FHIR IG analytics| Package | fhir.nwgenomics.nhs.uk |
| Resource Type | Questionnaire |
| Id | Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/nw-gmsa/nw-gmsa.github.com/Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html |
| URL | https://fhir.nwgenomics.nhs.uk/Questionnaire/ChimerismTestAdditionalAskAtOrderQuestions |
| Version | 2.2.0 |
| Status | draft |
| Date | 2026-09-27T08:17:18+00:00 |
| Title | Chimerism Testing Blood (PB) Ask At Order Entry |
| Realm | us |
| Authority | hl7 |
| Description | **Test Specific Additional Ask At Order Entry Questions** used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) for the "Chimerism Testing Blood (PB)" order screen within Histocompatibility and Immunogenetics orders (SNOMED CT `909871000000100`) - the same "Test Specific" tier pattern [WGS Test Additional Ask At Order Entry Questions](Questionnaire-WGSTestAdditionalAskAtOrderQuestions.html) follows for WGS orders - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and [Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions). For the sibling HLA testing order screen, see [HLA Tests - Transplant Ask At Order Entry](Questionnaire-HLATestsTransplantAskAtOrderEntry.html). Extracted from the `NTE` segments of a live Histotrac `ORM^O01` order for a Chimerism Testing (Performable) test - see the worked [example](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry) for the full message. Unlike HLA Tests - Transplant, this order carries only two `NTE` segments, and in the reverse order (Specimen Source before Patient Test(s)). See also [Chimerism Testing Result Panel](Questionnaire-ChimerismResultPanel.html) for the (separate) structured *result* payload this order eventually produces. **Research summary**: as with [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html), no NHS England or NHSBT-published order-comms/interoperability standard was found specifically for Chimerism testing order entry. NHSBT's INF136 "User Guide for Histocompatibility and Immunogenetics Diagnostics Services" defines `FRM1010` "H&I Haematopoietic Stem Cell Transplantation (Recipients & Donors)" as the relevant national request form for post-transplant chimerism monitoring, but does not publish a FHIR/LOINC/SNOMED binding for the specific test-panel or specimen-source values Hive uses. See each item below for candidate LOINC/SNOMED codes. |
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire ChimerismTestAdditionalAskAtOrderQuestions
Profile: Questionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | **Test Specific Additional Ask At Order Entry Questions** used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) for the "Chimerism Testing Blood (PB)" order screen within Histocompatibility and Immunogenetics orders (SNOMED CT `909871000000100`) - the same "Test Specific" tier pattern [WGS Test Additional Ask At Order Entry Questions](Questionnaire-WGSTestAdditionalAskAtOrderQuestions.html) follows for WGS orders - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and [Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions). For the sibling HLA testing order screen, see [HLA Tests - Transplant Ask At Order Entry](Questionnaire-HLATestsTransplantAskAtOrderEntry.html). Extracted from the `NTE` segments of a live Histotrac `ORM^O01` order for a Chimerism Testing (Performable) test - see the worked [example](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry) for the full message. Unlike HLA Tests - Transplant, this order carries only two `NTE` segments, and in the reverse order (Specimen Source before Patient Test(s)). See also [Chimerism Testing Result Panel](Questionnaire-ChimerismResultPanel.html) for the (separate) structured *result* payload this order eventually produces. **Research summary**: as with [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html), no NHS England or NHSBT-published order-comms/interoperability standard was found specifically for Chimerism testing order entry. NHSBT's INF136 "User Guide for Histocompatibility and Immunogenetics Diagnostics Services" defines `FRM1010` "H&I Haematopoietic Stem Cell Transplantation (Recipients & Donors)" as the relevant national request form for post-transplant chimerism monitoring, but does not publish a FHIR/LOINC/SNOMED binding for the specific test-panel or specimen-source values Hive uses. See each item below for candidate LOINC/SNOMED codes. | Questionnaire | https://fhir.nwgenomics.nhs.uk/Questionnaire/ChimerismTestAdditionalAskAtOrderQuestions#2.2.0 | |
  AskAtOrderEntry | Ask At Order Entry Questions | 0..1 | group | |
  ChimIG/specimen | Specimen | 0..* | group | |
  ChimIG/specimen-designNote | Groups Specimen Type and Specimen Identifier as a single repeating unit, one per specimen taken - the FHIR/HL7 v2 shape [Outstanding Issues](HistocompatibilityAndImmunogenetics.html#outstanding-issues) item 3 anticipated for the `ORM_O01` → `OML_O21` move (an `SPM` segment per specimen, carrying Specimen ID and Specimen Type). Only Specimen Type was present on the live `ORM^O01` order sourcing this Questionnaire (see [Chimerism Testing Ask At Order Entry](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry)); Specimen Identifier is added ahead of that move so an `SPM-2` value has somewhere to go once Histotrac starts sending one. | 0..1 | display | |
