US Core Implementation Guide
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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 8.0.0-ballot built by the FHIR (HL7® FHIR® 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: 8.0.0-ballot
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreServiceRequestProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.59

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

The US Core ServiceRequest Profile inherits from the FHIR ServiceRequest resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching the ServiceRequest information. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

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:

  • For more information on exchanging Social Determinants of Health (SDOH) service requests, See the Screening and Assessments guidance page.

  • The Must Support ServiceRequest.category is bound, at a minimum, to the US Core ServiceRequest Category Codes, and other category codes can be used. API consumers can query by category when accessing patient information. For the USCDI Laboratory Order, Imaging Order, Clinical Test Order, and Procedure Order Data Elements, implementers SHOULD use the corresponding category codes listed in the table below. For example, laboratory orders would have the category code "108252007" (Laboratory procedure).

    USCDI Order Data Element Category Codes
    Laboratory Order 108252007 Laboratory procedure (procedure)
    Imaging Order 363679005 Imaging (procedure)
    Clinical Test Order 386053000 Evaluation procedure (procedure),
    410606002 Social service procedure (procedure), or
    387713003 Surgical procedure (procedure)
    Procedure Order 386053000 Evaluation procedure (procedure),
    410606002 Social service procedure (procedure), or
    387713003 Surgical procedure (procedure)

  • The ServiceRequest.code value set is broad to accommodate a wide variety of use cases and SHOULD be constrained to a subset for a particular use case or domain. These value sets contain concepts that span many use cases and are not bound to any USCDI Data Element. However, the table below identifies additional value set bindings for the USCDI Laboratory Order, Imaging Order and Clinical Test Order Data Elements. Implementers SHOULD conform to the binding strengths listed for each USCDI Order context. For example, laboratory orders are [extensibly] bound to the LOINC Common Laboratory Orders Value Set. Note that the USCDI Class Procedure Order Data Element has no additional binding.

    USCDI Order Data Element Additional Binding Binding Strength Comments
    Laboratory Order LOINC Common Laboratory Orders Value Set extensible The LOINC Common Laboratory Orders Value Set is a ‘starter set’ for mapping commonly used laboratory orders. It does not attempt to include all possible laboratory order codes. For additional information on LOINC Common Laboratory Orders Value Set, refer to www.loinc.org/usage/orders.
    Imaging Order LOINC Radiology Codes preferred The LOINC Radiology Codes include all imaging codes minus concepts that are deprecated or discouraged.
    Clinical Test Order LOINC Clinical Test Codes example LOINC Clinical Test Codes include non-laboratory and non-imaging clinical test codes that represent clinical tests.
  • *Servers and Clients SHALL support both US Core ServiceRequest and US Core Procedure Profiles for communicating the reason or justification for a referral as Additional USCDI Requirements. Typically, the reason or justification for a referral or consultation is communicated through Procedure.basedOn linking the Procedure to the US Core ServiceRequest Profile that includes either ServiceRequest.reasonCode or ServiceRequest.reasonReference. When the Procedure does not have an associated ServiceRequest, it is communicated through the US Core Procedure Profile's Procedure.reasonCode or Procedure.reasonReference. Depending on the procedure being documented, a Server will select the appropriate Profile to use.
    • Although both 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.
      • when using ServiceRequest.reasonReference:
        • Servers SHALL support at least one target resource in ServiceRequest.reasonReference. Clients SHALL support all target resources.
        • The referenced resources SHOULD be a US Core Profile as documented in Referencing US Core Profiles.

Usage:

Changes since version 7.0.0:

  • No changes

    • 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..* ServiceRequest A request for a service to be performed
    ... 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
    ... Slices for category S 0..* CodeableConcept Classification of service
    Slice: Unordered, Open by value:$this
    .... category:us-core S 0..* CodeableConcept Classification of service
    Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

    ... code S 1..1 CodeableConcept What is being requested/ordered
    Binding: US Core Procedure Codes (extensible)
    ... subject S 1..1 Reference(US Core Patient Profile S | Group | US Core Location Profile | Device) Individual or Entity the service is ordered for
    ... encounter S 0..1 Reference(US Core Encounter Profile) Encounter in which the request was created
    ... occurrence[x] S 0..1 When service should occur
    .... occurrencePeriod Period S
    .... occurrenceDateTime dateTime
    .... occurrenceTiming Timing
    ... authoredOn S 0..1 dateTime Date request signed
    ... requester S 0..1 Reference(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..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
    Binding: US Core Condition Codes (extensible)
    ... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
    from this IG
    ServiceRequest.codeextensibleUSCoreProcedureCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
    from this IG
    ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
    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
    ... 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
    ... Slices for category SΣ 0..* CodeableConcept Classification of service
    Slice: Unordered, Open by value:$this
    Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


