Y8J7D ); these are recorded in the NW GMSA MRN-Mapping :
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/HbA1c-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/CRP-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/HBsAg-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/HPV-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/FBC-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/Lipids-HbA1c-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/LFT-UandE-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/GTT-Unstructured-Report-Example.hl7
web github.com HL7 v2 file: examples/hl7v2/ORU_R01/Urine-MCS-Unstructured-Report-Example.hl7
web www.ihe.net The IHE Pathology and Laboratory Medicine (PaLM) Technical Framework defines profiles (Volume 1), the transactions they use (Volume 2) and content (Volume 3) for laboratory and pathology workflows. IHE profiles are international; a national extension or localisation says how they are used in one country. This guide is a localisation for England.
web kevinmayfield.github.io Out of scope - see Cancer Pathology Report
web digital.nhs.uk Content - DAPB4101 everywhere. The NHS England Pathology and Laboratory Medicine Reporting information standard (DAPB4101) is written for reporting to general practice. This guide recommends that its content - SNOMED CT PaLM codes, units, report structure - is applied across England : LIMS to trust EPR, laboratory to laboratory, to shared care records and to GP systems, in HL7 v2 as well as FHIR. A result then means the same thing on every route, and moving it between routes (for example ORU^R01 to the NHS England API) changes the container, not the content
web hl7.eu FHIR - the FHIR equivalent of each HL7 v2 message, built on HL7 Europe Laboratory Report (as the NHS England Pathology FHIR IG is), and the mapping between them
web http://snomed.info/sct|http://snomed.info/sct/83821000000107 http://snomed.info/sct|http://snomed.info/sct/83821000000107
web digital.nhs.uk The NHS England Pathology and Laboratory Medicine Reporting FHIR API lets a laboratory middleware system send structured pathology test reports to the general practice that requested the test, and retrieve the practice's acknowledgement. It replaces Pathology Messaging - EDIFACT and implements the DAPB4101 Pathology and Laboratory Medicine Reporting information standard. In IHE terms it is a national route for Order Results Management [LAB-3] , with the report sent as a document (as in IHE XD-LAB) rather than a message.
web digital.nhs.uk Pathology and Laboratory Medicine Reporting - FHIR API (and its OAS file)
web digital.nhs.uk Pathology and Laboratory Medicine Reporting: Test Result Stored Event
web digital.nhs.uk DAPB4101 Pathology and Laboratory Medicine Reporting information standard
web digital.nhs.uk Patient Data Manager and the Multicast Notification Service
web digital.nhs.uk Patient Data Manager and the Multicast Notification Service
web github.com Examples: Bundle Document - Full blood count , and the NHS England examples converted from ORU^R01 by the notebooks ( examples/fhir/document/ ).
web github.com The order comms system (the "laboratory middleware system") receives ORU^R01 from the LIMS, usually through the TIE, and sends FHIR Documents to the API. Use the HL7 v2 to FHIR mapping to build the resources, then package them as a document . Worked examples: notebooks 01-oru-r01-to-fhir-message and 02-fhir-message-to-fhir-document .
web github.com The order comms system (the "laboratory middleware system") receives ORU^R01 from the LIMS, usually through the TIE, and sends FHIR Documents to the API. Use the HL7 v2 to FHIR mapping to build the resources, then package them as a document . Worked examples: notebooks 01-oru-r01-to-fhir-message and 02-fhir-message-to-fhir-document .
web digital.nhs.uk the ORU^R01 carries only codes for practitioners and organisations (GMC / GMP, ODS), so the document's Practitioner and Organization resources (requester, laboratory) are looked up - from the ODS APIs or ODS CSV downloads ( epraccur.csv , egpcur.csv ), usually through a local cache
web digital.nhs.uk the ORU^R01 carries only codes for practitioners and organisations (GMC / GMP, ODS), so the document's Practitioner and Organization resources (requester, laboratory) are looked up - from the ODS APIs or ODS CSV downloads ( epraccur.csv , egpcur.csv ), usually through a local cache
web github.com The notebook generates the narrative this way for the NHS England examples.
