Physical Activity Implementation Guide
1.0.1 - STU Release 1 United States of America flag

Physical Activity Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/physical-activity/ and changes regularly. See the Directory of published versions

Resource Profile: PAServiceRequest - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the pa-servicerequest resource profile.

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

0. ServiceRequest
Definition

Represents orders and referrals for interventions that help to improve or maintain a patient's level of physical activity

Invariantspa-sr-1: At least one of reasonCode or reasonReference must be provided (reasonCode.exists() or reasonReference.exists())
2. ServiceRequest.implicitRules
Control0..0
4. ServiceRequest.extension
SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. ServiceRequest.extension:pertainsToGoal
    Slice NamepertainsToGoal
    Control0..*
    TypeExtension(pertains to goal) (Extension Type: Reference(Goal))
    Must Supporttrue
    Requirements

    Allows linking a referral or exercise prescription to the goal(s) it's trying to address

    8. ServiceRequest.extension:pertainsToGoal.value[x]
    TypeReference(Reference - RESTful)(PA Goal)
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    10. ServiceRequest.extension:observationFocus
    Slice NameobservationFocus
    Control0..1
    TypeExtension(Extension Definition for Observation.focus for Version 5.0) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
    Requirements

    Allows referrals seeking services for relatives rather than the patient themselves - e.g. training or counselling for parents of a minor.

    12. ServiceRequest.extension:observationFocus.value[x]
    TypeReference(PA Related Person)
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    14. ServiceRequest.modifierExtension
    Control0..0
    16. ServiceRequest.status
    Shortdraft | active | on-hold | revoked | completed | entered-in-error
    BindingThe codes SHALL be taken from PA ServiceRequest Status
    (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-status)
    Must Supporttrue
    18. ServiceRequest.intent
    Shortoriginal-order | order | filler-order
    Comments

    ...Multiple codes are allowed to support situations where a Task might point to a filler order instead of an original. However, in almost all cases, the intent should be 'original-order' or just 'order'.

    BindingThe codes SHALL be taken from PA ServiceRequest Intents
    (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-intent)
    Must Supporttrue
    20. ServiceRequest.category
    Control1..?
    SlicingThis element introduces a set of slices on ServiceRequest.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 22. ServiceRequest.category:PA
      Slice NamePA
      Control1..1
      Must Supporttrue
      Pattern Value{
        "coding" : [{
          "system" : "http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes",
          "code" : "PhysicalActivity"
        }]
      }
      24. ServiceRequest.category:USCore
      Slice NameUSCore
      Control0..*
      BindingThe codes SHALL be taken from PA ServiceRequest Category - USCore
      (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-diagnosticreport-category)
      26. ServiceRequest.priority
      Must Supporttrue
      28. ServiceRequest.doNotPerform
      Control0..0
      30. ServiceRequest.code
      Control1..?
      BindingUnless not suitable, these codes SHALL be taken from PA ServiceRequest Intervention Codes
      (extensible to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-code)
      Must Supporttrue
      32. ServiceRequest.subject
      TypeReference(Reference - RESTful)(US Core Patient Profile)
      Must Supporttrue
      34. ServiceRequest.occurrence[x]
      TypeChoice of: dateTime, Period, Timing
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      SlicingThis element introduces a set of slices on ServiceRequest.occurrence[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 36. ServiceRequest.occurrence[x]:occurrencePeriod
        Slice NameoccurrencePeriod
        Control0..1
        TypePeriod
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Must Supporttrue
        Must Support TypesPeriod
        38. ServiceRequest.occurrence[x]:occurrencePeriod.start
        Must Supporttrue
        40. ServiceRequest.occurrence[x]:occurrencePeriod.end
        Must Supporttrue
        42. ServiceRequest.authoredOn
        Control1..?
        Must Supporttrue
        44. ServiceRequest.requester
        Control1..?
        TypeReference(Reference - RESTful or Logical)(US Core Practitioner Profile, US Core PractitionerRole Profile)
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        46. ServiceRequest.performer
        TypeReference(Reference - RESTful or Logical)(US Core Patient Profile, US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile, PA Related Person)
        Must Supporttrue
        Must Support TypesReference(US Core Patient Profile, US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile)
        48. ServiceRequest.reasonCode
        BindingUnless not suitable, these codes SHALL be taken from US Core Condition Code
        (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
        Must Supporttrue
        50. ServiceRequest.reasonCode.text
        Must Supporttrue
        52. ServiceRequest.reasonReference
        SlicingThis element introduces a set of slices on ServiceRequest.reasonReference. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 54. ServiceRequest.reasonReference:SupportedReasonReference
          Slice NameSupportedReasonReference
          Control0..*
          TypeReference(US Core Condition Profile)
          Must Supporttrue
          56. ServiceRequest.supportingInfo
          TypeReference(Reference - RESTful)(Resource)
          SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • profile @ resolve()
          • 58. ServiceRequest.supportingInfo:SupportedSupportingInfo
            Slice NameSupportedSupportingInfo
            Control0..*
            TypeReference(Reference - RESTful)(PA Observation EVS Base)
            Must Supporttrue
            60. ServiceRequest.specimen
            Control0..0
            62. ServiceRequest.note
            Definition