 ChimIG/specimen_source | Specimen Source | 0..1 | choice | Definition: Specimen.type.coding.code Options: 2 options |
| ChimIG/specimen_source-designNote | Confirmed as this 2-value list (Blood, Bone marrow) from the Hive/Histotrac order-entry UI's Chimerism panel - a different list from the Blood/Buccal/Other list [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) uses for the same underlying `code` (LOINC `66746-9`), since the two order screens offer different specimen-source options in Hive. Coded against SNOMED CT (the EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set's own generic codes - `119297000` "Blood specimen" for Blood (PB), `119359002` "Bone marrow specimen" for Bone Marrow (BM)) rather than a local `NWGMSA` code, once converted onto `SPM-4` (`Specimen.type`) - see [Chimerism Testing Ask At Order Entry](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry). Deliberately given its own `ChimIG/specimen_source` linkId rather than reusing the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own `LN/66746-9` Specimen Type item - the IG Publisher's Questionnaire derivation validator does not support a `derivedFrom`/`extends` item reusing a base item's linkId while also declaring more than one `answerOption`. Ordered first within Specimen (before Specimen Identifier) to match `NTE|1` in the live Histotrac order - the reverse of HLA Tests - Transplant, where Patient Test(s) comes first. | 0..1 | display | |
| ChimIG/specimen_source-reference | Post-transplant chimerism monitoring conventionally uses peripheral blood, with bone marrow used for deeper/marrow-level engraftment assessment - consistent with this 2-value list. No dedicated NHS-published specimen-type binding specific to H&I chimerism testing was found; the generic [Specimen Type](ValueSet-specimen-type.html) SNOMED CT codes above are used instead. | 0..1 | display | |
 ChimIG/specimen_identifier | Specimen Identifier | 0..1 | string | Definition: Specimen.identifier |
| ChimIG/specimen_identifier-designNote | Not present on the live `ORM^O01` order this Questionnaire was extracted from (which carries no `SPM` segment) - added so the specimen carries its own identifier (`SPM-2`) once the order moves to `OML_O21`, the same reasoning as [Outstanding Issues](HistocompatibilityAndImmunogenetics.html#outstanding-issues) item 3. | 0..1 | display | |
| ChimIG/patient_test | Patient Test(s) | 0..* | choice | Definition: ServiceRequest.orderDetail Options: 4 options |
| ChimIG/patient_test-designNote | Which chimerism panel/lineage is being tested - the same Ask At Order Entry pattern as `HistoIG/patient_test` on [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) (`repeats = true`, since the Hive UI presents them as checkboxes - more than one may be selected per order). Confirmed as this fixed 5-value checklist from the Hive/Histotrac order-entry UI - coded locally against the `NWGMSA` CodeSystem, as no NHSBT/NHS England-published FHIR/LOINC/SNOMED binding exists. Ordered second (after Specimen Source) to match `NTE|2` in the live Histotrac order, whose NTE-3 value carries a `(PB)` suffix ("Chimerism Peripheral Blood (PB)") the Hive checkbox label itself doesn't show - the same OBR-4-restatement behaviour as HLA Tests - Transplant's Patient Test(s) item. Mapped to `ServiceRequest.orderDetail` rather than `ServiceRequest.code` - the same reasoning as that item: `ServiceRequest.code` is single-cardinality and already targeted by the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item, with no `enableWhen` to say which wins, while `orderDetail` is repeating and intended for exactly this kind of further order qualifier. | 0..1 | display | |
| ChimIG/patient_test-reference | No MFT/NHS England code set was found for these five specific test names. LOINC has short tandem repeat (STR)/chimerism-adjacent panels (e.g. `48018-6` Gene studied, engraftment-monitoring local codes used elsewhere in genetics laboratories) but no exact match for a CD3/CD15/CD19 lineage-specific chimerism checklist was confirmed - a candidate future binding if a coded alternative to the local `NWGMSA` codes is wanted. See also this IG's existing [Chimerism](CodeSystem-Chimerism.html) CodeSystem, which covers the *result* payload's OBX-3 sub-identifiers (STR/IM/RANGE/CV/EXT/PURE/POST/DTP/DID) rather than these order-entry test-selection values. | 0..1 | display | |
| Documentation for this format | ||||
Options Sets
Answer options for ChimIG/specimen_source
Answer options for ChimIG/patient_test
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "ChimerismTestAdditionalAskAtOrderQuestions",
"meta": {
"profile": [
