CA ServiceRequest Profile

This Service Request Profile is based upon the core FHIR ServiceRequest resource and created to define the minimal set of data required to request for service such as diagnostic investigations, treatments, or operations to be performed.

This profile defines a service request structure that includes core localisation concepts for use as a diagnostic service request in a Canadian context.

Mandatory Data Elements

All elements or attributes defined in FHIR have cardinality as part of their definition - a minimum number of required appearances and a maximum number.

Most elements in FHIR specification have a minimum cardinality of 0, which means that they may be missing from a resource when it is exchanged between systems.

In this Canadian Baseline ServiceRequest Profile following elements are required:

• status of the order (ServiceRequest.status)
• progression of a business activity (ServiceRequest.intent)
• on whom or what the service is to be performed (ServiceRequest.subject)
• who initiated the request (ServiceRequest.requester)

Data Absent Reason

In situations where the minimum cardinality of an element or attribute is 1 and information is missing and the Responder knows the precise reason for the absence of data, Responders SHALL send the reason for the missing information using values (such as NullFlavor) from the value set where they exist or using the DataAbsentReason extension.

Must Support Data Elements

Some elements are labeled as MustSupport meaning that implementations that produce or consume resources SHALL provide "support" for the element in some meaningful way (see Must Support definition).

Following elements are marked as Must Support in the Canadian ServiceRequest profile.

Must Support elements:

• identifier
• requisition
• status
• intent
• category
• code
• subject
• authoredOn
• requester
• performer

Usage Note

This profile may be used to share relevant information required to support a referral or a transfer of care request from one practitioner to another in which a referral is sent directly to a specific health service described in a shared Health Services Directory.

A ServiceRequest can be supplemented with service-specific clinical decision support information and any other additionally required data, for example, available appointment slots.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from ServiceRequest

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	ServiceRequest	ServiceRequest Profile
identifier	S	0..*	Identifier	Identifiers assigned to this order
basedOn		0..*	Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile)	What request fulfills
replaces		0..*	Reference(ServiceRequest Profile for Results Reporting)	What request replaces
requisition	S	0..1	Identifier	Composite Request ID
status	S	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent	S	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
category	S	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (preferred)
code		0..1	CodeableConcept	What is being requested/ordered
Slices for coding	S	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LabOrder		0..*	Coding	Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French.
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
coding:@default		0..*	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
subject	S	1..1	Reference(Patient Profile | Location Profile | Device Profile (Implantable))	Individual or Entity the service is ordered for
encounter		0..1	Reference(Encounter Profile)	Encounter in which the request was created
authoredOn	S	0..1	dateTime	Date request signed
requester	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Who/what is requesting service
performer	S	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Requested performer
locationReference		0..*	Reference(Location Profile)	Requested location
reasonCode		0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred)
reasonReference		0..*	Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document)	Explanation/Justification for service or service
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
ServiceRequest.category	preferred	ServiceRequestCategoryCodes
ServiceRequest.code.coding:LabOrder	preferred	https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD
ServiceRequest.reasonCode	preferred	ProcedureReasonCodes

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	ServiceRequest Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management prr-1: orderDetail SHALL only be present if code is present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	0..*	Identifier	Identifiers assigned to this order ele-1: All FHIR elements must have a @value or children
basedOn	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile)	What request fulfills ele-1: All FHIR elements must have a @value or children
replaces	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting)	What request replaces ele-1: All FHIR elements must have a @value or children
requisition	SΣ	0..1	Identifier	Composite Request ID ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. ele-1: All FHIR elements must have a @value or children
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. ele-1: All FHIR elements must have a @value or children
category	SΣ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (preferred) ele-1: All FHIR elements must have a @value or children
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed ele-1: All FHIR elements must have a @value or children
code	Σ	0..1	CodeableConcept	​What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children
coding:LabOrder	Σ	0..*	Coding	Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French. ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children
coding:@default	Σ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient Profile | Location Profile | Device Profile (Implantable))	Individual or Entity the service is ordered for ele-1: All FHIR elements must have a @value or children
encounter	Σ	0..1	Reference(Encounter Profile)	Encounter in which the request was created ele-1: All FHIR elements must have a @value or children
authoredOn	SΣ	0..1	dateTime	Date request signed ele-1: All FHIR elements must have a @value or children
requester	SΣ	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Who/what is requesting service ele-1: All FHIR elements must have a @value or children
performer	SΣ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Requested performer ele-1: All FHIR elements must have a @value or children
locationReference	Σ	0..*	Reference(Location Profile)	Requested location ele-1: All FHIR elements must have a @value or children
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred) ele-1: All FHIR elements must have a @value or children
reasonReference	Σ	0..*	Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document)	Explanation/Justification for service or service ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	RequestIntent http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	preferred	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
ServiceRequest.code.coding:LabOrder	preferred	https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD
ServiceRequest.reasonCode	preferred	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists()

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	ServiceRequest Profile prr-1: orderDetail SHALL only be present if code is present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting)	What request replaces
requisition	SΣ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
category	SΣ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (preferred)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	Σ	0..1	CodeableConcept	​What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LabOrder	Σ	0..*	Coding	Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:@default	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(Patient Profile | Location Profile | Device Profile (Implantable))	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter Profile)	Encounter in which the request was created
occurrence[x]	Σ	0..1		When service should occur
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	SΣ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location Profile)	Requested location
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred)
reasonReference	Σ	0..*	Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document)	Explanation/Justification for service or service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ServiceRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	RequestIntent http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	preferred	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
ServiceRequest.code.coding:LabOrder	preferred	https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail from the FHIR Standard
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
ServiceRequest.performerType	example	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	preferred	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists()