web kevinmayfield.github.io Cellular pathology is out of scope of this guide - see Cancer Pathology Report ; genomics is covered by the NW GMSA FHIR IG . They are listed here because the distinction matters for the specialisms that are in scope (see Specialisms ), which are mostly discrete with some narrative.
web nw-gmsa.github.io Cellular pathology is out of scope of this guide - see Cancer Pathology Report ; genomics is covered by the NW GMSA FHIR IG . They are listed here because the distinction matters for the specialisms that are in scope (see Specialisms ), which are mostly discrete with some narrative.
web hl7.eu General rule. The patterns follow the split in the HL7 Europe Health Data API between Document Exchange and Resource Access (see also its FHIR Documents and Resources and Resource Exchange Patterns ):
  • where the DiagnosticReport is at the top, the pattern applies to FHIR Messages (the ORU^R01 equivalent) and to FHIR RESTful Resource Access (IPA / QEDm - for example a shared care record queried for results)
  • where the Composition is at the top, the pattern is a FHIR Document - FHIR RESTful Document Exchange (IHE MHD), and the NHS England Pathology Laboratory Reporting API
web hl7.eu General rule. The patterns follow the split in the HL7 Europe Health Data API between Document Exchange and Resource Access (see also its FHIR Documents and Resources and Resource Exchange Patterns ):
  • where the DiagnosticReport is at the top, the pattern applies to FHIR Messages (the ORU^R01 equivalent) and to FHIR RESTful Resource Access (IPA / QEDm - for example a shared care record queried for results)
  • where the Composition is at the top, the pattern is a FHIR Document - FHIR RESTful Document Exchange (IHE MHD), and the NHS England Pathology Laboratory Reporting API
web hl7.eu General rule. The patterns follow the split in the HL7 Europe Health Data API between Document Exchange and Resource Access (see also its FHIR Documents and Resources and Resource Exchange Patterns ):
  • where the DiagnosticReport is at the top, the pattern applies to FHIR Messages (the ORU^R01 equivalent) and to FHIR RESTful Resource Access (IPA / QEDm - for example a shared care record queried for results)
  • where the Composition is at the top, the pattern is a FHIR Document - FHIR RESTful Document Exchange (IHE MHD), and the NHS England Pathology Laboratory Reporting API
web hl7.eu General rule. The patterns follow the split in the HL7 Europe Health Data API between Document Exchange and Resource Access (see also its FHIR Documents and Resources and Resource Exchange Patterns ):
  • where the DiagnosticReport is at the top, the pattern applies to FHIR Messages (the ORU^R01 equivalent) and to FHIR RESTful Resource Access (IPA / QEDm - for example a shared care record queried for results)
  • where the Composition is at the top, the pattern is a FHIR Document - FHIR RESTful Document Exchange (IHE MHD), and the NHS England Pathology Laboratory Reporting API
web hl7.eu General rule. The patterns follow the split in the HL7 Europe Health Data API between Document Exchange and Resource Access (see also its FHIR Documents and Resources and Resource Exchange Patterns ):
  • where the DiagnosticReport is at the top, the pattern applies to FHIR Messages (the ORU^R01 equivalent) and to FHIR RESTful Resource Access (IPA / QEDm - for example a shared care record queried for results)
  • where the Composition is at the top, the pattern is a FHIR Document - FHIR RESTful Document Exchange (IHE MHD), and the NHS England Pathology Laboratory Reporting API
web hl7.eu Document Exchange
web hl7.eu Resource Access
web hl7.eu HL7 Europe Health Data API (1.0.0-ballot) - Document Exchange , Resource Access , FHIR Documents and Resources
web hl7.eu HL7 Europe Health Data API (1.0.0-ballot) - Document Exchange , Resource Access , FHIR Documents and Resources
web hl7.eu HL7 Europe Health Data API (1.0.0-ballot) - Document Exchange , Resource Access , FHIR Documents and Resources
web hl7.eu HL7 Europe Health Data API (1.0.0-ballot) - Document Exchange , Resource Access , FHIR Documents and Resources
web hl7.eu HL7 Europe Laboratory Report - Composition
web www.rcpath.org Royal College of Pathologists - Cancer datasets and tissue pathways
web fhir.interweavedigital.com Based on the Interweave Implementation Guide (CareConnect / FHIR STU3, with R4 profiles including Interweave-DiagnosticReport )
web www.omg.org ServD doco
web en.wikipedia.org Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS ).