"https://fhir.nwgenomics.nhs.uk/StructureDefinition/NWQuestionnaire"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm",
"valueCoding": {
"system": "http://hl7.org/fhir/version-algorithm",
"code": "semver"
}
}
],
"url": "https://fhir.nwgenomics.nhs.uk/Questionnaire/ChimerismTestAdditionalAskAtOrderQuestions",
"version": "2.2.0",
"title": "Chimerism Testing Blood (PB) Ask At Order Entry",
"derivedFrom": [
"https://fhir.nwgenomics.nhs.uk/Questionnaire/GenomicTestOrder"
],
"_derivedFrom": [
{
"extension": [
{
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"valueCoding": {
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"code": "extends"
}
}
]
}
],
"status": "draft",
"date": "2026-09-27T08:17:18+00:00",
"publisher": "NHS North West Genomics",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "https://www.nwgenomics.nhs.uk/contact-us"
}
]
}
],
"description": "**Test Specific Additional Ask At Order Entry Questions** used alongside the\n[common core order form](Questionnaire-GenomicTestOrder.html) for the\n\"Chimerism Testing Blood (PB)\" order screen within Histocompatibility and\nImmunogenetics orders (SNOMED CT `909871000000100`) - the same \"Test\nSpecific\" tier pattern [WGS Test Additional Ask At Order Entry\nQuestions](Questionnaire-WGSTestAdditionalAskAtOrderQuestions.html) follows\nfor WGS orders - see\n[Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and\n[Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions).\nFor the sibling HLA testing order screen, see\n[HLA Tests - Transplant Ask At Order Entry](Questionnaire-HLATestsTransplantAskAtOrderEntry.html).\n\nExtracted from the `NTE` segments of a live Histotrac `ORM^O01` order for a Chimerism\nTesting (Performable) test - see the worked\n[example](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry)\nfor the full message. Unlike HLA Tests - Transplant, this order carries only two `NTE`\nsegments, and in the reverse order (Specimen Source before Patient Test(s)). See also\n[Chimerism Testing Result Panel](Questionnaire-ChimerismResultPanel.html) for the\n(separate) structured *result* payload this order eventually produces.\n\n**Research summary**: as with [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html),\nno NHS England or NHSBT-published order-comms/interoperability standard was found\nspecifically for Chimerism testing order entry. NHSBT's INF136 \"User Guide for\nHistocompatibility and Immunogenetics Diagnostics Services\" defines `FRM1010` \"H&I\nHaematopoietic Stem Cell Transplantation (Recipients & Donors)\" as the relevant national\nrequest form for post-transplant chimerism monitoring, but does not publish a\nFHIR/LOINC/SNOMED binding for the specific test-panel or specimen-source values Hive\nuses. See each item below for candidate LOINC/SNOMED codes.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "GB",
"display": "United Kingdom of Great Britain and Northern Ireland"
}
]
}
],
"item": [
{
"linkId": "AskAtOrderEntry",
"text": "Ask At Order Entry Questions",
"type": "group",
"item": [
{
"linkId": "ChimIG/specimen",
"text": "Specimen",
"type": "group",
"repeats": true,
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "help"
}
]
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}
],
"linkId": "ChimIG/specimen-designNote",
"text": "Groups Specimen Type and Specimen Identifier as a single repeating unit, one per\nspecimen taken - the FHIR/HL7 v2 shape [Outstanding\nIssues](HistocompatibilityAndImmunogenetics.html#outstanding-issues) item 3\nanticipated for the `ORM_O01` → `OML_O21` move (an `SPM` segment per specimen,\ncarrying Specimen ID and Specimen Type). Only Specimen Type was present on the\nlive `ORM^O01` order sourcing this Questionnaire (see [Chimerism Testing Ask At\nOrder\nEntry](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry));\nSpecimen Identifier is added ahead of that move so an `SPM-2` value has somewhere\nto go once Histotrac starts sending one.",
"type": "display"
},
{
"linkId": "ChimIG/specimen_source",
"definition": "http://hl7.org/fhir/StructureDefinition/Specimen#Specimen.type.coding.code",
"code": [
{
"system": "http://loinc.org",
"code": "66746-9",
"display": "Specimen Type"
},
{
"system": "http://snomed.info/sct",
"code": "123038009",
"display": "Specimen"
}
],
"text": "Specimen Source",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "119359002",
"display": "Bone marrow specimen"
}
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "help"
}
]
}
}
],
"linkId": "ChimIG/specimen_source-designNote",
