{{DISPLAYTITLE: Technical Design Lab2zorg v4.0.0-beta.1}}

''The Information Standard Lab Exchange consists of four different components: Lab2Zorg, Lab2Lab, Lab2PublicHealth, and Lab2Patient. These four components were developed independently of each other and are subject to continuous development. This is reflected in the Semantic Versioning (SemVer). Each component undergoes its own development process with its own corresponding numerical publications.''

{{IssueBox| The FHIR resource used for one of the use cases described in this technical design is DiagnosticReport. DiagnosticReport is not the preferred FHIR resource for the information standard Laboratory exchange. However, this resource has been chosen as it contains information about the order data. Optimally, order data could be linked directly to the preferred FHIR resource Observation via basedOn element. This will be updated in a future version.}}

<imagemap>Bestand:functioneel-technisch-banner_00_alle.png|center|240px|alt=Functioneel-Technisch
circle 204 216 215 [[L2z:v4.0.0_ontwerp_lab2zorg|Functional]]
circle 990 216 215 [[Lab:V3.0.0-B4_FHIR_Lab2zorg|Technical]]
desc none
</imagemap>

<big>For an overview of all current documentation [[Landingspagina_Labuitwisseling| see information standard lab exchange main page]]</big>

__NUMBEREDHEADINGS__

==Introduction==
[[Bestand:Functioneel-02.png|link=Lab:V3.0.0-b4_Ontwerp_Lab2zorg|100px|rechts|Functional design|Go to functional design]]

This is the technical design (TO) for the information standard (IS) Lab2zorg. This TO must be used together with the IS functional design, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]]. The data exchange format used in this version is: FHIR R4.

=== Support ===
For questions, feedback, or change requests, please contact our support team at [https://nictiz.atlassian.net/servicedesk/customer/portal/4 Nictiz Servicemanagement].

=== Boundaries ===
This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]].

=== Prerequisite knowledge ===
The following background information is required for understanding this TO:
* The [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]] accompanying this TO.
* The data exchange format FHIR R4, which you can find here:
** [[FHIR:V1.0 FHIR IG R4|general FHIR R4 Implementation Guide]],
** [[FHIR:V1.0_FHIR_IG_R4#FHIR_Packages|FHIR packages]],
** [[FHIR:V1.0_FHIR_IG_R4#Usage_of_the_.id.2C_.identifier_and_.fullUrl_elements_in_FHIR_instances|usage of the .id, .identifier and .fullUrl]].

== Relationships ==

The diagrams below show the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship.

For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource.

===Model overview for usecases without the request===

[[Bestand:FHIR-model-overview-L2Z-SLR-BLR.png]]

===Model overview for usecase with the request===

[[Bestand:FHIR-model-overview-L2P-LOA.png]]

==Components==

HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.

=== HL7 FHIR R4 ===
{{NoteBoxNictizR4Package|p1=nictiz.fhir.nl.r4.labexchange|v1=3.0.0-beta.4|p2=nictiz.fhir.nl.r4.nl-core|v2=0.12.0-labtrial.1|p3=nictiz.fhir.nl.r4.zib2020|v3=0.12.0-beta.1}}

==== Artifacts ====

The artifacts of the information standard are presented in the following table:
{| style="text-align: left; background-color: white;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! zib
! FHIR resource
! FHIR profile

|- style="background-color: #fcf0e9;"
| HealthcareProvider
| Organization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthcareProvider-Organization}}

|- style="background-color: #fcf0e9;"
| rowspan="2" | HealthProfessional
| Practitioner
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-Practitioner}}

|- style="background-color: #fcf0e9;"
| PractitionerRole
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-PractitionerRole}}

|- style="background-color: #fcf0e9;"
| rowspan="3" | LaboratoryTestResult
| Device
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen.Source|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.7.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen.Source}}

|- style="background-color: #fcf0e9;"
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-labtrial.1|title=nl-core-LaboratoryTestResult}}

|- style="background-color: #fcf0e9;"
| Specimen
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen}}

|- style="background-color: #fcf0e9;"
| Patient
| Patient
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-Patient}}

|- style="background-color: #fcf0e9;"
|
| DiagnosticReport
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-LaboratoryTestResult-DiagnosticReport|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-LaboratoryTestResult-DiagnosticReport}}

|- style="background-color: #fcf0e9;"
|
| ServiceRequest
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-OrderData|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-OrderData}}
|}

==== Examples of FHIR instances ====
You can find examples of FHIR-instances (filled-in FHIR profiles) in the Nictiz GitHub repository: [https://github.com/Nictiz/HL7-mappings/tree/master/ada_2_fhir-r4/lab/l2z-3.0.0 <nowiki>Lab exchange HL7-mappings repository</nowiki>].