web nw-gmsa.github.io FHIR Messaging . Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Core Data Contract for FHIR Identifier, v2 CX and EI. Copied from the NW GMSA FHIR IG .
web siframework.org Quality Improvement and Clinical Knowledge (QUICK) doco
web wiki.ihe.net This is a metadata field from XDS/MHD .
web snomed.info SNOMED CT Concept Domain Binding
web nw-gmsa.github.io Patient identifier assigned by an NHS trust. Copied from the NW GMSA FHIR IG .
web www.enterpriseintegrationpatterns.com Messaging Document Message . The event is the HL7 v2 trigger event. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Messaging Document Message . The event is the HL7 v2 trigger event. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Only traced NHS Number SHOULD be used, un-traced NHS Numbers MUST be clearly indicated. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io DRAFT: Additional conformance on FHIR Attachment data type. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Placer or filler order number. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io ODS organisation code. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io ODS site code. Copied from the NW GMSA FHIR IG .
web www.omg.org ServD
web nw-gmsa.github.io Patient Administration HL7 Europe Core - Patient . Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Not applicable per the NHS England Canonical Data Model - use Medical Record Number instead. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Professional registration number (GMC, NMC, HCPC, GPhC) or GP code. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Identifier of a report, assigned by the filler (reporting) organisation. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io Encounter or visit number. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io IdentifierType work around to bypass lack of NH in based definition. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io PractitionerIdentifiers. Copied from the NW GMSA FHIR IG .
web nw-gmsa.github.io NHS Number, CHI Number and Health and Care Number. Copied from the NW GMSA FHIR IG .
web fhir.ch Switzerland DocumentEntry.mimeType
web nw-gmsa.github.io Copied from the NW GMSA FHIR IG .
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web snomed.info SCT UK vhttp://snomed.info/sct/83821000000107/version/20230412
web nw-gmsa.github.io Sources - the field rules follow the Digital Health and Care Wales HL7 ORU_R01 2.5.1 IG (DHCW) and the NW GMSA HL7 v2 standards , with English identifiers in place of NHS Wales OIDs.
web nw-gmsa.github.io Sources - the field rules follow the Digital Health and Care Wales HL7 ORU_R01 2.5.1 IG (DHCW) and the NW GMSA HL7 v2 standards , with English identifiers in place of NHS Wales OIDs.
web www.ihe.net This guide is an England Pathology and Laboratory Medicine (PaLM) Technical Framework . It takes the IHE Pathology and Laboratory Medicine (PaLM) Technical Framework
web nw-gmsa.github.io HL7 v2.5.1 for the messages laboratories, order communications, EPRs and GP systems already exchange ( OML^O21 , ORU^R01 , ACK ), following the IHE PaLM transactions and the conventions of the NW GMSA HL7 v2 standards and the Digital Health and Care Wales HL7 ORU_R01 2.5.1 Implementation Guide
web nw-gmsa.github.io HL7 v2.5.1 for the messages laboratories, order communications, EPRs and GP systems already exchange ( OML^O21 , ORU^R01 , ACK ), following the IHE PaLM transactions and the conventions of the NW GMSA HL7 v2 standards and the Digital Health and Care Wales HL7 ORU_R01 2.5.1 Implementation Guide
web digital.nhs.uk HL7 FHIR R4 for the same content, as FHIR Messages (the HL7 v2 equivalent) and FHIR Documents (the form used by the NHS England Pathology and Laboratory Medicine Reporting FHIR API )
web nw-gmsa.github.io Like the NW GMSA FHIR IG , it supports both HL7 v2 and FHIR rather than choosing one.
web digital.nhs.uk Laboratory orders and results for the specialisms covered by the NHS England Pathology and Laboratory Medicine Reporting standard ( DAPB4101 ): clinical biochemistry, haematology, immunology, transfusion medicine and microbiology (bacteriology, virology and serology)
web digital.nhs.uk Recommendation. Apply the content of DAPB4101 (SNOMED CT PaLM codes, units, report structure) to all laboratory reporting in England, not only to the NHS England API and GP systems - see IHE PaLM in England .