            This field contains additional details about the service request (for e.g. the appropriate time and mechanism for the service provider to contact the patient). Please note that service providers typically won't see notes that are added once a ServiceRequest has been accepted.

            ShortAdditional details about the service request
            64. ServiceRequest.note.author[x]
            Control1..?
            TypeReference(Reference - RESTful)(US Core Practitioner Profile, US Core Organization Profile)
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Must Supporttrue
            Must Support TypesReference(US Core Practitioner Profile, US Core Organization Profile)
            66. ServiceRequest.note.time
            Control1..?
            Must Supporttrue
            68. ServiceRequest.note.text
            Must Supporttrue

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

            0. ServiceRequest
            Definition

            Represents orders and referrals for interventions that help to improve or maintain a patient's level of physical activity


            A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

            ShortA request for a service to be performed
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Alternate Namesdiagnostic request, referral, referral request, transfer of care request
            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())
            prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
            pa-sr-1: At least one of reasonCode or reasonReference must be provided (reasonCode.exists() or reasonReference.exists())
            prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
            2. ServiceRequest.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..01
            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. ServiceRequest.extension
            Definition

            An Extension


            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.

            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..*
            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 ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 6. ServiceRequest.extension:pertainsToGoal
              Slice NamepertainsToGoal
              Definition

              Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

              ShortPertains to goal
              Comments

              This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(pertains to goal) (Extension Type: Reference(Goal))
              Is Modifierfalse
              Must Supporttrue
              Requirements

              Allows linking a referral or exercise prescription to the goal(s) it's trying to address

              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. ServiceRequest.extension:pertainsToGoal.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 ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 10. ServiceRequest.extension:pertainsToGoal.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/StructureDefinition/resource-pertainsToGoal
                12. ServiceRequest.extension:pertainsToGoal.value[x]
                Definition

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


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

                ShortValue of extension
                Control10..1
                TypeReference(Reference - RESTful)(PA Goal), 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, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                14. ServiceRequest.extension:observationFocus
                Slice NameobservationFocus
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Extension Definition for Observation.focus for Version 5.0) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                Is Modifierfalse
                Requirements

                Allows referrals seeking services for relatives rather than the patient themselves - e.g. training or counselling for parents of a minor.

                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())
                16. ServiceRequest.extension:observationFocus.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 ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 18. ServiceRequest.extension:observationFocus.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-Observation.focus
                  20. ServiceRequest.extension:observationFocus.value[x]
                  Definition

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

                  ShortValue of extension
                  Control10..1
                  TypeReference(PA Related Person), 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, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. ServiceRequest.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.