== Transactions ==
=== Health professional orders lab tests and receives results ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Send laboratory results based on a request
| Send laboratory results based on a request || Client || LAB-LAS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}

|- style="background-color: #fcf0e9;"
| Receive laboratory results || Server || LAB-LAO

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LAS = Laboratoriumresultaat antwoord sturend (systeem), LAO = Laboratoriumresultaat antwoord ontvangend (systeem).''
|}

=== Health professional retrieves lab results ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Retrieve laboratory results (PULL)
| Retrieve laboratory results request || Client || LAB-LRR || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-RetrieveServe|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_RetrieveServe}}

|- style="background-color: #fcf0e9;"
| Retrieve laboratory results response || Server || LAB-LRB

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem).''
|}

==== FHIR Search parameters ====
The search interaction is performed by an HTTP GET in agreement with the [http://hl7.org/fhir/R4/search.html FHIR specification]. The table below lists search parameters for Observation resource that SHALL be supported for processing by servers and clients.

{| style="text-align: left; width: 100%" cellpadding=5px;
|- style="color: white; background-color: #e7844b;"
! Variation type || Variation || Permitted values (if limited) || Data type || Description

|- style="color: white; background-color: #eda778;"
! colspan="5" | category

|- style="background-color: #fcf0e9;"
| || || {{fhir|<nowiki>https://terminology.hl7.org/CodeSystem/observation-category|laboratory</nowiki>}} || {{fhir|token}} || Search on laboratory observations.

|- style="color: white; background-color: #eda778;"
! colspan="5" | patient

|- style="background-color: #fcf0e9;"
| modifier || {{fhir|identifier}} || {{fhir|<nowiki>http://fhir.nl/fhir/NamingSystem/bsn|[BSN]</nowiki>}} || {{fhir|token}} || Search in a specific patient context

|- style="color: white; background-color: #eda778;"
! colspan="5" | code

|- style="background-color: #fcf0e9;"
| code system || LOINC || {{fhir|<nowiki>http://loinc.org|[test code]</nowiki>}} || {{fhir|token}} || Search on the LOINC test code

|- style="background-color: #fcf0e9;"
| code system || NHG || {{fhir|<nowiki>https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|[test code]</nowiki>}} || {{fhir|token}} || Search on the NHG test code

|- style="color: white; background-color: #eda778;"
! colspan="5" | date

|- style="background-color: #fcf0e9;"
| prefix || {{fhir|gt}} || || {{fhir|date}} || Search on observation date later than the value

|- style="background-color: #fcf0e9;"
| prefix || {{fhir|lt}} || || {{fhir|date}} || Search on observation date earlier than the value

|- style="color: white; background-color: #eda778;"
! colspan="5" | _include

|- style="background-color: #fcf0e9;"
| modifier || {{fhir|iterate}} || || {{fhir|reference}} || Include linked resources iteratively

|- style="background-color: #fcf0e9;"
| resource || {{fhir|Patient}} || {{fhir|Observation:patient}} || {{fhir|reference}} || Include linked Patient resources in the response bundle

|- style="background-color: #fcf0e9;"
| resource || {{fhir|Organization}} || {{fhir|Observation:organization}} || {{fhir|reference}} || Include linked Organization resources in the response bundle

|- style="background-color: #fcf0e9;"
| resource || {{fhir|Specimen}} || {{fhir|Observation:specimen}} || {{fhir|reference}} || Include linked Specimen resources in the response bundle

|+ style="align: bottom; caption-side: bottom; text-align: left;" |
|}

For the Observation search, the parameters {{fhir|category}} and {{fhir|patient:identifier}} SHALL be included within every search request. The parameters {{fhir|code}}, {{fhir|_include}}, and {{fhir|_include:iterate}} can be repeated; {{fhir|code}} supports combination with AND or OR, while {{fhir|_include}} and {{fhir|_include:iterate}} support combination with AND only. In FHIR search, OR logic is used when multiple values are supplied for the same search parameter (comma-separated), meaning a resource matches if any of the values apply. AND logic is used when a search parameter is to be repeated, meaning the resource must satisfy all of the specified conditions.

