Concepts/Specimen

conceptclinicalFHIR: SpecimenCARE 3.0+

Clinical

Concepts

Patient

Encounter Condition Allergy & Intolerance Observation Diagnostic Report Service Request Specimen Consent Clinical Notes

Questionnaire Response

Flows

Create a patient

References

Patient

Encounter Condition Allergy Intolerance Observation Diagnostic Report Consent Notes Specimen Service Request

Questionnaire Response

A specimen is a physical sample — blood, tissue, a swab, urine — collected from a patient so a laboratory can analyse it. It is the bridge between a lab order and a result: the order asks for a test, the specimen is the material that gets tested, and the report carries back what the lab found.

What it represents

In Care's FHIR-aligned model, a specimen maps to the Specimen resource. It captures:

• The material — what kind of sample was collected and its condition on arrival at the lab
• The collection — who took it, when, by what method, from which body site, and the patient's fasting status
• Its identity — an accession identifier (the lab barcode) used to find the sample fast
• Its links — the patient it came from, the encounter it was collected in, and the order it fulfils

The distinction worth holding onto: a specimen is neither the order nor the result. The order asks for work; the specimen is the tangible thing that work is performed on; the findings return separately through a diagnostic report. One order can yield several specimens, and a single specimen can pass through several processing steps before it is tested.

Lifecycle

A specimen sits in exactly one status as it moves from collection to testing. The first two are working states; the last three are terminal.

draft → available → unavailable / unsatisfactory / entered_in_error

• draft — a Care-specific starting state for a record still being prepared
• available — present at the lab and suitable for testing
• unavailable — no longer available, having been consumed, lost, or discarded
• unsatisfactory — reached the lab but unfit to test (contaminated, too little), so a recollection is usually needed
• entered_in_error — created by mistake; kept for audit, treated as void

How it connects

A specimen is the pivot of the lab workflow, and almost everything about it is borrowed from the records around it:

• It is always collected from a patient, during an encounter that gives the sample its clinical context.
• It exists to fulfil a service request — the lab order. One order may produce several specimens, and that order is also what governs who may read or write the specimen.
• It can be shaped by a specimen definition, an optional template describing the expected container and preparation.
• Once tested, its results surface through a diagnostic report, closing the loop back to the clinician who placed the order.

Permissions

Access to specimens is governed by two facility-scoped permissions.

Permission	Description	System Roles
can_read_specimen	View a specimen record, including lookup by accession identifier	Facility Admin, Administrator, Admin, Staff, Doctor, Nurse, Pharmacist
can_write_specimen	Update a specimen — record collection, processing, and status changes	Facility Admin, Admin, Doctor, Nurse

Both permissions are checked against the specimen's linked service request rather than the specimen alone. Roles are granted through a user's facility, organization, or patient memberships, and permissions cascade down the organization tree — a role given high in the tree applies to the facilities beneath it.

FHIR reference

This concept aligns with the FHIR Specimen resource. Care implements an opinionated subset: the patient, encounter, and order links are set on creation as subject_patient, subject_encounter, and request, and the status set adds a Care-specific draft value not present in FHIR.

Clinical

Concepts

Patient · Encounter · Condition · Allergy · Observation · Dx Report · Service Request · Specimen · Consent · Notes · Q. Response

Flows

Create a patient

References

Patient · Encounter · Condition · Allergy · Observation · Dx Report · Consent · Notes · Specimen · Service Request · Q. Response

Related

• Concept: Concepts/Patient
• Reference: References/Specimen

Wiki: ohcnwiki.tellmey.fyi

Fast Healthcare Interoperability Resources — an HL7 standard for exchanging healthcare data. CARE is built on FHIR R5.

Open Healthcare Network's flagship product: an open-source, FHIR-native electronic medical record (EMR) and healthcare operating system.