                  Control0..0*
                  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())
                  24. ServiceRequest.status
                  Definition

                  The status of the order.

                  Shortdraft | active | on-hold | revoked | completed | entered-in-errordraft | active | on-hold | revoked | completed | entered-in-error | unknown
                  Comments

                  The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

                  Control1..1
                  BindingThe codes SHALL be taken from PA ServiceRequest Statushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
                  (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-status)
                  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
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  26. ServiceRequest.intent
                  Definition

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

                  Shortoriginal-order | order | filler-orderproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
                  Comments

                  This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Multiple codes are allowed to support situations where a Task might point to a filler order instead of an original. However, in almost all cases, the intent should be 'original-order' or just 'order'.


                  This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                  Control1..1
                  BindingThe codes SHALL be taken from PA ServiceRequest Intentshttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
                  (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-intent)
                  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
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  28. ServiceRequest.category
                  Definition

                  A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                  ShortClassification of service
                  Comments

                  There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                  Control10..*
                  BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category
                  (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

                  Classification of the requested service.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Used for filtering what service request are retrieved and displayed.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on ServiceRequest.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • pattern @ $this
                  • 30. ServiceRequest.category:PA
                    Slice NamePA
                    Definition

                    A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                    ShortClassification of service
                    Comments

                    There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                    Control10..1*
                    BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category
                    (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

                    Classification of the requested service.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Used for filtering what service request are retrieved and displayed.

                    Pattern Value{
                      "coding" : [{
                        "system" : "http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes",
                        "code" : "PhysicalActivity"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    32. ServiceRequest.category:USCore
                    Slice NameUSCore
                    Definition

                    A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                    ShortClassification of service
                    Comments

                    There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                    Control0..*
                    BindingThe codes SHALL be taken from For example codes, see PA ServiceRequest Category - USCorehttp://hl7.org/fhir/ValueSet/servicerequest-category
                    (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-diagnosticreport-category)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Used for filtering what service request are retrieved and displayed.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    34. ServiceRequest.priority
                    Definition

                    Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

                    Shortroutine | urgent | asap | stat
                    Control0..1
                    BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
                    (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
                    Must Supporttrue
                    Summarytrue
                    Meaning if MissingIf missing, this task should be performed with normal priority
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    36. ServiceRequest.doNotPerform
                    Definition

                    Set this to true if the record is saying that the service/procedure should NOT be performed.

                    ShortTrue if service/procedure should not be performed
                    Comments

                    In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

                    Control0..01
                    Typeboolean
                    Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

                    Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    38. ServiceRequest.code
                    Definition

                    A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

                    ShortWhat is being requested/ordered
                    Comments

                    Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

                    Control10..1
                    BindingUnless not suitable, these codes SHALL be taken from For example codes, see PA ServiceRequest Intervention Codeshttp://hl7.org/fhir/ValueSet/procedure-code
                    (extensible to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-code)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Alternate Namesservice requested
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    40. ServiceRequest.subject
                    Definition

                    On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

                    ShortIndividual or Entity the service is ordered for
                    Control1..1
                    TypeReference(Reference - RESTful)(US Core Patient Profile, Patient, Group, Location, Device)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. ServiceRequest.occurrence[x]
                    Definition

                    The date/time at which the requested service should occur.

                    ShortWhen service should occur
                    Control0..1
                    TypeChoice of: dateTime, Period, Timing
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Alternate Namesschedule
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on ServiceRequest.occurrence[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 44. ServiceRequest.occurrence[x]:occurrencePeriod
                      Slice NameoccurrencePeriod
                      Definition

                      The date/time at which the requested service should occur.

                      ShortWhen service should occur
                      Control0..1
                      TypePeriod, dateTime, Timing
                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Must Support TypesPerioddateTime
                      Summarytrue
                      Alternate Namesschedule
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      46. ServiceRequest.occurrence[x]:occurrencePeriod.start
                      Definition

                      The start of the period. The boundary is inclusive.

