DSP FHIR

Laboratory order

DSP lab orders map onto ServiceRequest with category=laboratory. The lab concept is a LOINC-coded CodeableConcept in ServiceRequest.code, and sample_type becomes a Specimen resource.

DSP content_type

order.laboratory

FHIR target

ServiceRequest (category=laboratory) + Specimen

Field-by-field

DSPFHIR R4Notes
type: LAB_ORDERServiceRequest.category = laboratoryUse http://snomed.info/sct|108252007.
intentServiceRequest.intent
descriptionServiceRequest.code.text
order_data.lab.codes (LOINC)ServiceRequest.code.coding[]
order_data.lab_abbreviationExtension abbreviation"CMP" / "CBC".
order_data.sample_typeServiceRequest.specimen → Specimen.typeSNOMED specimen codes.
order_data.lab_instructionsServiceRequest.note.text
order_data.patient_instructionsServiceRequest.patientInstruction
reason / reason_referencesreasonCode / reasonReference
confidence_scoreDSP extension

Side-by-side example

DSP

{
  "id": "a61aa82032764e389481dba3dc090748",
  "type": "LAB_ORDER",
  "context": { "content_type": "order.laboratory" },
  "description": "Comprehensive metabolic panel to assess kidney function",
  "intent": "order",
  "order_data": {
    "lab": {
      "text": "Comprehensive metabolic panel to assess kidney function",
      "codes": [{
        "system":"LOINC","code":"24323-8",
        "description":"Comprehensive metabolic 2000 panel"
      }]
    },
    "lab_abbreviation": "CMP",
    "sample_type": "blood",
    "lab_instructions": "Fasting specimen preferred",
    "patient_instructions": "Fast for 8-12 hours before blood draw. Repeat in 3 months."
  },
  "confidence_score": 1.0
}

FHIR R4 (DSP-FHIR profile)

{
  "resourceType":"ServiceRequest",
  "status":"active","intent":"order",
  "category":[{"coding":[{"system":"http://snomed.info/sct","code":"108252007","display":"Laboratory procedure"}]}],
  "code":{
    "text":"Comprehensive metabolic panel to assess kidney function",
    "coding":[{"system":"http://loinc.org","code":"24323-8"}]
  },
  "specimen":[{"reference":"Specimen/spec-1"}],
  "patientInstruction":"Fast for 8-12 hours before blood draw. Repeat in 3 months.",
  "note":[{"text":"Fasting specimen preferred"}],
  "subject":{"reference":"Patient/pat-67890"},
  "encounter":{"reference":"Encounter/enc-12345"},
  "extension":[
    {"url":"https://dsp-fhir.org/StructureDefinition/abbreviation","valueString":"CMP"},
    {"url":"https://dsp-fhir.org/StructureDefinition/confidence-score","valueDecimal":1.0}
  ]
}

// Companion Specimen resource
{
  "resourceType":"Specimen",
  "id":"spec-1",
  "type":{"coding":[{"system":"http://snomed.info/sct","code":"119297000","display":"Blood specimen"}]},
  "subject":{"reference":"Patient/pat-67890"}
}

DSP → FHIR mapping

Skeleton for DspLabOrder → ServiceRequest(category=laboratory). The companion Specimen is created by a sibling group not shown here.

map "https://dsp-fhir.org/StructureMap/DspLabOrderToServiceRequest" = "DspLabOrderToServiceRequest"

uses "https://dsp-fhir.org/StructureDefinition/DspOrderLabResource" alias DspLabOrder as source
uses "http://hl7.org/fhir/StructureDefinition/ServiceRequest" alias ServiceRequest as target

group DspLabOrderToServiceRequest(source src : DspLabOrder, target tgt : ServiceRequest) {
  src.id as id -> tgt.id = id;
  src -> tgt.status = 'active';
  src -> tgt.intent = 'order';
  src -> tgt.category as cat, cat.coding as co,
    co.system = 'http://terminology.hl7.org/CodeSystem/service-category',
    co.code = 'laboratory' "category";

