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Owning committee name


Committee Approval Date:

2017-01-19 - in principal

2017-03-30 - content

Contributing or Reviewing Work Groups


FHIR Resource Development Project Insight ID

Ordering Service Interface Specification Project (1010)

Scope of coverage

SpecimenDefinition will define a kind of specimen, which can be associated with in vitro diagnostic procedures described in a catalog of orderable services. SpecimenDefinition describes the kind of specimen to be collected from the subject of these procedures as well as the requirements applying to the collection activity, the preparation of the subject for this collection. This resource also describes the associated type(s) of specimen conditioned for testing, which are the output of the specimen collection activity. A specimen conditioned for testing is described with the type(s) of container and possible additive to be used, the minimal and normal volumes of collection, the conditions of storage, transportation and handling for the specimen once collected and conditioned. This resource is a necessary building block of a sharable catalog of orderable in vitro diagnostic services. The subjects of these orderable services may be human patients, non-human living subjects or non-living materials such as water, surfaces, medical devices ... All sub-specialties of clinical and anatomic pathology latoratories are concerned, as well as all care services prone to order in vitro diagnostic services to those laboratories. A catalog of orderable services generally belongs to a specific laboratory or facility. Nonetheless, the data items used to build this catalog are of universal meaning and interest.

RIM scope

The correspondence of the new resource SpecimenDefinition with V3 can be established with the R_Specimen lite CMET (COCT_RM080200UV). The parts of this CMET, which are relevant for the proposed resource are:
- Entry point Specimen (role)
- Natural (entity playing this role)
- SpecimenContainer (role of specimen natural in a container)
- Container (entity scoping this role)
- SpecimenCollectionProcess (act whose specimen is a productOf),
- ActDefinition (the definition of the specimen collection procedure)

Resource appropriateness

SpecimenDefinition is a definitional resource conformant to the Definition pattern.

A SpecimenDefinition resource defines a kind of specimen with the associated set of requirements applying to the collection and provision of specimens of this kind. From this definition, Specimen resources representing actual specimens of the defined kind can be instantiated.

This type of resource is indispensable in a catalog of orderable in vitro diagnostic services. In such a catalog, all diagnostic services that require the same kind of specimen and associated set of requirements, reference the same instance of SpecimenDefinition, which is, thus, defined and identified once in the catalog. This resource helps with the creation and maintenance of the catalog: When defining or updating the definition of an in vitro diagnostic service in the catalog, one does not need to express again all the detailed properties and associated requirements of the kind of specimen needed by this service. Instead, one searches for the appropriate kind of specimen defined in the catalog, and references it.

The goal of catalogs of orderable diagnostic services is to provide guidance to clinicians for ordering these services, and to specimen collectors for obtaining and delivering the specimens needed for the execution of these services.

The exchange of catalogs is standardized in V2 by a set of Master Files messages (chapter 8), further refined by implementation guides such as the eDOS implementation guide for the US realm, and the IHE LCSD profile for the UV realm. The #1010 project of O&O, among other things, transposes these specifications into the FHIR standard.

Expected implementations

  • Cognitive Medical Systems, Inc
  • Intermountain Healthcare
  • Phast
  • Medlinx
  • Quest Diagnostics

Content sources

The main source of specifications is represented by:

  • HL7 v2.8.2 and >, chapter 8 "Master files", segment OM4, message structures MFN^M08 & MFN^M10 ;
  • The electronic Directory of Services (eDOS) implementation guide constraining these message structures for the US realm ;
  • The IHE Laboratory Code Set Distribution (LCSD) profile doing the same for the UV realm, however based on HL7 2.5 and 12 years old.

Example Scenarios

  • CPOE of a healthcare institution deriving the specimen collection plan from a set of test orders placed to a laboratory.
  • Ambulatory phlebotomists checking which specimens are expected for the test orders related to their patients.

Resource Relationships

  • SpecimenDefinition is referenced by ActivityDefinition and ObservationDefinition, both of which are also definitional resources.
  • SpecimenDefinition references (Practitioner |PractitionerRole | Organization) as the publisher of this resource.
  • SpecimenDefinition references (Group) as the definition of the intended subject for collection of that kind of specimen.
  • SpecimenDefinition references Substance to describe additives to be used in the production of specimens of this kind.
  • Specimen resources can be instantiated from the definition provided by SpecimenDefinition, using the $apply operation.


The Ordering Service Interface Specification Project (#1010) is aiming at the September 2017 ballot.

gForge Users

N/A: Identified contributors already have a gForge account.

François Macary, Rob Hausam

When Resource Proposal Is Complete

When you have completed your proposal, please send an email to