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Packagesynapxe.sgcdi
Resource TypeBundle
IdBundleGenomicsReportDocumentResponse.Example.json
FHIR VersionR5

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Source1

{
  "resourceType": "Bundle",
  "type": "searchset",
  "total": 1,
  "timestamp": "2026-07-29T14:30:30+08:00",
  "link": [
    {
      "relation": "self",
      "url": "[baseurl]/DiagnosticReport/$retrieve?patient.identifier=https://fhir.synapxe.sg/NamingSystem/nric|S9876543D&category=GE"
    }
  ],
  "entry": [
    {
      "fullUrl": "DiagnosticReport/genomicsreport-2026-001",
      "resource": {
        "resourceType": "DiagnosticReport",
        "id": "genomicsreport-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-genomicsreport"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Genomic Analysis Report</h1><h2>Patient: Jane Doe (S9876543D)</h2><h2>Report Date: 2026-07-29</h2><h2>Status: Final</h2><h2>Findings</h2><p><strong>BRCA1 Mutation Detected</strong></p><p>A pathogenic BRCA1 mutation (c.68_69delAG, p.E23Vfs*17) has been identified in the patient's germline DNA in heterozygous state.</p><h3>Genetic Variant Details:</h3><ul><li>Gene: BRCA1 (HGNC:1100)</li><li>Mutation: c.68_69delAG</li><li>Protein Impact: p.E23Vfs*17</li><li>Allelic State: Heterozygous</li><li>Clinical Significance: Pathogenic</li></ul><h3>Molecular Biomarker:</h3><ul><li>BRCA1 mRNA Expression: 2.5-fold change relative to control</li></ul><h2>Clinical Interpretation</h2><p>The detected BRCA1 mutation is associated with significantly increased lifetime risk of breast and ovarian cancers. Genetic counseling and preventive measures are strongly recommended.</p><h2>Recommendations</h2><ul><li>Genetic counseling for the patient and at-risk family members</li><li>Consideration of prophylactic hormone therapy or preventive mastectomy</li><li>Enhanced surveillance protocols</li></ul><h2>Interpretation</h2><p>Dr. John Smith (M45678)<br/>Singapore Genomics Laboratory (HCI-98765)</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/record-id",
            "value": "GR-2026-07-29-001"
          },
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/accession-no",
            "value": "ACC-2026-07-29-001"
          }
        ],
        "status": "final",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "51969-4",
              "display": "Genetic analysis report"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "reference": "Patient/genomics-patient-2026-001"
        },
        "issued": "2026-07-29T14:30:00+08:00",
        "performer": [
          {
            "type": "Organization",
            "identifier": {
              "system": "https://fhir.synapxe.sg/NamingSystem/hci-code",
              "value": "HCI-98765"
            }
          }
        ],
        "resultsInterpreter": [
          {
            "type": "Practitioner",
            "identifier": {
              "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
              "value": "M45678"
            }
          }
        ],
        "specimen": [
          {
            "type": "Specimen",
            "reference": "Specimen/genomics-specimen-2026-001"
          }
        ],
        "result": [
          {
            "type": "Observation",
            "reference": "Observation/variant-2026-001"
          },
          {
            "type": "Observation",
            "reference": "Observation/biomarker-2026-001"
          }
        ],
        "conclusion": "Pathogenic BRCA1 mutation detected. c.68_69delAG (p.E23Vfs*17) identified in heterozygous state. Recommend genetic counseling and preventive measures.",
        "extension": [
          {
            "url": "https://fhir.synapxe.sg/StructureDefinition/ext-recommended-action",
            "valueReference": {
              "type": "Task",
              "reference": "Task/medicationrecommendation-2026-001"
            }
          }
        ],
        "basedOn": [
          {
            "type": "ServiceRequest",
            "reference": "ServiceRequest/genomics-sr-2026-001"
          }
        ]
      }
    },
    {
      "fullUrl": "Observation/variant-2026-001",
      "resource": {
        "resourceType": "Observation",
        "id": "variant-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-variant"
          ]
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                "code": "laboratory"
              }
            ]
          },
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code": "GE"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "69548-6",
              "display": "Genetic variation - BRCA1"
            }
          ]
        },
        "component": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "48018-6",
                  "display": "Gene symbol"
                }
              ]
            },
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://www.genenames.org",
                  "code": "HGNC:1100",
                  "display": "BRCA1"
                }
              ]
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "48004-6",
                  "display": "DNA change (c.HGVS)"
