QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICoreDeviceNotRequested - Detailed Descriptions

Active as of 2019-07-11

Definitions for the qicore-devicenotrequested resource profile.

Guidance on how to interpret the contents of this table can be found here

0. DeviceRequest
Must Supportfalse
Invariantsdnr-1: to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided (code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists())
2. DeviceRequest.modifierExtension:doNotPerform
Slice NamedoNotPerform
Short(QI) Extension
Control1..1
TypeExtension(Extension Definition for DeviceRequest.doNotPerform for Version 5.0) (Extension Type: boolean)
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
4. DeviceRequest.modifierExtension:doNotPerform.value[x]
Short(QI) Value of extension
Control1..1
Typeboolean
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Fixed Valuetrue
6. DeviceRequest.status
Short(QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
8. DeviceRequest.intent
Short(QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
10. DeviceRequest.code[x]
Short(QI) Device requested
Control1..1
This element is affected by the following invariants: dnr-1
BindingThe codes SHOULD be taken from FHIRDeviceTypes
(preferred to http://hl7.org/fhir/ValueSet/device-kind)
TypeCodeableConcept, Reference(Device)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
12. DeviceRequest.code[x].extension:doNotPerformValueSet
Slice NamedoNotPerformValueSet
Definition

Specifies the value set that characterizes the events or activities that did not occur or were not performed.

Short(QI) What was not done
Control0..1
This element is affected by the following invariants: dnr-1
TypeExtension(Not Done ValueSet) (Extension Type: canonical(ValueSet))
Requirements

Must be able to indicate the value set from which the expected event would be drawn, had it occurred.

14. DeviceRequest.subject
Short(QI) Focus of request
TypeReference(QICore Patient)
16. DeviceRequest.authoredOn
Short(QI) When recorded
Control1..1
18. DeviceRequest.reasonCode
Short(QI) Explanation/Justification for procedure or service
BindingUnless not suitable, these codes SHALL be taken from QICore Negation Reason Codes
(extensible to http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason)
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. DeviceRequest
Definition

Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

ShortMedical device request
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dnr-1: to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided (code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists())
2. DeviceRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DeviceRequest.modifierExtension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensionExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control10..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. DeviceRequest.modifierExtension:doNotPerform
    Slice NamedoNotPerform
    Definition

    An Extension

    Short(QI) Extension
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension Definition for DeviceRequest.doNotPerform for Version 5.0) (Extension Type: boolean)
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. DeviceRequest.modifierExtension:doNotPerform.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. DeviceRequest.modifierExtension:doNotPerform.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
      12. DeviceRequest.modifierExtension:doNotPerform.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      Short(QI) Value of extensionValue of extension
      Control10..1
      Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Fixed Valuetrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. DeviceRequest.status
      Definition

      The status of the request.

      Short(QI) draft | active | on-hold | revoked | completed | entered-in-error | unknowndraft | active | on-hold | revoked | completed | entered-in-error | unknown
      Comments

      This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.

      Control0..1
      BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

      Codes representing the status of the request.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. DeviceRequest.intent
      Definition

      Whether the request is a proposal, plan, an original order or a reflex order.

      Short(QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | optionproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
      Control1..1
      BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

      The kind of diagnostic request.

      Typecode
      Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. DeviceRequest.code[x]
      Definition

      The details of the device to be used.

      Short(QI) Device requestedDevice requested
      Control1..1
      This element is affected by the following invariants: dnr-1
      BindingThe codes SHOULD be taken from For example codes, see FHIRDeviceTypeshttp://hl7.org/fhir/ValueSet/device-kind
      (preferred to http://hl7.org/fhir/ValueSet/device-kind)
      TypeCodeableConcept, Reference(Device)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. DeviceRequest.code[x].extension:doNotPerformValueSet
      Slice NamedoNotPerformValueSet
      Definition

      Specifies the value set that characterizes the events or activities that did not occur or were not performed.