  src.payload as p then {
    p.test as t -> tgt.code as code, code.text = t "test-text";
    p.loinc as l -> tgt.code as code, code.coding as co,
      co.system = 'http://loinc.org', co.code = l "loinc";
    p.abbreviation as ab -> tgt.extension as ext then {
      ab -> ext.url = 'https://dsp-fhir.org/StructureDefinition/dsp-abbreviation',
            ext.value = create('string') as v, v.value = ab;
    } "abbrev";
  };

  src.confidence as conf -> tgt.extension as ext then {
    conf -> ext.url = 'https://dsp-fhir.org/StructureDefinition/dsp-confidence-score',
            ext.value = create('decimal') as v, v.value = conf;
  } "confidence";
}

FHIR → DSP (canonical $graphql read)

Standard FHIR $graphql selects every native ServiceRequest field and DSP-namespaced extension that the write projection populated. A small adapter renames the result into the DSP shape.

Canonical query

query DspLabOrder($id: ID!) {
  ServiceRequest(id: $id) {
    id status intent
    category { coding { system code display } }
    code {
      text
      coding { system code display }
    }
    specimen { reference }
    note { text }
    patientInstruction
    reasonCode { text }
    reasonReference { reference }

    abbreviation: extension(url: "https://dsp-fhir.org/StructureDefinition/dsp-abbreviation") {
      valueString
    }
    confidence: extension(url: "https://dsp-fhir.org/StructureDefinition/dsp-confidence-score") {
      valueDecimal
    }
    turnRefs: extension(url: "https://dsp-fhir.org/StructureDefinition/dsp-transcript-turn-ref") {
      transcript: extension(url: "transcript") { valueReference { reference } }
      turn:       extension(url: "turn")       { valueInteger }
    }
  }
}

DSP reconstruction adapter

function toDspLabOrder(s) {
  const turnRefs = s.turnRefs ?? [];
  return {
    id: s.id,
    type: 'LAB_ORDER',
    intent: s.intent,
    description: s.code?.text,
    order_data: {
      lab: {
        text: s.code?.text,
        codes: (s.code?.coding ?? []).map(toDspCode),
      },
      lab_abbreviation:    s.abbreviation?.[0]?.valueString,
      sample_type:         s.specimen?.[0]?.reference,
      lab_instructions:    s.note?.map(n => n.text).join('\n'),
      patient_instructions: s.patientInstruction,
    },
    reason: s.reasonCode?.[0]?.text,
    reason_references: s.reasonReference?.map(r => r.reference),
    confidence_score: s.confidence?.[0]?.valueDecimal,
    provenance:       turnRefs.map(t => t.turn?.valueInteger),
    transcript_ref:   turnRefs[0]?.transcript?.valueReference?.reference,
  };
}
No data loss. Every DSP-originated field has a declared FHIR landing — native or dsp-* extension — and the canonical read selects each one explicitly.

SQL-on-FHIR v2 ViewDefinition that flattens every field above — including DSP extensions — into a tabular projection. Runnable as-is on any spec-conformant engine (Pathling, sof-exec, Aidbox SQL-on-FHIR, Databricks). See the SQL-on-FHIR v2 spec. These ViewDefinitions also ship as JSON in the IG zip.

dsp_service_request_lab — DSP Lab order (ServiceRequest)

Flattens DSP dsp lab order (servicerequest) orders. Filtered by category=laboratory.