                      ShortStarting time with inclusive boundary
                      Comments

                      If the low element is missing, the meaning is that the low boundary is not known.

                      Control0..1
                      This element is affected by the following invariants: per-1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. ServiceRequest.occurrence[x]:occurrencePeriod.end
                      Definition

                      The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                      ShortEnd time with inclusive boundary, if not ongoing
                      Comments

                      The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                      Control0..1
                      This element is affected by the following invariants: per-1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. ServiceRequest.authoredOn
                      Definition

                      When the request transitioned to being actionable.

                      ShortDate request signed
                      Control10..1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Alternate NamesorderedOn
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      52. ServiceRequest.requester
                      Definition

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

                      ShortWho/what is requesting service
                      Comments

                      This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

                      Control10..1
                      TypeReference(Reference - RESTful or Logical)(US Core Practitioner Profile, US Core PractitionerRole Profile, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                      Is Modifierfalse
                      Must Supporttrue
                      Must Support TypesNo must-support rules about the choice of types/profiles
                      Summarytrue
                      Alternate Namesauthor, orderer
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      54. ServiceRequest.performer
                      Definition

                      The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

                      ShortRequested performer
                      Comments

                      If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

                      Control0..*
                      TypeReference(Reference - RESTful or Logical)(US Core Patient Profile, US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile, PA Related Person, Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
                      Is Modifierfalse
                      Must Supporttrue
                      Must Support TypesReference(US Core Patient Profile, US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile)
                      Summarytrue
                      Alternate Namesrequest recipient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      56. ServiceRequest.reasonCode
                      Definition

                      An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

                      ShortExplanation/Justification for procedure or service
                      Comments

                      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                      Control0..*
                      BindingUnless not suitable, these codes SHALL be taken from For example codes, see US Core Condition Codehttp://hl7.org/fhir/ValueSet/procedure-reason
                      (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      58. ServiceRequest.reasonCode.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
                      Must Supporttrue
                      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()))
                      60. ServiceRequest.reasonReference
                      Definition

                      Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                      ShortExplanation/Justification for service or service
                      Comments

                      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                      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()))
                      SlicingThis element introduces a set of slices on ServiceRequest.reasonReference. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • profile @ resolve()
                      • 62. ServiceRequest.reasonReference:SupportedReasonReference
                        Slice NameSupportedReasonReference
                        Definition

                        Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                        ShortExplanation/Justification for service or service
                        Comments

                        This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                        Control0..*
                        TypeReference(US Core Condition Profile, Condition, Observation, DiagnosticReport, DocumentReference)
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        64. ServiceRequest.supportingInfo
                        Definition

                        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                        ShortAdditional clinical information
                        Comments

                        To represent information about how the services are to be delivered use the instructions element.

                        Control0..*
                        TypeReference(Reference - RESTful)(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Alternate NamesAsk at order entry question, AOE
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 66. ServiceRequest.supportingInfo:SupportedSupportingInfo
                          Slice NameSupportedSupportingInfo
                          Definition

                          Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                          ShortAdditional clinical information
                          Comments

                          To represent information about how the services are to be delivered use the instructions element.

                          Control0..*
                          TypeReference(Reference - RESTful)(PA Observation EVS Base, Resource)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Alternate NamesAsk at order entry question, AOE
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. ServiceRequest.specimen
                          Definition

                          One or more specimens that the laboratory procedure will use.

                          ShortProcedure Samples
                          Comments

                          Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

                          Control0..0*
                          TypeReference(Specimen)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          70. ServiceRequest.note
                          Definition

                          This field contains additional details about the service request (for e.g. the appropriate time and mechanism for the service provider to contact the patient). Please note that service providers typically won't see notes that are added once a ServiceRequest has been accepted.


                          Any other notes and comments made about the service request. For example, internal billing notes.

                          ShortAdditional details about the service requestComments
                          Control0..*
                          TypeAnnotation
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. ServiceRequest.note.author[x]
                          Definition

                          The individual responsible for making the annotation.