    ele-1: All FHIR elements must have a @value or children
    .... category:us-core SΣ 0..* CodeableConcept Classification of service
    Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    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 SΣ 1..1 CodeableConcept What is being requested/ordered
    Binding: US Core Procedure Codes (extensible)
    ele-1: All FHIR elements must have a @value or children
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Individual or Entity the service is ordered for
    ele-1: All FHIR elements must have a @value or children
    ... encounter SΣ 0..1 Reference(US Core Encounter Profile) Encounter in which the request was created
    ele-1: All FHIR elements must have a @value or children
    ... occurrence[x] SΣ 0..1 When service should occur
    ele-1: All FHIR elements must have a @value or children
    .... occurrencePeriod Period
    ... authoredOn SΣ 0..1 dateTime Date request signed
    ele-1: All FHIR elements must have a @value or children
    ... requester SΣ 0..1 Reference(US Core Practitioner Profile) Who/what is requesting service
    ele-1: All FHIR elements must have a @value or children
    ... reasonCode Σ 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
    Binding: US Core Condition Codes (extensible)
    ele-1: All FHIR elements must have a @value or children
    ... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    ServiceRequest.statusrequiredRequestStatus
    http://hl7.org/fhir/ValueSet/request-status|4.0.1
    from the FHIR Standard
    ServiceRequest.intentrequiredRequestIntent
    http://hl7.org/fhir/ValueSet/request-intent|4.0.1
    from the FHIR Standard
    ServiceRequest.categoryexampleServiceRequestCategoryCodes
    http://hl7.org/fhir/ValueSet/servicerequest-category
    from the FHIR Standard
    ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
    from this IG
    ServiceRequest.codeextensibleUSCoreProcedureCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
    from this IG
    ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
    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 BindingsPurpose
    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 Σ 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(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
    ... replaces Σ 0..* Reference(ServiceRequest) What request replaces
    ... requisition Σ 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.

    ... Slices for category SΣ 0..* CodeableConcept Classification of service
    Slice: Unordered, Open by value:$this
    Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


    .... category:us-core SΣ 0..* CodeableConcept Classification of service
    Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... 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 SΣ 1..1 CodeableConcept What is being requested/ordered
    Binding: US Core Procedure Codes (extensible)
    ... 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(US Core Patient Profile S | Group | US Core Location Profile | Device) Individual or Entity the service is ordered for
    ... encounter SΣ 0..1 Reference(US Core Encounter Profile) Encounter in which the request was created
    ... occurrence[x] SΣ 0..1 When service should occur
    .... occurrencePeriod Period S
    .... occurrenceDateTime dateTime
    .... 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 0..1 Reference(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 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 Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested performer
    ... locationCode Σ 0..* CodeableConcept Requested location
    Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


    ... locationReference Σ 0..* Reference(Location) Requested location
    ... reasonCode Σ 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
    Binding: US Core Condition Codes (extensible)
    ... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested 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

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    ServiceRequest.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    ServiceRequest.statusrequiredRequestStatus
    http://hl7.org/fhir/ValueSet/request-status|4.0.1
    from the FHIR Standard
    ServiceRequest.intentrequiredRequestIntent
    http://hl7.org/fhir/ValueSet/request-intent|4.0.1
    from the FHIR Standard
    ServiceRequest.categoryexampleServiceRequestCategoryCodes
    http://hl7.org/fhir/ValueSet/servicerequest-category
    from the FHIR Standard
    ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
    from this IG
    ServiceRequest.priorityrequiredRequestPriority
    http://hl7.org/fhir/ValueSet/request-priority|4.0.1
    from the FHIR Standard
    ServiceRequest.codeextensibleUSCoreProcedureCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
    from this IG
    ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
    http://hl7.org/fhir/ValueSet/servicerequest-orderdetail
    from the FHIR Standard
    ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
    http://hl7.org/fhir/ValueSet/medication-as-needed-reason
    from the FHIR Standard
    ServiceRequest.performerTypeexampleParticipantRoles
    http://hl7.org/fhir/ValueSet/participant-role
    from the FHIR Standard
    ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
    http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
    ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
    from this IG
    ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard

    Differential View

    This structure is derived from ServiceRequest

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. ServiceRequest 0..* ServiceRequest A request for a service to be performed
    ... 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
    ... Slices for category S 0..* CodeableConcept Classification of service
    Slice: Unordered, Open by value:$this
    .... category:us-core S 0..* CodeableConcept Classification of service
    Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

    ... code S 1..1 CodeableConcept What is being requested/ordered
    Binding: US Core Procedure Codes (extensible)
    ... subject S 1..1 Reference(US Core Patient Profile S | Group | US Core Location Profile | Device) Individual or Entity the service is ordered for
    ... encounter S 0..1 Reference(US Core Encounter Profile) Encounter in which the request was created
    ... occurrence[x] S 0..1 When service should occur
    .... occurrencePeriod Period S
    .... occurrenceDateTime dateTime
    .... occurrenceTiming Timing
    ... authoredOn S 0..1 dateTime Date request signed
    ... requester S 0..1 Reference(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..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
    Binding: US Core Condition Codes (extensible)
    ... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
    from this IG
    ServiceRequest.codeextensibleUSCoreProcedureCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
    from this IG
    ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
    from this IG

