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Version: 3.1

Specimen

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.

PermissionDescriptionSystem Roles
can_read_specimenView a specimen record, including lookup by accession identifierFacility Admin, Administrator, Admin, Staff, Doctor, Nurse, Pharmacist
can_write_specimenUpdate a specimen — record collection, processing, and status changesFacility 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.