      Short(QI) What was not done
      Control0..1
      This element is affected by the following invariants: dnr-1
      TypeExtension(Not Done ValueSet) (Extension Type: canonical(ValueSet))
      Is Modifierfalse
      Summaryfalse
      Requirements

      Must be able to indicate the value set from which the expected event would be drawn, had it occurred.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      22. DeviceRequest.subject
      Definition

      The patient who will use the device.

      Short(QI) Focus of requestFocus of request
      Control1..1
      TypeReference(QICore Patient, Patient, Group, Location, Device)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. DeviceRequest.authoredOn
      Definition

      When the request transitioned to being actionable.

      Short(QI) When recordedWhen recorded
      Control10..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. DeviceRequest.reasonCode
      Definition

      Reason or justification for the use of this device.

      Short(QI) Explanation/Justification for procedure or serviceCoded Reason for request
      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see QICore Negation Reason Codeshttp://hl7.org/fhir/ValueSet/condition-code
      (extensible to http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. DeviceRequest
      Definition

      Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

      ShortMedical device request
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      dnr-1: to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided (code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists())
      2. DeviceRequest.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. DeviceRequest.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. DeviceRequest.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. DeviceRequest.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. DeviceRequest.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. DeviceRequest.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. DeviceRequest.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. DeviceRequest.modifierExtension
      Definition

      An Extension

      ShortExtension
      Control1..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 18. DeviceRequest.modifierExtension:doNotPerform
        Slice NamedoNotPerform
        Definition

        An Extension

        Short(QI) Extension
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension Definition for DeviceRequest.doNotPerform for Version 5.0) (Extension Type: boolean)
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. DeviceRequest.modifierExtension:doNotPerform.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        22. DeviceRequest.modifierExtension:doNotPerform.extension
        Definition

        An Extension

        ShortExtension
        Control0..0
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 24. DeviceRequest.modifierExtension:doNotPerform.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
          26. DeviceRequest.modifierExtension:doNotPerform.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          Short(QI) Value of extension
          Control1..1
          Typeboolean
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Fixed Valuetrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. DeviceRequest.identifier
          Definition

          Identifiers assigned to this order by the orderer or by the receiver.

          ShortExternal Request identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. DeviceRequest.instantiatesCanonical
          Definition

          The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

          ShortInstantiates FHIR protocol or definition
          Comments

          Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

          Control0..*
          Typecanonical(ActivityDefinition, PlanDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. DeviceRequest.instantiatesUri
          Definition

          The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

          ShortInstantiates external protocol or definition
          Comments

          This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

          Control0..*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. DeviceRequest.basedOn
          Definition

          Plan/proposal/order fulfilled by this request.

          ShortWhat request fulfills
          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. DeviceRequest.priorRequest
          Definition

          The request takes the place of the referenced completed or terminated request(s).

          ShortWhat request replaces
          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. DeviceRequest.groupIdentifier
          Definition

          Composite request this is part of.

          ShortIdentifier of composite request
          Control0..1
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. DeviceRequest.status
          Definition

          The status of the request.

          Short(QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
          Comments

          This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.

          Control0..1
          BindingThe codes SHALL be taken from RequestStatus
          (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

          Codes representing the status of the request.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. DeviceRequest.intent
          Definition

          Whether the request is a proposal, plan, an original order or a reflex order.

          Short(QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
          Control1..1
          BindingThe codes SHALL be taken from RequestIntent
          (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

          The kind of diagnostic request.

          Typecode
          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. DeviceRequest.priority
          Definition

          Indicates how quickly the {{title}} should be addressed with respect to other requests.

          Shortroutine | urgent | asap | stat
          Control0..1
          BindingThe codes SHALL be taken from RequestPriority
          (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

          Identifies the level of importance to be assigned to actioning the request.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Meaning if MissingIf missing, normal priority
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. DeviceRequest.code[x]
          Definition

          The details of the device to be used.

