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Source1

{
  "resourceType": "ExampleScenario",
  "id": "BiopsyProcedure",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "url": "https://fhir.nwgenomics.nhs.uk/ExampleScenario/BiopsyProcedure",
  "version": "0.1.0",
  "name": "Biopsy Procedure",
  "status": "draft",
  "date": "2026-02-10T04:20:28+00:00",
  "publisher": "NHS North West Genomics",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nwgenomics.nhs.uk/contact-us"
        }
      ]
    }
  ],
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "GB",
          "display": "United Kingdom of Great Britain and Northern Ireland"
        }
      ]
    }
  ],
  "actor": [
    {
      "actorId": "nurse",
      "type": "entity",
      "name": "Nurse",
      "description": "TODO"
    },
    {
      "actorId": "forms",
      "type": "entity",
      "name": "Form Manager",
      "description": "This may be part of the EPR or be paper based"
    },
    {
      "actorId": "epr",
      "type": "entity",
      "name": "Electronic Patient Record",
      "description": " [Provider Information Source](ActorDefinition-ProviderInformationSource.html) "
    },
    {
      "actorId": "patient",
      "type": "entity",
      "name": "Patient/relative/carer",
      "description": "TODO"
    },
    {
      "actorId": "consultant",
      "type": "entity",
      "name": "Consultant",
      "description": "TODO"
    },
    {
      "actorId": "laboratory",
      "type": "entity",
      "name": "Diagnostic Testing",
      "description": "TODO"
    }
  ],
  "instance": [
    {
      "resourceId": "Request1",
      "resourceType": "Questionnaire",
      "name": "Query Questionnaire",
      "description": "Query for Froms: `GET https://example.nhs.uk/FHIR/R4/Questionnaire`"
    },
    {
      "resourceId": "Request2",
      "resourceType": "Observation",
      "name": "Query Observation and MedicationRequest"
    },
    {
      "resourceId": "Request3",
      "resourceType": "QuestionnaireResponse",
      "name": "Create QuestionnaireResponse"
    },
    {
      "resourceId": "Request4",
      "resourceType": "Observation",
      "name": "Create Observation and MedicationStatement from QuestionnaireResponse"
    },
    {
      "resourceId": "Reply1",
      "resourceType": "Binary",
      "name": "Dummy"
    },
    {
      "resourceId": "Reply3",
      "resourceType": "Binary",
      "name": "Dummy"
    },
    {
      "resourceId": "Request5",
      "resourceType": "Procedure",
      "name": "Update Procedure -Biopsy",
      "version": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString": "Procedure Liver Biopsy"
            },
            {
              "url": "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference": {
                "reference": "Procedure/13240a3b-d1db-4f1a-ad7d-b19f23967060"
              }
            }
          ],
          "versionId": "1"
        }
      ]
    },
    {
      "resourceId": "Request6",
      "resourceType": "Specimen",
      "name": "Update Specimen"
    },
    {
      "resourceId": "Request7",
      "resourceType": "Specimen",
      "name": "Update Specimen with tracking number"
    },
    {
      "resourceId": "Reply5",
      "resourceType": "Binary",
      "name": "Dummy"
    },
    {
      "resourceId": "Reply6",
      "resourceType": "Binary",
      "name": "Dummy"
    },
    {
      "resourceId": "Reply7",
      "resourceType": "Binary",
      "name": "Dummy"
    },
    {
      "resourceId": "Request8",
      "resourceType": "Observation",
      "name": "Create Observation - Vital Signs"
    },
    {
      "resourceId": "Request9",
      "resourceType": "Binary",
      "name": "Create Disharge Letter"
    },
    {
      "resourceId": "Reply8",
      "resourceType": "Binary",
      "name": "Dummy"
    },
    {
      "resourceId": "Reply9",
      "resourceType": "Binary",
      "name": "Dummy"
    }
  ],
  "process": [
    {
      "title": "Admission",
      "description": "Admit Patient. The process roughly follows [FHIR Structured Data Capture](https://build.fhir.org/ig/HL7/sdc)",
      "preConditions": "Test Order has been created ([Genomic Test Order Process](ExampleScenario-GenomicTestOrderProcess.html))",
      "step": [
        {
          "operation": {
            "number": "1",
            "type": "search-type",
            "name": "Select Admission Forms",
            "initiator": "nurse",
            "receiver": "forms",
            "description": "This may be paper based",
            "request": {
              "resourceId": "Request1"
            },
            "response": {
              "resourceId": "Reply1"
            }
          }
        },
        {
          "operation": {
            "number": "2",
            "type": "create",
            "name": "Pre-populate Admission Form",
            "initiator": "forms",
            "receiver": "epr",
            "description": "If using electronic forms and their is a connection to an EPR or Health Information Exchange - the forms may be pre-populated ",
            "request": {
              "resourceId": "Request2"
            }
          }
        },
        {
          "operation": {
            "number": "3",
            "type": "read",
            "name": "Complete Admission Form. ",
            "initiator": "nurse",
            "receiver": "patient",
            "description": "This includes enquiring about the patients medical history, such as conditions and medications. This also includes taking the patient vital signs - device data may be automatically uploaded into the EPR. ",
            "request": {
              "resourceId": "Request3"
            },
            "response": {
              "resourceId": "Reply3"
            }
          }
        },
        {
          "operation": {
            "number": "4",
            "type": "create",
            "name": "Complete Admission Form. ",
            "initiator": "nurse",
            "receiver": "forms",
            "description": "Enter answers to questions in the forms. The end of this process is likely to be signalled via a **IHE Patient Administration** HL7 v2 ADT Admission event. ",
            "request": {
              "resourceId": "Request4"
            }
          }
        }
      ]
    },
    {
      "title": "Perform Biopsy",
      "description": "Perform Biopsy Procedure",
      "step": [
        {
          "operation": {
            "number": "5",
            "type": "create",
            "name": "Document Procedure - Record procedure details",
            "initiator": "consultant",
            "receiver": "epr",
            "description": "TODO",
            "request": {
              "resourceId": "Request5"
            }
          }
        },
        {
          "operation": {
            "number": "6",
            "type": "update",
            "name": "Document Procedure - Update specimen details",
            "initiator": "nurse",
            "receiver": "epr",
            "description": "Ideally the updated specimen record should result in an update to the original order.  ",
            "request": {
              "resourceId": "Request6"
            }
          }
        },
        {
          "operation": {
            "number": "7",
            "type": "create",
            "name": "Send specimen",
            "initiator": "nurse",
            "receiver": "laboratory",
            "description": "If the specimen is being sent via a courier, then the specimen record should be updated with a tracking id ",
            "request": {
              "resourceId": "Request7"
            }
          }
        }
      ]
    },
    {
      "title": "Monitor and Discharge Patient",
      "description": "Monitor patient post procedure and Discharge Patient",
      "step": [
        {
          "operation": {
            "number": "8",
            "type": "update",
            "name": "Monitor Patient - Update specimen details",
            "initiator": "nurse",
            "receiver": "epr",
            "description": "This probably includes taking of vital signs to ensure the patient is stable ",
            "request": {
              "resourceId": "Request8"
            }
          }
        },
        {
          "operation": {
            "number": "9",
            "type": "update",
            "name": "Discharge Patient",
            "initiator": "nurse",
            "receiver": "epr",
            "description": "This includes a **IHE Patient Administration** - HL7 v2 ADT Discharge event and may include clinical notes",
            "request": {
              "resourceId": "Request9"
            }
          }
        }
      ]
    }
  ]
}