QI-Core Implementation Guide
4.1.0 - release

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## Resource Profile: QICoreCommunicationRequest - Detailed Descriptions

Definitions for the qicore-communicationrequest resource profile.

1. CommunicationRequest
Definition | A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.
Control | 0..*
Invariants | Defined on this element dom-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())
2. CommunicationRequest.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | string
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.
3. CommunicationRequest.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.
Control | 0..1
Type | Meta
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. CommunicationRequest.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.
Control | 0..1
Type | uri
Is Modifier | true
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. CommunicationRequest.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages Max Binding: AllLanguages A human language.
Type | code
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).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. CommunicationRequest.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.
Control | 0..1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. CommunicationRequest.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.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained 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.
8. CommunicationRequest.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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
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.
Invariants | Defined on this element ele-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())
9. CommunicationRequest.modifierExtension
Definition | 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).
Control | 0..*
Type | Extension
Is Modifier | true
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 Names | extensions, user content
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.
Invariants | Defined on this element ele-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())
10. CommunicationRequest.identifier
Definition | Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. CommunicationRequest.basedOn
Definition | A plan or proposal that is fulfilled in whole or in part by this request.
Control | 0..*
Type | Reference(Resource)
Requirements | Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.
Alternate Names | fulfills
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. CommunicationRequest.replaces
Definition | Completed or terminated request(s) whose function is taken by this new request.
Control | 0..*
Type | Reference(CommunicationRequest)
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.
Alternate Names | supersedes, prior
Comments | The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. CommunicationRequest.groupIdentifier
Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.
Control | 0..1
Type | Identifier
Alternate Names | grouperId
Comments | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. CommunicationRequest.status
Definition | The status of the proposal or order.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus The status of the communication request.
Type | code
Is Modifier | true
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. CommunicationRequest.statusReason
Definition | Captures the reason for the current state of the CommunicationRequest.
Control | 0..1
Binding | Codes identifying the reason for the current state of a request.
Type | CodeableConcept
Alternate Names | Suspended Reason, Cancelled Reason
Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. CommunicationRequest.category
Definition | The type of message to be sent such as alert, notification, reminder, instruction, etc.
Control | 0..*
Binding | For example codes, see CommunicationCategory Codes for general categories of communications such as alerts, instruction, etc.
Type | CodeableConcept
Must Support | true
Comments | There may be multiple axes of categorization and one communication request may serve multiple purposes.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. CommunicationRequest.priority
Definition | Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority Codes indicating the relative importance of a communication request.
Type | code
Meaning if Missing | If missing, this task should be performed with normal priority
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. CommunicationRequest.doNotPerform
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur.
Control | 0..1
Type | boolean
Is Modifier | true
Must Support | true
Alternate Names | prohibited
Comments | The attributes provided with the request qualify what is not to be done.
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform"
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. CommunicationRequest.medium
Definition | A channel that was used for this communication (e.g. email, fax).
Control | 0..*
Binding | For example codes, see ParticipationMode Codes for communication mediums such as phone, fax, email, in person, etc.
Type | CodeableConcept
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. CommunicationRequest.subject
Definition | The patient or group that is the focus of this communication request.
Control | 0..1
Type | Reference(QICorePatient)
Must Support | true
Alternate Names | patient
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. CommunicationRequest.about
Definition | Other resources that pertain to this communication request and to which this communication request should be associated.
Control | 0..*
Type | Reference(Resource)
Comments | Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. CommunicationRequest.encounter
Definition | The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.
Control | 0..1
Type | Reference(QICoreEncounter)
Must Support | true
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. CommunicationRequest.payload
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient.
Control | 0..*
Type | BackboneElement
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. CommunicationRequest.payload.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
25. CommunicationRequest.payload.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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
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.
Invariants | Defined on this element ele-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())
26. CommunicationRequest.payload.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).
Control | 0..*
Type | Extension
Is Modifier | true
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 Names | extensions, user content, modifiers
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.
Invariants | Defined on this element ele-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())
27. CommunicationRequest.payload.content[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication).
Control | 1..1
Type | Choice of: string, Attachment, Reference(Resource)
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. CommunicationRequest.occurrence[x]
Definition | The time when this communication is to occur.
Control | 0..1
Type | Choice of: dateTime, Period
[x] Note | See Choice of Data Types for further information about how to use [x]
Alternate Names | timing
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. CommunicationRequest.authoredOn
Definition | For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.
Control | 0..1
Type | dateTime
Alternate Names | createdOn
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. CommunicationRequest.requester
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation.
Control | 0..1
Type | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
Alternate Names | author
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. CommunicationRequest.recipient
Definition | The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.
Control | 0..*
Type | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson | Group | CareTeam)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. CommunicationRequest.sender
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.
Control | 0..1
Type | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. CommunicationRequest.reasonCode
Definition | Describes why the request is being made in coded or textual form.
Control | 0..*
Binding | For example codes, see v3 Code System ActReason Codes for describing reasons for the occurrence of a communication.
Type | CodeableConcept
Comments | Textual reasons can be captured using reasonCode.text.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. CommunicationRequest.reasonReference
Definition | Indicates another resource whose existence justifies this request.
Control | 0..*
Type | Reference(Condition | Observation | DiagnosticReport | DocumentReference)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. CommunicationRequest.note
Definition | Comments made about the request by the requester, sender, recipient, subject or other participants.
Control | 0..*
Type | Annotation
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))