                          ShortIndividual responsible for the annotation
                          Comments

                          Organization is used when there's no need for specific attribution as to who made the comment.

                          Control10..1
                          TypeReference(Reference - RESTful)(US Core Practitioner Profile, US Core Organization Profile, Practitioner, Patient, RelatedPerson, Organization), string
                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Must Support TypesReference(US Core Practitioner Profile, US Core Organization Profile)
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. ServiceRequest.note.time
                          Definition

                          Indicates when this particular annotation was made.

                          ShortWhen the annotation was made
                          Control10..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          76. ServiceRequest.note.text
                          Definition

                          The text of the annotation in markdown format.

                          ShortThe annotation - text content (as markdown)
                          Control1..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          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. ServiceRequest
                          Definition

                          Represents orders and referrals for interventions that help to improve or maintain a patient's level of physical activity

                          ShortA request for a service to be performed
                          Control0..*
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesdiagnostic request, referral, referral request, transfer of care request
                          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())
                          prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
                          pa-sr-1: At least one of reasonCode or reasonReference must be provided (reasonCode.exists() or reasonReference.exists())
                          2. ServiceRequest.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. ServiceRequest.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. ServiceRequest.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..0
                          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. ServiceRequest.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. ServiceRequest.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. ServiceRequest.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. ServiceRequest.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          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 ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 16. ServiceRequest.extension:pertainsToGoal
                            Slice NamepertainsToGoal
                            Definition

                            Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.

                            ShortPertains to goal
                            Comments

                            This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(pertains to goal) (Extension Type: Reference(Goal))
                            Is Modifierfalse
                            Must Supporttrue
                            Requirements

                            Allows linking a referral or exercise prescription to the goal(s) it's trying to address

                            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())
                            18. ServiceRequest.extension:pertainsToGoal.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
                            20. ServiceRequest.extension:pertainsToGoal.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 ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 22. ServiceRequest.extension:pertainsToGoal.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/StructureDefinition/resource-pertainsToGoal
                              24. ServiceRequest.extension:pertainsToGoal.value[x]
                              Definition

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

                              ShortValue of extension
                              Control1..1
                              TypeReference(Reference - RESTful)(PA Goal)
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              26. ServiceRequest.extension:observationFocus
                              Slice NameobservationFocus
                              Definition

                              Optional Extension Element - found in all resources.

                              ShortOptional Extensions Element
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Extension Definition for Observation.focus for Version 5.0) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                              Is Modifierfalse
                              Requirements

                              Allows referrals seeking services for relatives rather than the patient themselves - e.g. training or counselling for parents of a minor.

                              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())
                              28. ServiceRequest.extension:observationFocus.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
                              30. ServiceRequest.extension:observationFocus.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 ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 32. ServiceRequest.extension:observationFocus.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-Observation.focus
                                34. ServiceRequest.extension:observationFocus.value[x]
                                Definition

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

                                ShortValue of extension
                                Control1..1
                                TypeReference(PA Related Person)
                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                36. ServiceRequest.modifierExtension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..0
                                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())
                                38. ServiceRequest.identifier
                                Definition

                                Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

                                ShortIdentifiers assigned to this order
                                Comments

                                The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

                                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()))
                                40. ServiceRequest.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 ServiceRequest.

                                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()))
                                42. ServiceRequest.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 ServiceRequest.

                                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()))
                                44. ServiceRequest.basedOn
                                Definition

                                Plan/proposal/order fulfilled by this request.

                                ShortWhat request fulfills
                                Control0..*
                                TypeReference(CarePlan, ServiceRequest, MedicationRequest)
                                Is Modifierfalse
                                Summarytrue
                                Alternate Namesfulfills
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                46. ServiceRequest.replaces
                                Definition

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

                                ShortWhat request replaces
                                Control0..*
                                TypeReference(ServiceRequest)
                                Is Modifierfalse
                                Summarytrue
                                Alternate Namessupersedes, prior, renewed order
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                48. ServiceRequest.requisition
                                Definition

                                A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.