"text": "Confirmed as this 2-value list (Blood, Bone marrow) from the Hive/Histotrac\norder-entry UI's Chimerism panel - a different list from the Blood/Buccal/Other\nlist [HLA Tests -\nTransplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) uses for the\nsame underlying `code` (LOINC `66746-9`), since the two order screens offer\ndifferent specimen-source options in Hive. Coded against SNOMED CT (the EU/UK/NW-compatible\n[Specimen Type](ValueSet-specimen-type.html) value set's own generic codes -\n`119297000` \"Blood specimen\" for Blood (PB), `119359002` \"Bone marrow specimen\"\nfor Bone Marrow (BM)) rather than a local `NWGMSA` code, once converted onto\n`SPM-4` (`Specimen.type`) - see [Chimerism Testing Ask At Order\nEntry](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry).\nDeliberately given its own `ChimIG/specimen_source` linkId rather than reusing\nthe base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own\n`LN/66746-9` Specimen Type item - the IG Publisher's Questionnaire derivation\nvalidator does not support a `derivedFrom`/`extends` item reusing a base item's\nlinkId while also declaring more than one `answerOption`. Ordered first within\nSpecimen (before Specimen Identifier) to match `NTE|1` in the live Histotrac\norder - the reverse of HLA Tests - Transplant, where Patient Test(s) comes\nfirst.",
"type": "display"
},
{
"extension": [
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"valueCodeableConcept": {
"coding": [
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"code": "help"
}
]
}
}
],
"linkId": "ChimIG/specimen_source-reference",
"text": "Post-transplant chimerism monitoring conventionally uses peripheral blood, with\nbone marrow used for deeper/marrow-level engraftment assessment - consistent with\nthis 2-value list. No dedicated NHS-published specimen-type binding specific to\nH&I chimerism testing was found; the generic [Specimen\nType](ValueSet-specimen-type.html) SNOMED CT codes above are used instead.",
"type": "display"
}
]
},
{
"linkId": "ChimIG/specimen_identifier",
"definition": "http://hl7.org/fhir/StructureDefinition/Specimen#Specimen.identifier",
"text": "Specimen Identifier",
"type": "string",
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "help"
}
]
}
}
],
"linkId": "ChimIG/specimen_identifier-designNote",
"text": "Not present on the live `ORM^O01` order this Questionnaire was extracted from\n(which carries no `SPM` segment) - added so the specimen carries its own\nidentifier (`SPM-2`) once the order moves to `OML_O21`, the same reasoning as\n[Outstanding Issues](HistocompatibilityAndImmunogenetics.html#outstanding-issues)\nitem 3.",
"type": "display"
}
]
}
]
},
{
"linkId": "ChimIG/patient_test",
"definition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.orderDetail",
"text": "Patient Test(s)",
"type": "choice",
"repeats": true,
"answerOption": [
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "C1-Post-PB"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "C2-Post-CD3"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "C3-Post-CD15"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "C5-Post-BM"
}
}
],
"item": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/questionnaire-item-control",
"code": "help"
}
]
}
}
],
"linkId": "ChimIG/patient_test-designNote",
"text": "Which chimerism panel/lineage is being tested - the same Ask At Order Entry\npattern as `HistoIG/patient_test` on\n[HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html)\n(`repeats = true`, since the Hive UI presents them as checkboxes - more than one\nmay be selected per order). Confirmed as this fixed 5-value checklist from the\nHive/Histotrac order-entry UI - coded locally against the `NWGMSA` CodeSystem, as\nno NHSBT/NHS England-published FHIR/LOINC/SNOMED binding exists. Ordered second\n(after Specimen Source) to match `NTE|2` in the live Histotrac order, whose\nNTE-3 value carries a `(PB)` suffix (\"Chimerism Peripheral Blood (PB)\") the Hive\ncheckbox label itself doesn't show - the same OBR-4-restatement behaviour as HLA\nTests - Transplant's Patient Test(s) item. Mapped to `ServiceRequest.orderDetail`\nrather than `ServiceRequest.code` - the same reasoning as that item:\n`ServiceRequest.code` is single-cardinality and already targeted by the base\n[Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item,\nwith no `enableWhen` to say which wins, while `orderDetail` is repeating and\nintended for exactly this kind of further order qualifier.",
"type": "display"
},
{
"extension": [
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"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
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"coding": [
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"code": "help"
}
]
}
}
],
"linkId": "ChimIG/patient_test-reference",
"text": "No MFT/NHS England code set was found for these five specific test names. LOINC\nhas short tandem repeat (STR)/chimerism-adjacent panels (e.g. `48018-6` Gene\nstudied, engraftment-monitoring local codes used elsewhere in genetics\nlaboratories) but no exact match for a CD3/CD15/CD19 lineage-specific chimerism\nchecklist was confirmed - a candidate future binding if a coded alternative to\nthe local `NWGMSA` codes is wanted. See also this IG's existing\n[Chimerism](CodeSystem-Chimerism.html) CodeSystem, which covers the *result*\npayload's OBX-3 sub-identifiers (STR/IM/RANGE/CV/EXT/PURE/POST/DTP/DID) rather\nthan these order-entry test-selection values.",
"type": "display"
}
]
}
]
}
]
}