Messaging Specifications

Product Vision Statement

For producers and consumers of pathology diagnostics within the NHS

Who need federated sharing of pathology requests and results

The FHIR pathology message realises an information model that structures SNOMED CT coded elements of the pathology request, investigation and reporting process whilst preserving the relationships between the process components.

That is the current recommended interface serialisation method for modern healthcare systems


This product - FHIR - carries the data model which has been mapped to published FHIR resources and their attributes, is compatible with SNOMED CT, is easily implementable and supports RESTful request & response transactions.


The pathology messaging work is one of four workstreams of an over arching programme of work to plan for system-wide enhancement of basic pathology data exchanges.  The objective of this enhancement is to ensure data exchange is interoperable and machine-readable, to support one of the CCIO priorities – pathology information sharing. 

We are working on replacing the current EDIFACT & READ code based PMIP messaging standard with a generic FHIR message capable of supporting multiple pathology workflows. The messaging workstream will design and publish FHIR based CareConnect profiles to support the sharing of pathology information (requests and results).

Results are more clinically significant than requests. 

  • Requests/ordering of tests in both primary and secondary care is offered via vendor provided portals, which are then interpreted by labs to perform tests ordered by clinicians
  • Since clinicians are often are more interested in the results of a test they have ordered, this work will prioritise the development & use of information standards for results over requests.

The delivery of FHIR messaging to facilitate the above will:

  • Reduce the clinical and administrative time taken to review and extract important information, providing efficiency benefits to NHS providers
  • Improve clinical safety by reducing the risk of misinterpretation of results
  • Improve data quality for secondary uses, providing benefits to the commissioners of pathology services


The following scenarios provide a mapping between a set of basic pathology (in this context, basic pathology is defined as those processes relating to haematology and biochemistry test requesting and reporting) related scenario descriptions and the FHIR resources that could be used to support the implementation of those scenarios.  For each of the key entities included in the scenarios, a proposed FHIR resource is referenced. 

FHIR Profiles and Implementation Guidance

New draft CareConnect FHIR profiles for DiagnosticReport, ProcedureRequest and Specimen, together with an existing profile for Observation, are available here:

Draft FHIR Implementation Guidance for National Pathology reporting is available here:


  • Liaised with internal stakeholders to understand potential options around adding additional content and improvements to the message. 

  • Commenced message curation with INTEROPen, February 2019 with GP Connect and GP to GP programmes 

  • Internal design activity completed prior to the start of curation 

  • HL7 FHIR message specification and implementation guidance published.

For previous Done / Planned milestones please visit our Newsletter Archive.