{
  "resourceType": "ViewDefinition",
  "url": "https://dsp-fhir.org/ViewDefinition/dsp-service-request-lab",
  "name": "dsp_service_request_lab",
  "title": "DSP Lab order (ServiceRequest)",
  "status": "draft",
  "description": "Flattens DSP dsp lab order (servicerequest) orders. Filtered by category=laboratory.",
  "resource": "ServiceRequest",
  "fhirVersion": [
    "4.0.1"
  ],
  "where": [
    {
      "path": "category.coding.where(code='laboratory').exists()"
    }
  ],
  "select": [
    {
      "column": [
        {
          "name": "id",
          "path": "id",
          "type": "id",
          "description": "Server-assigned logical id."
        },
        {
          "name": "version_id",
          "path": "meta.versionId",
          "type": "id",
          "description": "FHIR version id (drives NEW/UPDATED classification)."
        },
        {
          "name": "last_updated",
          "path": "meta.lastUpdated",
          "type": "instant",
          "description": "Instant of last mutation."
        },
        {
          "name": "meta_source",
          "path": "meta.source",
          "type": "uri"
        },
        {
          "name": "payload_version",
          "path": "meta.tag.where(system='https://dsp-fhir.org/CodeSystem/payload-version').code.first()",
          "type": "code",
          "description": "DSP payload version this resource was last emitted under."
        },
        {
          "name": "confidence_score",
          "path": "extension('https://dsp-fhir.org/StructureDefinition/confidence-score').value.ofType(decimal)",
          "type": "decimal",
          "description": "DSP confidence (0..1)."
        },
        {
          "name": "transcript_ref",
          "path": "extension('https://dsp-fhir.org/StructureDefinition/transcript-turn-refs').extension('transcript').value.ofType(Reference).reference",
          "type": "string",
          "description": "DocumentReference/<id>/_history/<v> that pins the transcript version for turn indices."
        },
        {
          "name": "turn_indices",
          "path": "extension('https://dsp-fhir.org/StructureDefinition/transcript-turn-refs').extension('turn').value.ofType(integer)",
          "type": "integer",
          "collection": true,
          "description": "Turn indices joined by $ground into transcript content."
        },
        {
          "name": "spoken_forms",
          "path": "extension('https://dsp-fhir.org/StructureDefinition/spoken-forms').extension('form').value.ofType(string)",
          "type": "string",
          "collection": true
        },
        {
          "name": "search_terms",
          "path": "extension('https://dsp-fhir.org/StructureDefinition/search-terms').extension('term').value.ofType(string)",
          "type": "string",
          "collection": true
        },
        {
          "name": "status",
          "path": "status",
          "type": "code"
        },
        {
          "name": "intent",
          "path": "intent",
          "type": "code"
        },
        {
          "name": "priority",
          "path": "priority",
          "type": "code"
        },
        {
          "name": "subject_patient_id",
          "path": "subject.reference.substring(8)",
          "type": "string"
        },
        {
          "name": "encounter_id",
          "path": "encounter.reference.substring(10)",
          "type": "string"
        },
        {
          "name": "authored_on",
          "path": "authoredOn",
          "type": "dateTime"
        },
        {
          "name": "requester_practitioner_id",
          "path": "requester.reference.where($this.startsWith('Practitioner/')).substring(13).first()",
          "type": "string"
        },
        {
          "name": "code_system",
          "path": "code.coding.system.first()",
          "type": "uri"
        },
        {
          "name": "code",
          "path": "code.coding.code.first()",
          "type": "code"
        },
        {
          "name": "code_display",
          "path": "code.coding.display.first()",
          "type": "string"
        },
        {
          "name": "code_text",
          "path": "code.text",
          "type": "string"
        },
        {
          "name": "reason_code_text",
          "path": "reasonCode.text.first()",
          "type": "string"
        },
        {
          "name": "reason_reference",
          "path": "reasonReference.reference.first()",
          "type": "string"
        },
        {
          "name": "body_site_code",
          "path": "bodySite.coding.code.first()",
          "type": "code"
        },
        {
          "name": "specimen_ref",
          "path": "specimen.reference.first()",
          "type": "string"
        },
        {
          "name": "occurrence_datetime",
          "path": "occurrence.ofType(dateTime)",
          "type": "dateTime"
        },
        {
          "name": "fasting_required",
          "path": "extension('http://hl7.org/fhir/StructureDefinition/servicerequest-questionnaireRequest').exists()",
          "type": "boolean"
        }
      ]
    }
  ]
}