US Core Implementation Guide
7.0.0-ballot - Ballot United States of America flag

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 7.0.0-ballot built by the FHIR (HL7ยฎ FHIRยฎ Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Resource Profile: US Core ServiceRequest Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest Version: 7.0.0-ballot
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreServiceRequestProfile

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

This profile sets minimum expectations for recording, searching, and fetching the ServiceRequest resource to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for a specific procedure or test request, such as an electrocardiogram (ECG) order or a referral to a support program.
  • Query for a specific service offered to a patient, such as a referral to a support program.
  • Query for a category of service request (e.g., all cardiology requests)

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Service Request Must Have:

  1. a status
  2. an intent code indicating whether the request is a proposal, plan, or order.
  3. a code defining what is being requested
  4. a patient

Each Service Request Must Support:

  1. a category
  2. the encounter in which the request was created
  3. when requested serviceSHOULDhappen
  4. when the request was made
  5. the requester

Additional USCDI Requirements:

This Additional USCDI Requirements element is not Mandatory or Must Support but is required for ONC Health IT certification testing and is included in the formal definition of the profile and the ServiceRequest examples.

  1. a reason or indication for referral or consultation*

*see guidance below

Profile Specific Implementation Guidance:

  • See the Screening and Assessments guidance page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
  • The ServiceRequest.category binding Must Support, at a minimum, the US Core ServiceRequest Category Codes. However, this valueset can be treated as extensible, and other category codes can be used instead.
  • The ServiceRequest.code valueset is broad to accommodate a wide variety of use cases andSHOULDbe constrained to a subset for a particular use case or domain. (for example, LOINC for laboratory orders.)
  • *The Reason or justification for a referral or consultation is communicated through:
    1. ServiceRequest.reason or ServiceRequest.reason, and Procedure.basedOn that links the Procedure to the US Core ServiceRequest Profile.
      • ServiceRequest.reasonCode and ServiceRequest.reasonReference are marked as Additional USCDI Requirements. The certifying server system is not required to support both but SHALL support at least one of these elements. The certifying client application SHALL support both elements.
      • As documented here, when using ServiceRequest.reasonReference, the referenced resources SHOULD be a US Core Profile.
    2. Procedure.reasonCode or Procedure.reasonReference when the Procedure does not have an associated ServiceRequest.
      • Although both Procedure.reasonCode and Procedure.reasonReference are marked as Additional USCDI Requirements. The certifying server system is not required to support both but SHALL support at least one of these elements. The certifying client application SHALL support both elements.
      • As documented here, when using Procedure.reasonReference, the referenced resources SHOULD be a US Core Profile.

    Certifying Servers and Clients SHALL support options 1 and 2 as Additional USCDI Requirements.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from ServiceRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest 0..*ServiceRequestA request for a service to be performed
... status S1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent S1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
... Slices for category S0..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
.... category:us-core S0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

... code S1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
... subject S1..1Reference(US Core Patient Profile S | Group | US Core Location Profile | Device)Individual or Entity the service is ordered for
... encounter S0..1Reference(US Core Encounter Profile)Encounter in which the request was created
... occurrence[x] S0..1When service should occur
.... occurrencePeriodPeriod S
.... occurrenceDateTimedateTime
.... occurrenceTimingTiming
... authoredOn S0..1dateTimeDate request signed
... requester S0..1Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device)Who/what is requesting service
... reasonCode 0..*CodeableConcept๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: US Core Profile that supports the requested service

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*ServiceRequestA request for a service to be performed
... implicitRules ?!ฮฃ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Sฮฃ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!Sฮฃ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category Sฮฃ0..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core Sฮฃ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... doNotPerform ?!ฮฃ0..1booleanTrue if service/procedure should not be performed
... code Sฮฃ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
... subject Sฮฃ1..1Reference(US Core Patient Profile)Individual or Entity the service is ordered for
... encounter Sฮฃ0..1Reference(US Core Encounter Profile)Encounter in which the request was created
... occurrence[x] Sฮฃ0..1When service should occur
.... occurrencePeriodPeriod
... authoredOn Sฮฃ0..1dateTimeDate request signed
... requester Sฮฃ0..1Reference(US Core Practitioner Profile)Who/what is requesting service
... reasonCode ฮฃ0..*CodeableConcept๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference ฮฃ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: US Core Profile that supports the requested service

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*ServiceRequestA request for a service to be performed
... id ฮฃ0..1idLogical id of this artifact
... meta ฮฃ0..1MetaMetadata about the resource
... implicitRules ?!ฮฃ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier ฮฃ0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical ฮฃ0..*canonical(ActivityDefinition | PlanDefinition)Instantiates FHIR protocol or definition
... instantiatesUri ฮฃ0..*uriInstantiates external protocol or definition
... basedOn ฮฃ0..*Reference(CarePlan | ServiceRequest | MedicationRequest)What request fulfills
... replaces ฮฃ0..*Reference(ServiceRequest)What request replaces
... requisition ฮฃ0..1IdentifierComposite Request ID
... status ?!Sฮฃ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!Sฮฃ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category Sฮฃ0..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core Sฮฃ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... priority ฮฃ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!ฮฃ0..1booleanTrue if service/procedure should not be performed
... code Sฮฃ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
... orderDetail ฮฃC0..*CodeableConceptAdditional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.