==== FHIR Operations ====

Clients may invoke {{fhir|$lastn}} to retrieve the most recent Observation(s). The parameter {{fhir|max}} can optionally be provided to specify the number of observations to be returned. For more information on {{fhir|$lastn}}, consult [https://build.fhir.org/observation-operation-lastn.html $lastn operation].

==== FHIR Search examples ====

{| style="text-align: left; width: 100%;" cellpadding=5px;
|- style="color: white; background-color: #e7844b;"
! Examples

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 from 12 March 2022

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7&date=gt2022-12-03</pre>

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 between 12 March 2022 and 7 June 2022

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7&date=gt2022-12-03&date=lt2022-07-06</pre>

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) or 3583 (NHG) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7,https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|3583</pre>

|- style="color: white; background-color: #eda778;"
! Show the most recent laboratory result with test code 14683-7 (LOINC) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! Show the five most recent laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! Show the most recent laboratory result of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333</pre>

|+ style="align: bottom; caption-side: bottom; text-align: left;" |
|}

=== Health professional sends lab results to other health professional ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Send laboratory results (PUSH)
| Send laboratory results || Client || LAB-LRS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}

|- style="background-color: #fcf0e9;"
| Receive laboratory results || Server || LAB-LRO

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRS = Laboratoriumresultaat sturend (systeem), LRO = Laboratoriumresultaat ontvangend (systeem).''
|}

L2z:v4.0.0 FHIR lab2zorg

2026-06-04T11:54:07Z

2026-02-04T15:24:59Z

Michal Ciszewski: /* FHIR Operations */

{{DISPLAYTITLE:Technical Design Lab2zorg V3.0.0-beta.5}}
{{underconstruction}}

<imagemap>Bestand:functioneel-technisch-banner_00_alle.png|center|240px|alt=Functioneel-Technisch
circle 204 216 215 [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg|Functional]]
circle 990 216 215 [[Lab:V3.0.0-B3_FHIR_Lab2zorg|Technical]]
desc none
</imagemap>

<big>For an overview of all current documentation [[Lab:V3.0.0_Ontwerp_Laboverdacht| see information standard lab exchange main page]]</big>

__NUMBEREDHEADINGS__

==Introduction==
[[Bestand:Functioneel-02.png|link=Lab:V3.0.0-b4_Ontwerp_Lab2zorg|100px|rechts|Functional design|Go to functional design]]

This is the technical design (TO) for the information standard (IS) Lab2zorg. This TO must be used together with the IS functional design, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]]. The data exchange format used in this version is: FHIR R4.

=== Support ===
For questions, feedback, or change requests, please contact our support team at [https://nictiz.atlassian.net/servicedesk/customer/portal/4 Nictiz Servicemanagement].

=== Boundaries ===
This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]].

=== Prerequisite knowledge ===
The following background information is required for understanding this TO:
* The [[Lab:V3.0.0-b4_Ontwerp_Lab2zorg| functional design Lab2zorg 3.0.0-beta.4]] accompanying this TO.
* The data exchange format FHIR R4, which you can find here:
** [[FHIR:V1.0 FHIR IG R4|general FHIR R4 Implementation Guide]],
** [[FHIR:V1.0_FHIR_IG_R4#FHIR_Packages|FHIR packages]],
** [[FHIR:V1.0_FHIR_IG_R4#Usage_of_the_.id.2C_.identifier_and_.fullUrl_elements_in_FHIR_instances|usage of the .id, .identifier and .fullUrl]].

== Relationships ==

The diagrams below show the relationships between different FHIR profiles. The arrows indicate an “is referenced in” relationship.

For example, Patient → Laboratory Test means that the Patient is referenced within the Laboratory Test resource.

===Model overview for usecases without the request===

[[Bestand:FHIR-model-overview-L2Z-SLR-BLR.png]]

===Model overview for usecase with the request===

[[Bestand:FHIR-model-overview-L2P-LOA.png]]

==Components==

HL7 FHIR is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.

