QI-Core Implementation Guide
7.0.2 - STU 7 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 7.0.2 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: QICore Service Prohibited

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-serviceprohibited Version: 7.0.2
Standards status: Trial-use Maturity Level: 4 Computable Name: QICoreServiceProhibited

Negation profile of ServiceRequest for decision support/quality metrics. Indicates a request not to provide a service

Contents:

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:
  • intent: (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  • code: (QI) What is being requested/ordered
  • subject: (QI) Individual or Entity the service is ordered for
  • authoredOn: (QI) Date request signed
  • status: (QI) draft | active | on-hold | completed
QI Elements:
  • code.extension(codeOptions): (QI) Url of a value set of candidate services
  • reasonCode: (QI) Explanation/Justification for procedure or service
  • occurrence[x]: (QI) When service should occur
  • doNotPerform: (QI) True if service/procedure should not be performed
  • reasonReference: (QI) Explanation/Justification for service or service
Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve

Guidance

Reference Guidance for use of the Service Prohibited profile can be found here.

  • See the Social Determinants of Health (SDOH) Guidance Page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
  • The ServiceRequest.category binding must support at a minimum the US Core ServiceRequest Category Codes. However, this valueset can be treated as extensible and other category codes can be used instead.
  • The ServiceRequest.code.extension:notDoneValueSet valueset identifies a set of possible coded values representing activities that were not requested, ordered, or performed.
  • The ServiceRequest.subject is Must Support with Must Support reference to QI-Core Patient

Usage

The ServiceRequest profile defines the conformance expectations for a ServiceRequest, regardless of whether it is a positive or negative statement. The ServiceRequested and ServiceProhibited profiles represent the positive and negative statements for a service request.

To create an expression indicating the existence of a service request, use the profile QICoreServiceRequested; to specifically request information that a ServiceRequest intentionally did not occur for a medical, patient or system reason, use the profile QICoreServiceProhibited.

The following expression retrieves instances that meet measure intent for exclusion: 

define "Intermittent Pneumatic Compression Devices Not Ordered":
  ["ServiceProhibited": "Application of intermittent pneumatic compression devices (IPC)"] DeviceProhibited
    where (DeviceProhibited.reasonRefused in "Medical Reason"
      or DeviceProhibited.reasonRefused in "Patient Refusal")

For a more complete discussion of representation of negation within QI-Core and quality improvement artifacts, see the Negation in QI-Core topic.

See the patterns page for implementation and usage patterns.

Examples

Negation Example with valuesetService discontinued; indicates that none of the services in the given `codeOptions` value set were requested.
Negation Example with codeService discontinued; indicates that the given service, by code, was not requested.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* QICoreServiceRequest A request for a service to be performed
Constraints: prr-1, srq-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (QI) draft | active | on-hold | completed
Binding: Positive Request Status (required)
... Slices for category SΣ 0..* CodeableConcept Classification of service
Slice: Unordered, Open by pattern:$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
... doNotPerform ?!Σ 1..1 boolean (QI) True if service/procedure should not be performed
Fixed Value: true
... code SΣC 1..1 CodeableConcept (QI) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... subject SΣ 1..1 Reference(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... occurrenceTiming Timing
... authoredOn SΣ 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) Who/what is requesting service
... reasonCode Σ 0..* CodeableConcept (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Extensible


doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required Positive Request Status 📦7.0.2 This IG
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

This structure is derived from QICoreServiceRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest 0..* QICoreServiceRequest A request for a service to be performed
... status 1..1 code (QI) draft | active | on-hold | completed
Binding: Positive Request Status (required)
... doNotPerform 1..1 boolean (QI) True if service/procedure should not be performed
Fixed Value: true
... authoredOn 1..1 dateTime (QI) Date request signed

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required Positive Request Status 📦7.0.2 This IG
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* QICoreServiceRequest A request for a service to be performed
Constraints: prr-1, srq-1
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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 (QI) draft | active | on-hold | completed
Binding: Positive Request Status (required)
... intent ?!SΣ 1..1 code (QI) 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 pattern:$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 1..1 boolean (QI) True if service/procedure should not be performed
Fixed Value: true
... code SΣC 1..1 CodeableConcept (QI) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject SΣ 1..1 Reference(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... 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 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) 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 (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Extensible

... reasonReference Σ 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
ServiceRequest.status Base required Positive Request Status 📦7.0.2 This IG
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📦4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📦4.0.1 FHIR Std.
ServiceRequest.locationCode Base example ServiceDeliveryLocationRoleType 📦3.0.0 THO v6.5
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

This structure is derived from QICoreServiceRequest

Summary

Mandatory: 2 elements
Fixed: 1 element

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* QICoreServiceRequest A request for a service to be performed
Constraints: prr-1, srq-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (QI) draft | active | on-hold | completed
Binding: Positive Request Status (required)
... Slices for category SΣ 0..* CodeableConcept Classification of service
Slice: Unordered, Open by pattern:$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
... doNotPerform ?!Σ 1..1 boolean (QI) True if service/procedure should not be performed
Fixed Value: true
... code SΣC 1..1 CodeableConcept (QI) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... subject SΣ 1..1 Reference(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... occurrenceTiming Timing
... authoredOn SΣ 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) Who/what is requesting service
... reasonCode Σ 0..* CodeableConcept (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Extensible


doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required Positive Request Status 📦7.0.2 This IG
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

Differential View

This structure is derived from QICoreServiceRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest 0..* QICoreServiceRequest A request for a service to be performed
... status 1..1 code (QI) draft | active | on-hold | completed
Binding: Positive Request Status (required)
... doNotPerform 1..1 boolean (QI) True if service/procedure should not be performed
Fixed Value: true
... authoredOn 1..1 dateTime (QI) Date request signed

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required Positive Request Status 📦7.0.2 This IG
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* QICoreServiceRequest A request for a service to be performed
Constraints: prr-1, srq-1
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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 (QI) draft | active | on-hold | completed
Binding: Positive Request Status (required)
... intent ?!SΣ 1..1 code (QI) 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 pattern:$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 1..1 boolean (QI) True if service/procedure should not be performed
Fixed Value: true
... code SΣC 1..1 CodeableConcept (QI) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject SΣ 1..1 Reference(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... 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 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) 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 (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Extensible

... reasonReference Σ 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
ServiceRequest.status Base required Positive Request Status 📦7.0.2 This IG
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📦4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📦4.0.1 FHIR Std.
ServiceRequest.locationCode Base example ServiceDeliveryLocationRoleType 📦3.0.0 THO v6.5
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

This structure is derived from QICoreServiceRequest

Summary

Mandatory: 2 elements
Fixed: 1 element

Maturity: 4

 

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