web kevinmayfield.github.io Cellular pathology and genomics reports - see the Cancer Pathology Report proof of concept and the NW GMSA FHIR IG
web nw-gmsa.github.io Cellular pathology and genomics reports - see the Cancer Pathology Report proof of concept and the NW GMSA FHIR IG
web github.com Notebooks (in the GitHub repository )
web www.ihe.net IHE PaLM Technical Framework - Volume 1 (profiles), Volume 2 (transactions), Volume 3 (content)
web digital.nhs.uk NHS England - Pathology and Laboratory Medicine Reporting FHIR API and the NHS England Pathology FHIR Implementation Guide
web digital.nhs.uk NHS England - Pathology and Laboratory Medicine Reporting: Test Result Stored Event
web nw-gmsa.github.io NW GMSA - HL7 v2 Standards
web nw-gmsa.github.io Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide (v2.0.0 STU, approved 22 March 2023)
web hl7.eu HL7 Europe Laboratory Report 2.1.0 and HL7 Europe Base and Core 2.0.1
web hl7.eu HL7 Europe Laboratory Report 2.1.0 and HL7 Europe Base and Core 2.0.1
web digital.nhs.uk Look up the Practitioners and Organizations referenced by identifier and add them as resources: organisations from the NHS England Organisation Data Service - the ODS APIs (ORD, or the ODS FHIR API) or the ODS CSV downloads ( epraccur.csv GP practices, etr.csv trusts); GP practitioners (GMP codes) from the ODS download egpcur.csv ; other clinicians from the system's own practitioner directory
web digital.nhs.uk Look up the Practitioners and Organizations referenced by identifier and add them as resources: organisations from the NHS England Organisation Data Service - the ODS APIs (ORD, or the ODS FHIR API) or the ODS CSV downloads ( epraccur.csv GP practices, etr.csv trusts); GP practitioners (GMP codes) from the ODS download egpcur.csv ; other clinicians from the system's own practitioner directory
web github.com Worked through for the NHS England examples in notebook 02-fhir-message-to-fhir-document ; the HL7 v2 to FHIR Message step is notebook 01-oru-r01-to-fhir-message , and the reverse (FHIR Document to ORU^R01 ) is scripts/nhse_document_to_oru.py
web github.com Worked through for the NHS England examples in notebook 02-fhir-message-to-fhir-document ; the HL7 v2 to FHIR Message step is notebook 01-oru-r01-to-fhir-message , and the reverse (FHIR Document to ORU^R01 ) is scripts/nhse_document_to_oru.py
web github.com Worked through for the NHS England examples in notebook 02-fhir-message-to-fhir-document ; the HL7 v2 to FHIR Message step is notebook 01-oru-r01-to-fhir-message , and the reverse (FHIR Document to ORU^R01 ) is scripts/nhse_document_to_oru.py
web digital.nhs.uk Recommendation: use the DAPB4101 codes on every route in England, not only to GP systems - see IHE PaLM in England . The NHS England DAPB4101 standard defines the PaLM SNOMED CT codes and their use. Laboratories map their local test codes to them (the PaLM mapping project). Where a local code has no PaLM code yet, send the local code with coding system L and flag the gap.
web www.england.nhs.uk Genomics has the National Genomic Test Directory and imaging has NICIP. For laboratory medicine the national list of tests that can be requested is the SNOMED CT UK Edition Pathology and laboratory medicine procedure simple reference set ( 1853561000000109 ) - the PaLM requestables , modelled as SNOMED CT procedures. Results are the PaLM reportables , the observables refset 1853551000000106 (and the older Pathology Bounded Code List 999002881000000100 ).
web hl7.eu HL7 Europe Laboratory, which this guide's profiles derive from, prefers LOINC: ServiceRequest.code is bound to lab-orderCodes-eu-lab (LOINC ORDER_OBS = Order or Both) and Observation.code to lab-obsCode-eu-lab , which includes lab-obsCode-loinc-eu-lab . A map from PaLM to LOINC lets England orders and reports also carry the LOINC code, as a second coding.

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