=== HL7 FHIR R4 ===
{{NoteBoxNictizR4Package|p1=nictiz.fhir.nl.r4.labexchange|v1=3.0.0-beta.4|p2=nictiz.fhir.nl.r4.nl-core|v2=0.12.0-labtrial.1|p3=nictiz.fhir.nl.r4.zib2020|v3=0.12.0-beta.1}}

==== Artifacts ====

The artifacts of the information standard are presented in the following table:
{| style="text-align: left; background-color: white;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! zib
! FHIR resource
! FHIR profile

|- style="background-color: #fcf0e9;"
| HealthcareProvider
| Organization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthcareProvider-Organization}}

|- style="background-color: #fcf0e9;"
| rowspan="2" | HealthProfessional
| Practitioner
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-Practitioner}}

|- style="background-color: #fcf0e9;"
| PractitionerRole
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-HealthProfessional-PractitionerRole}}

|- style="background-color: #fcf0e9;"
| rowspan="3" | LaboratoryTestResult
| Device
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen.Source|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.7.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen.Source}}

|- style="background-color: #fcf0e9;"
| Observation
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-labtrial.1|title=nl-core-LaboratoryTestResult}}

|- style="background-color: #fcf0e9;"
| Specimen
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-LaboratoryTestResult.Specimen|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-LaboratoryTestResult.Specimen}}

|- style="background-color: #fcf0e9;"
| Patient
| Patient
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient|nictiz.fhir.nl.r4.nl-core|pkgVersion=0.12.0-beta.1|title=nl-core-Patient}}

|- style="background-color: #fcf0e9;"
|
| DiagnosticReport
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-LaboratoryTestResult-DiagnosticReport|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-LaboratoryTestResult-DiagnosticReport}}

|- style="background-color: #fcf0e9;"
|
| ServiceRequest
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/lu-OrderData|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=lu-OrderData}}
|}

==== Examples of FHIR instances ====
You can find examples of FHIR-instances (filled-in FHIR profiles) in the Nictiz GitHub repository: [https://github.com/Nictiz/HL7-mappings/tree/master/ada_2_fhir-r4/lab/3.0.0 <nowiki>Lab exchange HL7-mappings repository</nowiki>].

== Transactions ==
=== Health professional orders lab tests and receives results ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Send laboratory results based on a request
| Send laboratory results based on a request || Client || LAB-LAS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}

|- style="background-color: #fcf0e9;"
| Receive laboratory results || Server || LAB-LAO

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LAS = Laboratoriumresultaat antwoord sturend (systeem), LAO = Laboratoriumresultaat antwoord ontvangend (systeem).''
|}

=== Health professional retrieves lab results ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Retrieve laboratory results (PULL)
| Retrieve laboratory results request || Client || LAB-LRR || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-RetrieveServe|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_RetrieveServe}}

|- style="background-color: #fcf0e9;"
| Retrieve laboratory results response || Server || LAB-LRB

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRR = Laboratoriumresultaat raadplegend (systeem), LRB = Laboratoriumresultaat beschikbaarstellend (systeem).''
|}

==== FHIR Search parameters ====
The search interaction is performed by an HTTP GET in agreement with the [http://hl7.org/fhir/R4/search.html FHIR specification]. The table below lists search parameters for Observation resource that SHALL be supported for processing by servers and clients.
{| style="text-align: left;" cellpadding=5px;
|- style="color: white; background-color: #e7844b;"
! Variations || Permitted values || Data type || Description

|- style="color: white; background-color: #eda778;"
! colspan="4" | category

|- style="background-color: #fcf0e9;"
| || <nowiki>https://terminology.hl7.org/CodeSystem/observation-category|laboratory</nowiki> || {{fhir|token}} || Search on laboratory observations.