... quantity[x] ฮฃ0..1Service amount
.... quantityQuantityQuantity
.... quantityRatioRatio
.... quantityRangeRange
... subject Sฮฃ1..1Reference(US Core Patient Profile S | Group | US Core Location Profile | Device)Individual or Entity the service is ordered for
... encounter Sฮฃ0..1Reference(US Core Encounter Profile)Encounter in which the request was created
... occurrence[x] Sฮฃ0..1When service should occur
.... occurrencePeriodPeriod S
.... occurrenceDateTimedateTime
.... occurrenceTimingTiming
... asNeeded[x] ฮฃ0..1Preconditions 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.

.... asNeededBooleanboolean
.... asNeededCodeableConceptCodeableConcept
... authoredOn Sฮฃ0..1dateTimeDate request signed
... requester Sฮฃ0..1Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device)Who/what is requesting service
... performerType ฮฃ0..1CodeableConceptPerformer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer ฮฃ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)Requested performer
... locationCode ฮฃ0..*CodeableConceptRequested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


... locationReference ฮฃ0..*Reference(Location)Requested location
... reasonCode ฮฃ0..*CodeableConcept๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference ฮฃ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: US Core Profile that supports the requested service
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... supportingInfo 0..*Reference(Resource)Additional clinical information
... specimen ฮฃ0..*Reference(Specimen)Procedure Samples
... bodySite ฮฃ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... note 0..*AnnotationComments
... patientInstruction ฮฃ0..1stringPatient or consumer-oriented instructions
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.priorityrequiredRequestPriority
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerTypeexampleParticipantRoles
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()

Differential View

This structure is derived from ServiceRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest 0..*ServiceRequestA request for a service to be performed
... status S1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent S1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
... Slices for category S0..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
.... category:us-core S0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

... code S1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
... subject S1..1Reference(US Core Patient Profile S | Group | US Core Location Profile | Device)Individual or Entity the service is ordered for
... encounter S0..1Reference(US Core Encounter Profile)Encounter in which the request was created
... occurrence[x] S0..1When service should occur
.... occurrencePeriodPeriod S
.... occurrenceDateTimedateTime
.... occurrenceTimingTiming
... authoredOn S0..1dateTimeDate request signed
... requester S0..1Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device)Who/what is requesting service
... reasonCode 0..*CodeableConcept๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: US Core Profile that supports the requested service

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*ServiceRequestA request for a service to be performed
... implicitRules ?!ฮฃ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!Sฮฃ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!Sฮฃ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category Sฮฃ0..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core Sฮฃ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... doNotPerform ?!ฮฃ0..1booleanTrue if service/procedure should not be performed
... code Sฮฃ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
... subject Sฮฃ1..1Reference(US Core Patient Profile)Individual or Entity the service is ordered for
... encounter Sฮฃ0..1Reference(US Core Encounter Profile)Encounter in which the request was created
... occurrence[x] Sฮฃ0..1When service should occur
.... occurrencePeriodPeriod
... authoredOn Sฮฃ0..1dateTimeDate request signed
... requester Sฮฃ0..1Reference(US Core Practitioner Profile)Who/what is requesting service
... reasonCode ฮฃ0..*CodeableConcept๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference ฮฃ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: US Core Profile that supports the requested service

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*ServiceRequestA request for a service to be performed
... id ฮฃ0..1idLogical id of this artifact
... meta ฮฃ0..1MetaMetadata about the resource
... implicitRules ?!ฮฃ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier ฮฃ0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical ฮฃ0..*canonical(ActivityDefinition | PlanDefinition)Instantiates FHIR protocol or definition
... instantiatesUri ฮฃ0..*uriInstantiates external protocol or definition
... basedOn ฮฃ0..*Reference(CarePlan | ServiceRequest | MedicationRequest)What request fulfills
... replaces ฮฃ0..*Reference(ServiceRequest)What request replaces
... requisition ฮฃ0..1IdentifierComposite Request ID
... status ?!Sฮฃ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!Sฮฃ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category Sฮฃ0..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core Sฮฃ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... priority ฮฃ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!ฮฃ0..1booleanTrue if service/procedure should not be performed
... code Sฮฃ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
... orderDetail ฮฃC0..*CodeableConceptAdditional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.