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
    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
    ... 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
    ... Slices for category SΣ 0..* CodeableConcept Classification of service
    Slice: Unordered, Open by value:$this
    Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


    ele-1: All FHIR elements must have a @value or children
    .... category:us-core SΣ 0..* CodeableConcept Classification of service
    Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    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 SΣ 1..1 CodeableConcept What is being requested/ordered
    Binding: US Core Procedure Codes (extensible)
    ele-1: All FHIR elements must have a @value or children
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Individual or Entity the service is ordered for
    ele-1: All FHIR elements must have a @value or children
    ... encounter SΣ 0..1 Reference(US Core Encounter Profile) Encounter in which the request was created
    ele-1: All FHIR elements must have a @value or children
    ... occurrence[x] SΣ 0..1 When service should occur
    ele-1: All FHIR elements must have a @value or children
    .... occurrencePeriod Period
    ... authoredOn SΣ 0..1 dateTime Date request signed
    ele-1: All FHIR elements must have a @value or children
    ... requester SΣ 0..1 Reference(US Core Practitioner Profile) Who/what is requesting service
    ele-1: All FHIR elements must have a @value or children
    ... reasonCode Σ 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
    Binding: US Core Condition Codes (extensible)
    ele-1: All FHIR elements must have a @value or children
    ... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    ServiceRequest.statusrequiredRequestStatus
    http://hl7.org/fhir/ValueSet/request-status|4.0.1
    from the FHIR Standard
    ServiceRequest.intentrequiredRequestIntent
    http://hl7.org/fhir/ValueSet/request-intent|4.0.1
    from the FHIR Standard
    ServiceRequest.categoryexampleServiceRequestCategoryCodes
    http://hl7.org/fhir/ValueSet/servicerequest-category
    from the FHIR Standard
    ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
    from this IG
    ServiceRequest.codeextensibleUSCoreProcedureCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
    from this IG
    ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
    from this IG

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
    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 BindingsPurpose
    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 Σ 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(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
    ... replaces Σ 0..* Reference(ServiceRequest) What request replaces
    ... requisition Σ 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.

    ... Slices for category SΣ 0..* CodeableConcept Classification of service
    Slice: Unordered, Open by value:$this
    Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


    .... category:us-core SΣ 0..* CodeableConcept Classification of service
    Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... 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 SΣ 1..1 CodeableConcept What is being requested/ordered
    Binding: US Core Procedure Codes (extensible)
    ... 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(US Core Patient Profile S | Group | US Core Location Profile | Device) Individual or Entity the service is ordered for
    ... encounter SΣ 0..1 Reference(US Core Encounter Profile) Encounter in which the request was created
    ... occurrence[x] SΣ 0..1 When service should occur
    .... occurrencePeriod Period S
    .... occurrenceDateTime dateTime
    .... 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 0..1 Reference(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 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 Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested performer
    ... locationCode Σ 0..* CodeableConcept Requested location
    Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


    ... locationReference Σ 0..* Reference(Location) Requested location
    ... reasonCode Σ 0..* CodeableConcept 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
    Binding: US Core Condition Codes (extensible)
    ... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested 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

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    ServiceRequest.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    ServiceRequest.statusrequiredRequestStatus
    http://hl7.org/fhir/ValueSet/request-status|4.0.1
    from the FHIR Standard
    ServiceRequest.intentrequiredRequestIntent
    http://hl7.org/fhir/ValueSet/request-intent|4.0.1
    from the FHIR Standard
    ServiceRequest.categoryexampleServiceRequestCategoryCodes
    http://hl7.org/fhir/ValueSet/servicerequest-category
    from the FHIR Standard
    ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
    from this IG
    ServiceRequest.priorityrequiredRequestPriority
    http://hl7.org/fhir/ValueSet/request-priority|4.0.1
    from the FHIR Standard
    ServiceRequest.codeextensibleUSCoreProcedureCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
    from this IG
    ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
    http://hl7.org/fhir/ValueSet/servicerequest-orderdetail
    from the FHIR Standard
    ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
    http://hl7.org/fhir/ValueSet/medication-as-needed-reason
    from the FHIR Standard
    ServiceRequest.performerTypeexampleParticipantRoles
    http://hl7.org/fhir/ValueSet/participant-role
    from the FHIR Standard
    ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
    http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
    ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
    http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
    from this IG
    ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard

     

    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 profile'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.

    • See the Scopes Format section for a description of the SMART scopes syntax.
    • See the Search Syntax section for a description of the US Core search syntax.
    • 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:

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

    • granular scopes: <patient|user|system>/ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh

    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 both 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)