|- style="color: white; background-color: #eda778;"
! colspan="4" | patient

|- style="background-color: #fcf0e9;"
| (modifier) {{fhir|identifier}} || <nowiki>http://fhir.nl/fhir/NamingSystem/bsn|[BSN]</nowiki> || {{fhir|token}} || Search in a specific patient context

|- style="color: white; background-color: #eda778;"
! colspan="4" | code

|- style="background-color: #fcf0e9;"
| rowspan="2" || <nowiki>http://loinc.org|[test code]</nowiki> || {{fhir|token}} || Search on the LOINC test code

|- style="background-color: #fcf0e9;"
| || <nowiki>https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|[test code]</nowiki> || {{fhir|token}} || Search on the NHG test code

|- style="color: white; background-color: #eda778;"
! colspan="4" | date

|- style="background-color: #fcf0e9;"
| (prefix) {{fhir|gt}} || || {{fhir|date}} || Search on observation date later than the value

|- style="background-color: #fcf0e9;"
| (prefix) {{fhir|lt}} || || {{fhir|date}} || Search on observation date earlier than the value

|- style="color: white; background-color: #eda778;"
! colspan="4" | _include

|- style="background-color: #fcf0e9;"
| Specimen || Observation:specimen || {{fhir|reference}} || Include linked resources in the response bundle

|- style="background-color: #fcf0e9;"
| Patient || Observation:patient || {{fhir|reference}} || Include linked resources in the response bundle

|- style="background-color: #fcf0e9;"
| Organization || Observation:organization || {{fhir|reference}} || Include linked resources in the response bundle

|- style="background-color: #fcf0e9;"
| {{fhir|_include:iterate}} || || {{fhir|reference}} || Include linked resources iteratively

|+ style="align: bottom; caption-side: bottom; text-align: left;" |
|}

For the Observation search, the parameters {{fhir|category}} and {{fhir|patient:identifier}} SHALL be included within every search request. The parameters {{fhir|code}}, {{fhir|_include}}, and {{fhir|_include:iterate}} can be repeated; {{fhir|code}} supports combination with AND or OR, while {{fhir|_include}} and {{fhir|_include:iterate}} support combination with AND only. In FHIR search, OR logic is used when multiple values are supplied for the same search parameter (comma-separated), meaning a resource matches if any of the values apply. AND logic is used when a search parameter is to be repeated, meaning the resource must satisfy all of the specified conditions.

==== FHIR Operations ====

Clients may invoke {{fhir|$lastn}} to retrieve the most recent Observation(s). The parameter {{fhir|max}} can optionally be provided to specify the number of observations to be returned. For more information on {{fhir|$lastn}}, consult [https://build.fhir.org/observation-operation-lastn.html $lastn operation].

==== FHIR Search examples ====

{| style="text-align: left; width: 100%;" cellpadding=5px;
|- style="color: white; background-color: #e7844b;"
! Examples

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 from 12 March 2022

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7&date=gt2022-12-03</pre>

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333 between 12 March 2022 and 7 June 2022

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7&date=gt2022-12-03&date=lt2022-07-06</pre>

|- style="color: white; background-color: #eda778;"
! Show all laboratory results with test code 14683-7 (LOINC) or 3583 (NHG) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7,https://referentiemodel.nhg.org/tabellen/nhg-tabel-45-diagnostische-bepalingen|3583</pre>

|- style="color: white; background-color: #eda778;"
! Show the most recent laboratory result with test code 14683-7 (LOINC) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! Show the five most recent laboratory results with test code 14683-7 (LOINC) of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation/$lastn?max=5&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333&code=http://loinc.org|14683-7</pre>

|- style="color: white; background-color: #eda778;"
! Show the most recent laboratory result of the patient with BSN 111222333

|- class="mw-collapsible mw-collapsed" style="background-color: #fcf0e9;"
| <pre>GET [base]/Observation/$lastn?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&patient:identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333</pre>

|+ style="align: bottom; caption-side: bottom; text-align: left;" |
|}

=== Health professional sends lab results to other health professional ===
==== Involved actors ====
{| style="text-align: left;" cellpadding=5px;

|- style="color: white; background-color: #e7844b;"
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement

|- style="background-color: #fcf0e9;"
| rowspan="2" | Send laboratory results (PUSH)
| Send laboratory results || Client || LAB-LRS || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/Lab2Healthcare-Results-SendReceive|nictiz.fhir.nl.r4.labexchange|pkgVersion=3.0.0-beta.4|title=Lab2Healthcare_Results_SendReceive}}

|- style="background-color: #fcf0e9;"
| Receive laboratory results || Server || LAB-LRO

|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: LAB = Laboratorium, LRS = Laboratoriumresultaat sturend (systeem), LRO = Laboratoriumresultaat ontvangend (systeem).''
|}