                }
              ]
            },
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://varnomen.hgvs.org",
                  "code": "c.68_69delAG",
                  "display": "c.68_69delAG (p.E23Vfs*17)"
                }
              ]
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "53034-5",
                  "display": "Allelic state"
                }
              ]
            },
            "valueString": "Heterozygous"
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "53037-8",
                  "display": "Clinical significance"
                }
              ]
            },
            "valueString": "Pathogenic"
          }
        ]
      }
    },
    {
      "fullUrl": "Observation/biomarker-2026-001",
      "resource": {
        "resourceType": "Observation",
        "id": "biomarker-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-molecularbiomarker"
          ]
        },
        "status": "final",
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                "code": "laboratory"
              }
            ]
          },
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code": "GE"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "48676-1",
              "display": "Molecular biomarker"
            }
          ]
        },
        "component": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "48018-6",
                  "display": "Gene symbol"
                }
              ]
            },
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://www.genenames.org",
                  "code": "HGNC:1100",
                  "display": "BRCA1"
                }
              ]
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "31881-7",
                  "display": "mRNA expression"
                }
              ]
            },
            "valueQuantity": {
              "value": 2.5,
              "unit": "fold change",
              "system": "http://unitsofmeasure.org",
              "code": "{fold}"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "Specimen/genomics-specimen-2026-001",
      "resource": {
        "resourceType": "Specimen",
        "id": "genomics-specimen-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-genomics-specimen"
          ]
        },
        "type": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "122555007",
              "display": "Venous blood specimen"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "reference": "Patient/genomics-patient-2026-001"
        },
        "receivedTime": "2026-07-28T09:15:00+08:00",
        "collection": {
          "collectedDateTime": "2026-07-27T14:00:00+08:00"
        }
      }
    },
    {
      "fullUrl": "ServiceRequest/genomics-sr-2026-001",
      "resource": {
        "resourceType": "ServiceRequest",
        "id": "genomics-sr-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-genomics-servicerequest"
          ]
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/order-id",
            "value": "SR-2026-07-20-001"
          }
        ],
        "status": "completed",
        "intent": "order",
        "code": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "47528-5",
              "display": "Genetic testing"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "reference": "Patient/genomics-patient-2026-001"
        },
        "authoredOn": "2026-07-20T10:00:00+08:00",
        "requester": {
          "type": "Practitioner",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
            "value": "M34567"
          }
        }
      }
    },
    {
      "fullUrl": "Patient/genomics-patient-2026-001",
      "resource": {
        "resourceType": "Patient",
        "id": "genomics-patient-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-genomics-patient"
          ]
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S9876543D"
          }
        ],
        "name": [
          {
            "use": "official",
            "text": "Jane Doe"
          }
        ],
        "birthDate": "1980-05-15",
        "gender": "female"
      }
    },
    {
      "fullUrl": "Task/medicationrecommendation-2026-001",
      "resource": {
        "resourceType": "Task",
        "id": "medicationrecommendation-2026-001",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2026-07-29T14:30:30+08:00",
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-medicationrecommendation"
          ]
        },
        "status": "proposed",
        "intent": "proposal",
        "code": {
          "coding": [
            {
              "system": "https://fhir.synapxe.sg/CodeSystem/medicationrecommendation-code",
              "code": "clinical-protocol",
              "display": "Clinical Protocol"
            }
          ]
        },
        "focus": {
          "type": "MedicationStatement",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/medication-statement-id",
            "value": "MS-BRCA1-PREVENTIVE-001"
          }
        },
        "description": "Consider prophylactic hormone therapy or preventive mastectomy. Genetic counseling recommended for family members."
      }
    }
  ]
}