          Short(QI) Device requested
          Control1..1
          This element is affected by the following invariants: dnr-1
          BindingThe codes SHOULD be taken from FHIRDeviceTypes
          (preferred to http://hl7.org/fhir/ValueSet/device-kind)
          TypeCodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. DeviceRequest.code[x].id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          50. DeviceRequest.code[x].extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on DeviceRequest.code[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 52. DeviceRequest.code[x].extension:doNotPerformValueSet
            Slice NamedoNotPerformValueSet
            Definition

            Specifies the value set that characterizes the events or activities that did not occur or were not performed.

            Short(QI) What was not done
            Control0..1
            This element is affected by the following invariants: dnr-1
            TypeExtension(Not Done ValueSet) (Extension Type: canonical(ValueSet))
            Is Modifierfalse
            Summaryfalse
            Requirements

            Must be able to indicate the value set from which the expected event would be drawn, had it occurred.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            54. DeviceRequest.code[x].coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. DeviceRequest.code[x].text
            Definition

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. DeviceRequest.parameter
            Definition

            Specific parameters for the ordered item. For example, the prism value for lenses.

            ShortDevice details
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. DeviceRequest.parameter.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            62. DeviceRequest.parameter.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            64. DeviceRequest.parameter.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            66. DeviceRequest.parameter.code
            Definition

            A code or string that identifies the device detail being asserted.

            ShortDevice detail
            Control0..1
            Binding

            A code that identifies the device detail.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. DeviceRequest.parameter.value[x]
            Definition

            The value of the device detail.

            ShortValue of detail
            Comments

            Range means device should have a value that falls somewhere within the specified range.

            Control0..1
            TypeChoice of: CodeableConcept, Quantity, Range, boolean
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. DeviceRequest.subject
            Definition

            The patient who will use the device.

            Short(QI) Focus of request
            Control1..1
            TypeReference(QICore Patient)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. DeviceRequest.encounter
            Definition

            An encounter that provides additional context in which this request is made.

            ShortEncounter motivating request
            Control0..1
            TypeReference(Encounter)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. DeviceRequest.occurrence[x]
            Definition

            The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".

            ShortDesired time or schedule for use
            Control0..1
            TypeChoice of: dateTime, Period, Timing
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. DeviceRequest.authoredOn
            Definition

            When the request transitioned to being actionable.

            Short(QI) When recorded
            Control1..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. DeviceRequest.requester
            Definition

            The individual who initiated the request and has responsibility for its activation.

            ShortWho/what is requesting diagnostics
            Control0..1
            TypeReference(Device, Practitioner, PractitionerRole, Organization)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. DeviceRequest.performerType
            Definition

            Desired type of performer for doing the diagnostic testing.

            ShortFiller role
            Control0..1
            BindingFor example codes, see ParticipantRoles
            (example to http://hl7.org/fhir/ValueSet/participant-role)

            Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            82. DeviceRequest.performer
            Definition

            The desired performer for doing the diagnostic testing.

            ShortRequested Filler
            Control0..1
            TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. DeviceRequest.reasonCode
            Definition

            Reason or justification for the use of this device.

            Short(QI) Explanation/Justification for procedure or service
            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from QICore Negation Reason Codes
            (extensible to http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason)
            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. DeviceRequest.reasonReference
            Definition

            Reason or justification for the use of this device.

            ShortLinked Reason for request
            Control0..*
            TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. DeviceRequest.insurance
            Definition

            Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

            ShortAssociated insurance coverage
            Control0..*
            TypeReference(Coverage, ClaimResponse)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. DeviceRequest.supportingInfo
            Definition

            Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site).

            ShortAdditional clinical information
            Control0..*
            TypeReference(Resource)
            Is Modifierfalse
            Summaryfalse
            Requirements

            Knowing where the device is targeted is important for tracking if multiple sites are possible.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. DeviceRequest.note
            Definition

            Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

            ShortNotes or comments
            Control0..*
            TypeAnnotation
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. DeviceRequest.relevantHistory
            Definition

            Key events in the history of the request.

            ShortRequest provenance
            Comments

            This might not include provenances for all versions of the request - only those deemed "relevant" or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

            Control0..*
            TypeReference(Provenance)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))