                                ShortComposite Request ID
                                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.

                                Control0..1
                                TypeIdentifier
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

                                Alternate NamesgrouperId, groupIdentifier
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                50. ServiceRequest.status
                                Definition

                                The status of the order.

                                Shortdraft | active | on-hold | revoked | completed | entered-in-error
                                Comments

                                The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

                                Control1..1
                                BindingThe codes SHALL be taken from PA ServiceRequest Status
                                (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-status)
                                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
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                52. ServiceRequest.intent
                                Definition

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

                                Shortoriginal-order | order | filler-order
                                Comments

                                This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Multiple codes are allowed to support situations where a Task might point to a filler order instead of an original. However, in almost all cases, the intent should be 'original-order' or just 'order'.

                                Control1..1
                                BindingThe codes SHALL be taken from PA ServiceRequest Intents
                                (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-intent)
                                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
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                54. ServiceRequest.category
                                Definition

                                A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                                ShortClassification of service
                                Comments

                                There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                                Control1..*
                                BindingFor example codes, see ServiceRequestCategoryCodes
                                (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

                                Classification of the requested service.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Used for filtering what service request are retrieved and displayed.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on ServiceRequest.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • pattern @ $this
                                • 56. ServiceRequest.category:PA
                                  Slice NamePA
                                  Definition

                                  A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                                  ShortClassification of service
                                  Comments

                                  There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                                  Control1..1
                                  BindingFor example codes, see ServiceRequestCategoryCodes
                                  (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

                                  Classification of the requested service.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Used for filtering what service request are retrieved and displayed.

                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes",
                                      "code" : "PhysicalActivity"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  58. ServiceRequest.category:USCore
                                  Slice NameUSCore
                                  Definition

                                  A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                                  ShortClassification of service
                                  Comments

                                  There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                                  Control0..*
                                  BindingThe codes SHALL be taken from PA ServiceRequest Category - USCore
                                  (required to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-diagnosticreport-category)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Used for filtering what service request are retrieved and displayed.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  60. ServiceRequest.priority
                                  Definition

                                  Indicates how quickly the ServiceRequest 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
                                  Must Supporttrue
                                  Summarytrue
                                  Meaning if MissingIf missing, this task should be performed with normal priority
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  62. ServiceRequest.doNotPerform
                                  Definition

                                  Set this to true if the record is saying that the service/procedure should NOT be performed.

                                  ShortTrue if service/procedure should not be performed
                                  Comments

                                  In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

                                  Control0..0
                                  Typeboolean
                                  Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

                                  Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  64. ServiceRequest.code
                                  Definition

                                  A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

                                  ShortWhat is being requested/ordered
                                  Comments

                                  Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

                                  Control1..1
                                  BindingUnless not suitable, these codes SHALL be taken from PA ServiceRequest Intervention Codes
                                  (extensible to http://hl7.org/fhir/us/physical-activity/ValueSet/pa-servicerequest-code)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate Namesservice requested
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  66. ServiceRequest.orderDetail
                                  Definition

                                  Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.

                                  ShortAdditional order information
                                  Comments

                                  For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

                                  Control0..*
                                  This element is affected by the following invariants: prr-1
                                  BindingFor example codes, see ServiceRequestOrderDetailsCodes
                                  (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

                                  Codified order entry details which are based on order context.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Alternate Namesdetailed instructions
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  68. ServiceRequest.quantity[x]
                                  Definition

                                  An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

                                  ShortService amount
                                  Control0..1
                                  TypeChoice of: Quantity, Ratio, Range
                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  When ordering a service the number of service items may need to be specified separately from the the service item.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  70. ServiceRequest.subject
                                  Definition

                                  On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

                                  ShortIndividual or Entity the service is ordered for
                                  Control1..1
                                  TypeReference(Reference - RESTful)(US Core Patient Profile)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  72. ServiceRequest.encounter
                                  Definition

                                  An encounter that provides additional information about the healthcare context in which this request is made.