Differential View

This structure is derived from ServiceRequest

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	ServiceRequest	ServiceRequest Profile
identifier	S	0..*	Identifier	Identifiers assigned to this order
basedOn		0..*	Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile)	What request fulfills
replaces		0..*	Reference(ServiceRequest Profile for Results Reporting)	What request replaces
requisition	S	0..1	Identifier	Composite Request ID
status	S	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent	S	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
category	S	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (preferred)
code		0..1	CodeableConcept	What is being requested/ordered
Slices for coding	S	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LabOrder		0..*	Coding	Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French.
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
coding:@default		0..*	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
subject	S	1..1	Reference(Patient Profile | Location Profile | Device Profile (Implantable))	Individual or Entity the service is ordered for
encounter		0..1	Reference(Encounter Profile)	Encounter in which the request was created
authoredOn	S	0..1	dateTime	Date request signed
requester	S	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Who/what is requesting service
performer	S	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Requested performer
locationReference		0..*	Reference(Location Profile)	Requested location
reasonCode		0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred)
reasonReference		0..*	Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document)	Explanation/Justification for service or service
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
ServiceRequest.category	preferred	ServiceRequestCategoryCodes
ServiceRequest.code.coding:LabOrder	preferred	https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD
ServiceRequest.reasonCode	preferred	ProcedureReasonCodes

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	ServiceRequest Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management prr-1: orderDetail SHALL only be present if code is present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	0..*	Identifier	Identifiers assigned to this order ele-1: All FHIR elements must have a @value or children
basedOn	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile)	What request fulfills ele-1: All FHIR elements must have a @value or children
replaces	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting)	What request replaces ele-1: All FHIR elements must have a @value or children
requisition	SΣ	0..1	Identifier	Composite Request ID ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. ele-1: All FHIR elements must have a @value or children
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. ele-1: All FHIR elements must have a @value or children
category	SΣ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (preferred) ele-1: All FHIR elements must have a @value or children
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed ele-1: All FHIR elements must have a @value or children
code	Σ	0..1	CodeableConcept	​What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children
coding:LabOrder	Σ	0..*	Coding	Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French. ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children
coding:@default	Σ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identity of the terminology system ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	code	Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient Profile | Location Profile | Device Profile (Implantable))	Individual or Entity the service is ordered for ele-1: All FHIR elements must have a @value or children
encounter	Σ	0..1	Reference(Encounter Profile)	Encounter in which the request was created ele-1: All FHIR elements must have a @value or children
authoredOn	SΣ	0..1	dateTime	Date request signed ele-1: All FHIR elements must have a @value or children
requester	SΣ	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Who/what is requesting service ele-1: All FHIR elements must have a @value or children
performer	SΣ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Requested performer ele-1: All FHIR elements must have a @value or children
locationReference	Σ	0..*	Reference(Location Profile)	Requested location ele-1: All FHIR elements must have a @value or children
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred) ele-1: All FHIR elements must have a @value or children
reasonReference	Σ	0..*	Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document)	Explanation/Justification for service or service ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	RequestIntent http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	preferred	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
ServiceRequest.code.coding:LabOrder	preferred	https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD
ServiceRequest.reasonCode	preferred	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	ServiceRequest Profile prr-1: orderDetail SHALL only be present if code is present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest Profile for Results Reporting)	What request replaces
requisition	SΣ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
category	SΣ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (preferred)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	Σ	0..1	CodeableConcept	​What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:LabOrder	Σ	0..*	Coding	Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:@default	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(Patient Profile | Location Profile | Device Profile (Implantable))	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter Profile)	Encounter in which the request was created
occurrence[x]	Σ	0..1		When service should occur
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	1..1	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	SΣ	0..*	Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable))	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location Profile)	Requested location
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred)
reasonReference	Σ	0..*	Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document)	Explanation/Justification for service or service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
ServiceRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	RequestIntent http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	preferred	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
ServiceRequest.code.coding:LabOrder	preferred	https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail from the FHIR Standard
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
ServiceRequest.performerType	example	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	preferred	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists()

This structure is derived from ServiceRequest

Summary

Mandatory: 1 element(4 nested mandatory elements)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• ServiceRequest Profile for Results Reporting (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-servicerequest)
• MedicationRequest Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest)
• Patient Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient)
• Location Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location)
• Device Profile (Implantable) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device)
• Encounter Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter)
• Practitioner Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner)
• PractitionerRole Profile (General) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole)
• Organization Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization)
• Condition Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-condition)
• Observation Profile (General Use) (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation)
• DiagnosticReport Profile for Laboratory Results Reporting (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreport)
• Diagnostic Report for Report and Note Exchange Profile (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-diagnosticreportnote)
• DocumentReference Profile for metadata about the document (http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-documentreference)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of ServiceRequest.code.coding

Category

The ServiceRequest.category element conveys a code that classifies the service for searching, sorting and display purposes.

It may use Canada Health Infoway defined InterventionCodeSubsetCare value set to represent the care procedures performed by a Provider.

Code

The ServiceRequest.code element identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

If the service identified by the ServiceRequest.category is laboratory procedure the pan-Canadian LOINC Observation Code Database (pCLOCD) is preferred. pCLOCD is the Canadian version of the LOINC(tm) database.

Reason Code

The ServiceRequest.reasonCode element in this profile uses the same ProcedureReasonCodes value set as defined by the FHIR standard.

The binding is chagned from Example to Preferred. Implementers are encouraged to draw codes from the specified code system for interoperability purposes.