FHIR Clinical Guidelines (v1.0.0) (STU1)

Clinical Practice Guidelines, published by Clinical Decision Support WG. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

D.4.1 StructureDefinition-cpg-servicerequest

Introduction:

This is an activity request profile

Examples:

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-servicerequest

Recommendation for a particular procedure or referral to a specialist or instructions for self-care such as smoking cessation counseling or exercise

This profile builds on ServiceRequest.

This profile was published on Thu Jun 06 00:00:00 UTC 2019 as a draft by Health Level Seven, Inc. - CDS WG.

Description of Profiles, Differentials, and Snapshots.

Summary

Must-Support: 14 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest 0..*ServiceRequestA request for a service to be performed
... cpg-rationale S0..1markdownExplanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... identifier S0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical S0..*canonical(ActivityDefinition | PlanDefinition)Source
... 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
... category S0..*CodeableConceptClassification of service
... priority S0..1coderoutine | urgent | asap | stat
... doNotPerform S0..1booleanTrue if service/procedure should not be performed
... code S0..1CodeableConceptWhat is being requested/ordered
... subject S1..1Reference(CPGPatient)Individual or Entity the service is ordered for
... encounter S0..1Reference(CPGEncounter)Encounter in which the request was created
... occurrence[x] S0..1dateTime, Period, TimingWhen service should occur
... asNeeded[x] S0..1boolean, CodeableConceptPreconditions for service
... supportingInfo S0..*Reference(Resource)Pertinent information

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest I0..*ServiceRequestA request for a service to be performed
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-rationale S0..1markdownExplanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical SΣ0..*canonical(ActivityDefinition | PlanDefinition)Source
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | ServiceRequest | MedicationRequest)What request fulfills
... replaces Σ0..*Reference(ServiceRequest)What request replaces
... requisition Σ0..1IdentifierComposite Request ID
... status ?!SΣ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... category SΣ0..*CodeableConceptClassification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


... priority SΣ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ0..1booleanTrue if service/procedure should not be performed
... code SΣ0..1CodeableConceptWhat 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)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here.

... orderDetail ΣI0..*CodeableConceptAdditional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.


... quantity[x] Σ0..1Service amount
.... quantityQuantityQuantity
.... quantityRatioRatio
.... quantityRangeRange
... subject SΣ1..1Reference(CPGPatient)Individual or Entity the service is ordered for
... encounter SΣ0..1Reference(CPGEncounter)Encounter in which the request was created
... occurrence[x] SΣ0..1When service should occur
.... occurrenceDateTimedateTime
.... occurrencePeriodPeriod
.... occurrenceTimingTiming
... asNeeded[x] SΣ0..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 Σ0..1dateTimeDate request signed
... requester Σ0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)Who/what is requesting service
... performerType Σ0..1CodeableConceptPerformer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)Requested performer
... locationCode Σ0..*CodeableConceptRequested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


... locationReference Σ0..*Reference(Location)Requested location
... reasonCode Σ0..*CodeableConceptExplanation/Justification for procedure or service
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.


... reasonReference Σ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Explanation/Justification for service or service
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... supportingInfo S0..*Reference(Resource)Pertinent information
... specimen Σ0..*Reference(Specimen)Procedure Samples
... bodySite Σ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... note 0..*AnnotationComments
... patientInstruction Σ0..1stringPatient or consumer-oriented instructions
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Summary

Must-Support: 14 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest 0..*ServiceRequestA request for a service to be performed
... cpg-rationale S0..1markdownExplanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... identifier S0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical S0..*canonical(ActivityDefinition | PlanDefinition)Source
... 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
... category S0..*CodeableConceptClassification of service
... priority S0..1coderoutine | urgent | asap | stat
... doNotPerform S0..1booleanTrue if service/procedure should not be performed
... code S0..1CodeableConceptWhat is being requested/ordered
... subject S1..1Reference(CPGPatient)Individual or Entity the service is ordered for
... encounter S0..1Reference(CPGEncounter)Encounter in which the request was created
... occurrence[x] S0..1dateTime, Period, TimingWhen service should occur
... asNeeded[x] S0..1boolean, CodeableConceptPreconditions for service
... supportingInfo S0..*Reference(Resource)Pertinent information

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest I0..*ServiceRequestA request for a service to be performed
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... cpg-rationale S0..1markdownExplanation
URL: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-rationale
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical SΣ0..*canonical(ActivityDefinition | PlanDefinition)Source
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | ServiceRequest | MedicationRequest)What request fulfills
... replaces Σ0..*Reference(ServiceRequest)What request replaces
... requisition Σ0..1IdentifierComposite Request ID
... status ?!SΣ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... category SΣ0..*CodeableConceptClassification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


... priority SΣ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ0..1booleanTrue if service/procedure should not be performed
... code SΣ0..1CodeableConceptWhat 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)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here.

... orderDetail ΣI0..*CodeableConceptAdditional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.


... quantity[x] Σ0..1Service amount
.... quantityQuantityQuantity
.... quantityRatioRatio
.... quantityRangeRange
... subject SΣ1..1Reference(CPGPatient)Individual or Entity the service is ordered for
... encounter SΣ0..1Reference(CPGEncounter)Encounter in which the request was created
... occurrence[x] SΣ0..1When service should occur
.... occurrenceDateTimedateTime
.... occurrencePeriodPeriod
.... occurrenceTimingTiming
... asNeeded[x] SΣ0..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 Σ0..1dateTimeDate request signed
... requester Σ0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)Who/what is requesting service
... performerType Σ0..1CodeableConceptPerformer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)Requested performer
... locationCode Σ0..*CodeableConceptRequested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


... locationReference Σ0..*Reference(Location)Requested location
... reasonCode Σ0..*CodeableConceptExplanation/Justification for procedure or service
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.


... reasonReference Σ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Explanation/Justification for service or service
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... supportingInfo S0..*Reference(Resource)Pertinent information
... specimen Σ0..*Reference(Specimen)Procedure Samples
... bodySite Σ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


... note 0..*AnnotationComments
... patientInstruction Σ0..1stringPatient or consumer-oriented instructions
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet
ServiceRequest.languagepreferredCommonLanguages
Max Binding: AllLanguages
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.priorityrequiredRequestPriority
ServiceRequest.codeexampleProcedureCodes(SNOMEDCT)
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerTypeexampleParticipantRoles
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeexampleProcedureReasonCodes
ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2ServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3ServiceRequestIf 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-4ServiceRequestIf 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-5ServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6ServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
prr-1ServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
ele-1ServiceRequest.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1ServiceRequest.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1ServiceRequest.extension:rationaleAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1ServiceRequest.extension:rationaleMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1ServiceRequest.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1ServiceRequest.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1ServiceRequest.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.instantiatesCanonicalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.instantiatesUriAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.replacesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.requisitionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.intentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.priorityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.doNotPerformAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.orderDetailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.quantity[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.occurrence[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.asNeeded[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.authoredOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.requesterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.performerTypeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.locationCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.locationReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.reasonCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.reasonReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.insuranceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.supportingInfoAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.specimenAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.patientInstructionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1ServiceRequest.relevantHistoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())