... quantity[x] ฮฃ0..1Service amount
.... quantityQuantityQuantity
.... quantityRatioRatio
.... quantityRangeRange
... subject Sฮฃ1..1Reference(US Core Patient Profile S | Group | US Core Location Profile | Device)Individual or Entity the service is ordered for
... encounter Sฮฃ0..1Reference(US Core Encounter Profile)Encounter in which the request was created
... occurrence[x] Sฮฃ0..1When service should occur
.... occurrencePeriodPeriod S
.... occurrenceDateTimedateTime
.... occurrenceTimingTiming
... asNeeded[x] ฮฃ0..1Preconditions 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.

.... asNeededBooleanboolean
.... asNeededCodeableConceptCodeableConcept
... authoredOn Sฮฃ0..1dateTimeDate request signed
... requester Sฮฃ0..1Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device)Who/what is requesting service
... performerType ฮฃ0..1CodeableConceptPerformer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer ฮฃ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)Requested performer
... locationCode ฮฃ0..*CodeableConceptRequested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


... locationReference ฮฃ0..*Reference(Location)Requested location
... reasonCode ฮฃ0..*CodeableConcept๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference ฮฃ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)๐—”๐——๐——๐—œ๐—ง๐—œ๐—ข๐—ก๐—”๐—Ÿ ๐—จ๐—ฆ๐—–๐——๐—œ: US Core Profile that supports the requested service
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... supportingInfo 0..*Reference(Resource)Additional clinical information
... specimen ฮฃ0..*Reference(Specimen)Procedure Samples
... bodySite ฮฃ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... note 0..*AnnotationComments
... patientInstruction ฮฃ0..1stringPatient or consumer-oriented instructions
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.priorityrequiredRequestPriority
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerTypeexampleParticipantRoles
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:


Quick Start


Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profileโ€™s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

  • The syntax used to describe the interactions is described here.
  • See the General Requirements section for additional rules and expectations when a server requires status parameters.
  • See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to order and referral data SHALL support these US Core SMART Scopes:

  • resource level scopes: patient/ServiceRequest.rs
  • granular scopes: patient.ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh and patient.ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|functional-status and patient.ServiceRequest.rs?category=http://snomed.info/sct|surgical-procedure.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support searching for all servicerequests for a patient using the patient search parameter:

    GET [base]/ServiceRequest?patient={Type/}[id]

    Example:

    1. GET [base]/ServiceRequest?patient=1137192

    Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient (how to search by reference)

  2. SHALL support bothย read ServiceRequest by id AND ServiceRequest search using the _id search parameter:

    GET [base]/ServiceRequest/[id] or GET [base]/ServiceRequest?_id=[id]

    Example:

    1. GET [base]/ServiceRequest/1032702
    2. GET [base]/ServiceRequest?_id=1032702

    Implementation Notes: (how to search by the logical id of the resource)

  3. SHALL support searching using the combination of the patient and category search parameters:

    GET [base]/ServiceRequest?patient={Type/}[id]&category={system|}[code]

    Example:

    1. GET [base]/ServiceRequest?patient=f201&category=http://loinc.org|LG41762-2

    Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and a category code (how to search by reference and how to search by token)

  4. SHALL support searching using the combination of the patient and code search parameters:
    • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)

    GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/ServiceRequest?patient=1032702&code=http://snomed.info/sct|35637008

    Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and report code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token)

  5. SHALL support searching using the combination of the patient and category and authored search parameters:
    • including support for these authored comparators: gt,lt,ge,le
    • including optional support for AND search on authored (e.g.authored=[date]&authored=[date]]&...)

    GET [base]/ServiceRequest?patient={Type/}[id]&category={system|}[code]&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/ServiceRequest?patient=f201&category=http://loinc.org|LG41762-2&date=ge2010-01-14T00:00:00Z

    Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and date and a category code (how to search by reference and how to search by token and how to search by date)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

  1. SHOULD support searching using the combination of the patient and status search parameters:
    • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

    GET [base]/ServiceRequest?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/ServiceRequest?patient=1137192&status=completed

    Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and status (how to search by reference and how to search by token)

  2. SHOULD support searching using the combination of the patient and code and authored search parameters:
    • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
    • including support for these authored comparators: gt,lt,ge,le
    • including optional support for AND search on authored (e.g.authored=[date]&authored=[date]]&...)

    GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/ServiceRequest?patient=f201&code=http://snomed.info/sct|35637008&date=ge2019-01-14T00:00:00Z

    Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and date and service code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token and how to search by date)