QI-Core Implementation Guide
4.1.0 - release

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## Resource Profile: QICoreDeviceNotRequested - Detailed Descriptions

Definitions for the qicore-devicenotrequested resource profile.

1. 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.
Control | 0..*
Invariants | Defined on this element 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/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()) 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. DeviceRequest.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. 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.
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. 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.
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. DeviceRequest.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. 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.
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. 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.
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. DeviceRequest.extension
Definition | An Extension
Control | 0..*
Type | Extension
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())
Slicing | This element introduces a set of slices on DeviceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
9. DeviceRequest.extension:doNotPerformReason
SliceName | doNotPerformReason
Definition | Indicates the reason the event was not performed.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(QICoreDoNotPerformReason) (Extension Type: CodeableConcept)
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())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. DeviceRequest.modifierExtension
Definition | An Extension
Control | 0..*
Type | Extension
Is Modifier | true
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())
Slicing | This element introduces a set of slices on DeviceRequest.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
11. DeviceRequest.modifierExtension:doNotPerform
SliceName | doNotPerform
Definition | An Extension
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(Extension-4.6-DeviceRequest.doNotPerform) (Extension Type: boolean)
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())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. 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.
Control | 0..1
Type | string
13. DeviceRequest.modifierExtension:doNotPerform.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())
Slicing | This element introduces a set of slices on DeviceRequest.modifierExtension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
14. DeviceRequest.modifierExtension:doNotPerform.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
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.
15. 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).
Control | 1..1
Type | boolean
[x] Note | See Choice of Data Types for further information about how to use [x]
Must Support | true
Fixed Value | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. DeviceRequest.identifier
Definition | Identifiers assigned to this order by the orderer or by the receiver.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. 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.
Control | 0..*
Type | canonical(ActivityDefinition | PlanDefinition)
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. 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.
Control | 0..*
Type | uri
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. DeviceRequest.basedOn
Definition | Plan/proposal/order fulfilled by this request.
Control | 0..*
Type | Reference(Resource)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. DeviceRequest.priorRequest
Definition | The request takes the place of the referenced completed or terminated request(s).
Control | 0..*
Type | Reference(Resource)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. DeviceRequest.groupIdentifier
Definition | Composite request this is part of.
Control | 0..1
Type | Identifier
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. DeviceRequest.status
Definition | The status of the request.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus Codes representing the status of the request.
Type | code
Is Modifier | true
Must Support | true
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.
Fixed Value | completed
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. DeviceRequest.intent
Definition | Whether the request is a proposal, plan, an original order or a reflex order.
Control | 1..1
Binding | The codes SHALL be taken from RequestIntent The kind of diagnostic 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()))
24. DeviceRequest.priority
Definition | Indicates how quickly the {{title}} should be addressed with respect to other requests.
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority Identifies the level of importance to be assigned to actioning the request.
Type | code
Meaning if Missing | If missing, normal priority
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. DeviceRequest.code[x]
Definition | The details of the device to be used.
Control | 1..1 This element is affected by the following invariants: dnr-1
Binding | For example codes, see FHIRDeviceTypes Codes for devices that can be requested.
Type | CodeableConcept
[x] Note | See Choice of Data Types for further information about how to use [x]
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()))
26. 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.
Control | 0..1
Type | string
27. 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.
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())
Slicing | This element introduces a set of slices on DeviceRequest.code[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
28. DeviceRequest.code[x].extension:doNotPerformValueSet
SliceName | doNotPerformValueSet
Definition | Specifies the value set that characterizes the events or activities that did not occur or were not performed.
Control | 0..1 This element is affected by the following invariants: dnr-1
Type | Extension(NotDoneValueSet) (Extension Type: canonical(ValueSet))
Must Support | true
Requirements | Must be able to indicate the value set from which the expected event would be drawn, had it occurred.
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())
29. DeviceRequest.code[x].coding
Definition | A reference to a code defined by a terminology system.
Control | 0..*
Type | Coding
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. 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.
Control | 0..1
Type | string
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.
Comments | Very often the text is the same as a displayName of one of the codings.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. DeviceRequest.parameter
Definition | Specific parameters for the ordered item. For example, the prism value for lenses.
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()))
32. 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.
Control | 0..1
Type | string
33. 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.
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())
34. 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).
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())
35. DeviceRequest.parameter.code
Definition | A code or string that identifies the device detail being asserted.
Control | 0..1
Binding | A code that identifies the device detail.
Type | CodeableConcept
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. DeviceRequest.parameter.value[x]
Definition | The value of the device detail.
Control | 0..1
Type | Choice of: CodeableConcept, Quantity, Range, boolean
[x] Note | See Choice of Data Types for further information about how to use [x]
Comments | Range means device should have a value that falls somewhere within the specified range.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. DeviceRequest.subject
Definition | The patient who will use the device.
Control | 1..1
Type | Reference(QICorePatient)
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()))
38. DeviceRequest.encounter
Definition | An encounter that provides additional context in which this request is made.
Control | 0..1
Type | Reference(QICoreEncounter)
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()))
39. 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".
Control | 0..1
Type | Choice of: dateTime, Period, Timing
[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()))
40. DeviceRequest.authoredOn
Definition | When the request transitioned to being actionable.
Control | 1..1
Type | dateTime
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()))
41. DeviceRequest.requester
Definition | The individual who initiated the request and has responsibility for its activation.
Control | 0..1
Type | Reference(Device | Practitioner | PractitionerRole | Organization)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. DeviceRequest.performerType
Definition | Desired type of performer for doing the diagnostic testing.
Control | 0..1
Binding | For example codes, see ParticipantRoles Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", 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()))
43. DeviceRequest.performer
Definition | The desired performer for doing the diagnostic testing.
Control | 0..1
Type | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. DeviceRequest.reasonCode
Definition | Reason or justification for the use of this device.
Control | 0..*
Binding | For example codes, see Condition/Problem/DiagnosisCodes Diagnosis or problem codes justifying the reason for requesting the device.
Type | CodeableConcept
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. DeviceRequest.reasonReference
Definition | Reason or justification for the use of this device.
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()))
46. DeviceRequest.insurance
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Control | 0..*
Type | Reference(Coverage | ClaimResponse)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. 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).
Control | 0..*
Type | Reference(Resource)
Requirements | Knowing where the device is targeted is important for tracking if multiple sites are possible.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. 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.
Control | 0..*
Type | Annotation
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()))
49. DeviceRequest.relevantHistory
Definition | Key events in the history of the request.
Control | 0..*
Type | Reference(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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))