profile-medicalproductofhumanorigin
Introduction
Scope and Usage
Note to Balloters: To ensure this resource is ready for Normative status, we are seeking ballot comment on the substantive content. The key changes made since R5 include:
Change to the .collection backbone with respect to the collection source. This includes updates to the corresponding search parameters.
Addition of a Notes section: biologicallyderivedproduct.html#8.25.5 to include information on how to handle information about the intended recipient.
The following artifacts have been moved to the [OO Incubator IG|https://build.fhir.org/ig/HL7/oo-incubator]
The Medical Product of Human Origin (MPHO) Profile is still under development.
The BiologicallyDerivedProductDispense resource. Additional work needs to be done on dispensing and administering biologically derived products.
Note to Implementers: For an overview of this resource and others in the Biologically Derived Product domain, also see the module page.
This is a base resource that represents a material substance originating from a biological entity intended to be clinically applied (e.g., transplanted, infused, grafted) to another (possibly the same) biological entity. Examples include:
- hematopoietic stem cells (bone marrow, peripheral blood, or cord blood extraction)
- mesenchymal stromal cells
- blood products (whole blood, red blood cells, platelets, plasma, etc.)
- organs (kidney, lung, heart, liver etc.)
- tissues, human (cornea, heart valves, blood vessels, skin, tendons, cartilage, bone)
- tissues, non-human (porcine valves, porcine skin, bovine cardiac tissue, etc.)
- ART tissue (sperm, oocyte, embryo)
- manipulated cells (e.g. CAR T-cells)
- human milk for immunological properties
- topical products (serum eye drops, fibrin sealant)
- fecal microbiota
- regenerated tissue products (regenerated epidermis, regenerated corneal epithelium, regenerated trachea)
Boundaries and Relationships
The following boundaries need to be considered:
- Medication - If the product is derived from an individual or small pool, or is blood group specific, it is a BiologicallyDerivedProduct, otherwise it is to be considered a Medication.
- NutritionProduct - If the product is for dietary administration it is represented as a NutritionProduct. If the product is for transplant, infusion, therapeutic administration, or injection it is represented as a BiologicallyDerivedProduct. We note that this remains ambiguous, particularly around certain uses of donated human milk, and additional use cases may need to be clarified to determine the appropriate representation. Local implementation guidance may provide further direction.
- Device - Some biologically derived products are considered a device within certain jurisdictions.
- Specimen - A biologically derived product may involve the same material (e.g., tissue, blood, organ, etc.) as a specimen where the intended use determines whether to use Specimen or BiologicallyDerivedProduct. The focus of the Specimen is to conduct a diagnostic test, while the BiologicallyDerivedProduct is to use for a clinical therapy or procedure on the same or different patient. E.g., blood used for a test is represented by a Specimen, while blood for transfusion is represented as a BiologicallyDerivedProduct. A specimen can be obtained from a BiologicallyDerivedProduct thus creating a Specimen instance where Specimen.subject is a BiologicallyDerivedProduct as a source.
- Substance - A substance is a homogeneous material with a definite composition that can be reproduced in the same way consistently. Certain substances may include or originate from biologically derived product, but from the point where the substance is identified by batch/lot number and any necessary links to the originating donor(s) are held within the manufacturing records the product can be considered and managed as a substance.
Background and Context
Provides additional detail on exactly how the resource is to be used
Notes
Notes
Intended Recipients
In some areas of medicine, it is important to record the intended recipient for designated or directed BiologicallyDerivedProducts. The intended recipient represents the individual for whom the product was originally collected or manufactured, reflecting the purpose or intent behind its creation. This may differ from the actual recipient of the product during administration. Even in cases where the BiologicallyDerivedProduct is ultimately dispensed or administered to a different patient, the original intended recipient remains a factual and traceable aspect of the product’s history and should be persisted. This can be an important regulatory or accreditation requirement.
There are two approaches to representing the intended recipient of a designated or directed BiologicallyDerivedProduct:
- Within the collection order:
- Use
ServiceRequest.subjectto indicate the patient from whom the product is being collected, andServiceRequest.focusto reference the patient who is the intended recipient. This approach associates the intended recipient with the order rather than the product itself.
- Use
- Within the BiologicallyDerivedProduct resource:
- Use the core extension
biologicallyderivedproduct-intendedRecipientto explicitly record the intended recipient directly on the BiologicallyDerivedProduct. This approach ensures the intent remains associated with the product throughout its lifecycle, independent of any ordering context.
- Use the core extension
Preferred approach: The second approach is recommended, as it maintains the intended recipient as an intrinsic attribute of the BiologicallyDerivedProduct, supporting long-term traceability even if the original ServiceRequest is no longer available.
Note to Implementers: At the time of authorship, the
biologicallyderivedproduct-intendedRecipientextension had not yet been published. It will be included in the FHIR Extension Pack when available. Feedback from implementers is welcomed to inform further refinement and usage guidance.
Important: When PHI from multiple patients (e.g., donor and recipient) is represented within a single BiologicallyDerivedProduct resource, systems should apply appropriate access controls and redaction practices to ensure that users only see the data they are authorized to view. Implementers should follow established standards such as ISBT 128, which governs when donor PHI may be included versus when coded identifiers (e.g., WMDA GRID) should be used.
StructureDefinition
Elements (Simplified)
- BiologicallyDerivedProduct [0..*]: - Medical Product of Human Origin Profile
- BiologicallyDerivedProduct.productCategory [1..-]: -
- BiologicallyDerivedProduct.productCategory [1..1]: -
- BiologicallyDerivedProduct.productCode [1..1]: -
- BiologicallyDerivedProduct.productCode.coding [1..-]: -
- BiologicallyDerivedProduct.productCode.coding.system [1..1]: -
- BiologicallyDerivedProduct.productCode.coding.code [1..1]: -
- BiologicallyDerivedProduct.identifier [1..-]: - Under most circumstances an MPHO will be uniquely identified using a single identifier from production to point of use. In some cases, a second identifier may be required (for example, import from another country that uses a different identification coding system). In these cases, both the original and new identifier must be included.
- BiologicallyDerivedProduct.identifier.system [1..1]: - Identity of the Issuing Agency responsible for the allocation of unique identifiers
- BiologicallyDerivedProduct.identifier.value [1..1]: - Unique identifier of the MPHO item
- BiologicallyDerivedProduct.biologicalSourceEvent [1..1]: -
- BiologicallyDerivedProduct.biologicalSourceEvent.system [1..1]: - Identity of the Issuing Agency responsible for the allocation of unique identifiers
- BiologicallyDerivedProduct.biologicalSourceEvent.value [1..1]: - Unique identifier of the donation, collection or pooling event from which the MPHO item was derived
Mappings
- profile-medicalproductofhumanorigin Mappings — 0 mapping entries
Mapping Exceptions
biologicallyderivedproduct-fivews-mapping-exceptions.xml
Unmapped Elements
- FiveWs.what — Unknown
- FiveWs.recorded — Unknown
- FiveWs.author — Unknown
- FiveWs.actor — Unknown
- FiveWs.cause — Unknown
- FiveWs.version — Unknown
- FiveWs.witness — Unknown
- FiveWs.class — Unknown
- FiveWs.where — Unknown
- FiveWs.context — Unknown
- FiveWs.init — Unknown
- FiveWs.why — Unknown
- FiveWs.source — Unknown
- FiveWs.who — Unknown
- FiveWs.grade — Unknown
- FiveWs.status — Unknown
- FiveWs.planned — Unknown
- FiveWs.done — Unknown
- FiveWs.subject — Unknown