                                  ShortEncounter in which the request was created
                                  Control0..1
                                  TypeReference(Encounter)
                                  Is Modifierfalse
                                  Summarytrue
                                  Alternate Namescontext
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  74. ServiceRequest.occurrence[x]
                                  Definition

                                  The date/time at which the requested service should occur.

                                  ShortWhen service should occur
                                  Control0..1
                                  TypeChoice of: dateTime, Period, Timing
                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Alternate Namesschedule
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on ServiceRequest.occurrence[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 76. ServiceRequest.occurrence[x]:occurrencePeriod
                                    Slice NameoccurrencePeriod
                                    Definition

                                    The date/time at which the requested service should occur.

                                    ShortWhen service should occur
                                    Control0..1
                                    TypePeriod
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Must Support TypesPeriod
                                    Summarytrue
                                    Alternate Namesschedule
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    78. ServiceRequest.occurrence[x]:occurrencePeriod.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
                                    80. ServiceRequest.occurrence[x]:occurrencePeriod.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 ServiceRequest.occurrence[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 82. ServiceRequest.occurrence[x]:occurrencePeriod.start
                                      Definition

                                      The start of the period. The boundary is inclusive.

                                      ShortStarting time with inclusive boundary
                                      Comments

                                      If the low element is missing, the meaning is that the low boundary is not known.

                                      Control0..1
                                      This element is affected by the following invariants: per-1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      84. ServiceRequest.occurrence[x]:occurrencePeriod.end
                                      Definition

                                      The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                      ShortEnd time with inclusive boundary, if not ongoing
                                      Comments

                                      The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                      Control0..1
                                      This element is affected by the following invariants: per-1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      86. ServiceRequest.asNeeded[x]
                                      Definition

                                      If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

                                      ShortPreconditions for service
                                      Control0..1
                                      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                      (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                                      A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

                                      TypeChoice of: boolean, CodeableConcept
                                      [x] NoteSee Choice of Data Types for 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()))
                                      88. ServiceRequest.authoredOn
                                      Definition

                                      When the request transitioned to being actionable.

                                      ShortDate request signed
                                      Control1..1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Alternate NamesorderedOn
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      90. ServiceRequest.requester
                                      Definition

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

                                      ShortWho/what is requesting service
                                      Comments

                                      This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

                                      Control1..1
                                      TypeReference(Reference - RESTful or Logical)(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                      Summarytrue
                                      Alternate Namesauthor, orderer
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      92. ServiceRequest.performerType
                                      Definition

                                      Desired type of performer for doing the requested service.

                                      ShortPerformer role
                                      Comments

                                      This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

                                      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
                                      Alternate Namesspecialty
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      94. ServiceRequest.performer
                                      Definition

                                      The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

                                      ShortRequested performer
                                      Comments

                                      If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

                                      Control0..*
                                      TypeReference(Reference - RESTful or Logical)(US Core Patient Profile, US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile, PA Related Person)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Must Support TypesReference(US Core Patient Profile, US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile)
                                      Summarytrue
                                      Alternate Namesrequest recipient
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      96. ServiceRequest.locationCode
                                      Definition

                                      The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

                                      ShortRequested location
                                      Control0..*
                                      BindingFor example codes, see ServiceDeliveryLocationRoleType
                                      (example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

                                      A location type where services are delivered.

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

                                      A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

                                      ShortRequested location
                                      Control0..*
                                      TypeReference(Location)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      100. ServiceRequest.reasonCode
                                      Definition

                                      An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

                                      ShortExplanation/Justification for procedure or service
                                      Comments

                                      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                                      Control0..*
                                      BindingUnless not suitable, these codes SHALL be taken from US Core Condition Code
                                      (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      102. ServiceRequest.reasonCode.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
                                      104. ServiceRequest.reasonCode.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 ServiceRequest.reasonCode.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 106. ServiceRequest.reasonCode.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()))
                                        108. ServiceRequest.reasonCode.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
                                        Must Supporttrue
                                        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()))
                                        110. ServiceRequest.reasonReference
                                        Definition

                                        Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                                        ShortExplanation/Justification for service or service
                                        Comments

                                        This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                                        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()))
                                        SlicingThis element introduces a set of slices on ServiceRequest.reasonReference. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • profile @ resolve()
                                        • 112. ServiceRequest.reasonReference:SupportedReasonReference
                                          Slice NameSupportedReasonReference
                                          Definition

                                          Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                                          ShortExplanation/Justification for service or service
                                          Comments

                                          This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                                          Control0..*
                                          TypeReference(US Core Condition Profile)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          114. ServiceRequest.insurance
                                          Definition

                                          Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed 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()))
                                          116. ServiceRequest.supportingInfo
                                          Definition

                                          Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                                          ShortAdditional clinical information
                                          Comments

                                          To represent information about how the services are to be delivered use the instructions element.

                                          Control0..*
                                          TypeReference(Reference - RESTful)(Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate NamesAsk at order entry question, AOE
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                          • profile @ resolve()
                                          • 118. ServiceRequest.supportingInfo:SupportedSupportingInfo
                                            Slice NameSupportedSupportingInfo
                                            Definition

                                            Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                                            ShortAdditional clinical information
                                            Comments

                                            To represent information about how the services are to be delivered use the instructions element.

                                            Control0..*
                                            TypeReference(Reference - RESTful)(PA Observation EVS Base)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Alternate NamesAsk at order entry question, AOE
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            120. ServiceRequest.specimen
                                            Definition

                                            One or more specimens that the laboratory procedure will use.

                                            ShortProcedure Samples
                                            Comments

                                            Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

                                            Control0..0
                                            TypeReference(Specimen)
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            122. ServiceRequest.bodySite
                                            Definition

                                            Anatomic location where the procedure should be performed. This is the target site.

                                            ShortLocation on Body
                                            Comments

                                            Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

                                            Control0..*
                                            BindingFor example codes, see SNOMEDCTBodyStructures
                                            (example to http://hl7.org/fhir/ValueSet/body-site)

                                            Codes describing anatomical locations. May include laterality.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Knowing where the procedure is performed is important for tracking if multiple sites are possible.

                                            Alternate Nameslocation
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            124. ServiceRequest.note
                                            Definition

                                            This field contains additional details about the service request (for e.g. the appropriate time and mechanism for the service provider to contact the patient). Please note that service providers typically won't see notes that are added once a ServiceRequest has been accepted.

                                            ShortAdditional details about the service request
                                            Control0..*
                                            TypeAnnotation
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            126. ServiceRequest.note.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
                                            128. ServiceRequest.note.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 ServiceRequest.note.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 130. ServiceRequest.note.author[x]
                                              Definition

                                              The individual responsible for making the annotation.

                                              ShortIndividual responsible for the annotation
                                              Comments

                                              Organization is used when there's no need for specific attribution as to who made the comment.

                                              Control1..1
                                              TypeReference(Reference - RESTful)(US Core Practitioner Profile, US Core Organization Profile)
                                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Must Support TypesReference(US Core Practitioner Profile, US Core Organization Profile)
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              132. ServiceRequest.note.time
                                              Definition

                                              Indicates when this particular annotation was made.

                                              ShortWhen the annotation was made
                                              Control1..1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              134. ServiceRequest.note.text
                                              Definition

                                              The text of the annotation in markdown format.

                                              ShortThe annotation - text content (as markdown)
                                              Control1..1
                                              Typemarkdown
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              136. ServiceRequest.patientInstruction
                                              Definition

                                              Instructions in terms that are understood by the patient or consumer.

                                              ShortPatient or consumer-oriented instructions
                                              Control0..1
                                              Typestring
                                              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()))
                                              138. ServiceRequest.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()))