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12.24 Resource DeviceRequest - Content

Orders and Observations icon Work GroupMaturity Level: 1 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Group, Patient, Practitioner

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

12.24.1 Scope and Usage

This resource is a request resource from a FHIR workflow perspective - see Workflow.

This resource describes the request for the use of a device by a patient. The device may be any pertinent device specified in the Device resource. Examples of devices that may be requested include wheelchair, hearing aids, or an insulin pump. The request may lead to the delivery of the device to the patient directly, or to, e.g., a surgery suite for an implantation procedure.

The device use request may represent an order or a prescription entered by a practitioner in a CPOE system or a proposal made by a clinical decision support (CDS) system based on a patient's clinical record and context of care.

12.24.2 Boundaries and Relationships

This resource deals with the allocation of a device to a patient and while it may contain instructions on how to use the device, the data about getting the device to the patient is addressed in other resources. For example, when requesting an oxygen pump for home use instructions on how to use it may be included. For devices that must be implanted via a surgical or other procedure the implantation is represented in the Procedure resource.

The DeviceRequest resource represents an authorization for a device to be provided. Details about the fulfillment of the authorization are handled by the Task resource. For further information about this separation of responsibilities, refer to the Fulfillment/Execution icon section of the Request pattern.

VisionPrescription may appear to overlap with DeviceRequest, but not completely as there are specific vision lens specification details that are present in VisionPrescription. To illustrate this, the devicerequest-left-lens and devicerequest-right-lens examples are based on the general glasses example.

To determine the purchase date, a search of DeviceRequest, SupplyRequest, DeviceDispense, or SupplyDelivery as defined in an implementation guide can be done , as the context of the use case actually determines which date of either resource is considered the purchase date.

12.24.3 References to this Resource

12.24.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest TU DomainResource Medical device request

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier External Request identifier

... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition

... instantiatesUri Σ 0..* uri Instantiates external protocol or definition

... replaces Σ 0..* Reference(DeviceRequest) What request replaces

... groupIdentifier Σ 0..1 Identifier Identifier of composite request
... status ?!Σ 0..1 code draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
Binding: RequestStatus (Required)
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (Required)
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (Required)
... doNotPerform ?!Σ 0..1 boolean True if the request is to stop or not to start using the device
... code Σ 1..1 CodeableReference(Device | DeviceDefinition) Device requested
Binding: Device Type (Example)
... quantity 0..1 integer Quantity of devices to supply
... parameter 0..* BackboneElement Device details

.... code 0..1 CodeableConcept Device detail
Binding: ParameterCode (Example)
.... value[x] 0..1 Value of detail
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject Σ 1..1 Reference(Patient | Group | Location | Device) Focus of request
... encounter Σ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] Σ 0..1 Desired time or schedule for use
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn Σ 0..1 dateTime When recorded
... requester Σ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Who/what submitted the device request
... performer Σ 0..1 CodeableReference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested Filler
... reason Σ 0..* CodeableReference(Condition | Observation | DiagnosticReport | DocumentReference) Coded/Linked Reason for request
Binding: Condition/Problem/Diagnosis Codes (Example)

... asNeeded 0..1 boolean PRN status of request
... asNeededFor 0..1 CodeableConcept Device usage reason
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage

... supportingInfo 0..* Reference(Any) Additional clinical information

... note 0..* Annotation Notes or comments

... relevantHistory 0..* Reference(Provenance) Request provenance


doco Documentation for this format icon

See the Extensions for this resource

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

12.24.4.1 Terminology Bindings

Path ValueSet Type Documentation
DeviceRequest.status RequestStatus Required

Codes identifying the lifecycle stage of a request.
DeviceRequest.intent RequestIntent Required

Codes indicating the degree of authority/intentionality associated with a request.
DeviceRequest.priority RequestPriority Required

Identifies the level of importance to be assigned to actioning the request.
DeviceRequest.code DeviceType Example

Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.
DeviceRequest.parameter.code Example
DeviceRequest.reason ConditionProblemDiagnosisCodes Example

Example value set for Condition/Problem/Diagnosis codes.

Notes to reviewers:

At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

12.24.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
authored-on date When the request transitioned to being actionable DeviceRequest.authoredOn
based-on reference Plan/proposal/order fulfilled by this request DeviceRequest.basedOn
(Any)
code token Code for what is being requested/ordered DeviceRequest.code.concept 21 Resources
device reference Reference to resource that is being requested/ordered DeviceRequest.code.reference
encounter reference Encounter during which request was created DeviceRequest.encounter
(Encounter)		 29 Resources
event-date date When service should occur (DeviceRequest.occurrence.ofType(dateTime)) | (DeviceRequest.occurrence.ofType(Period))
group-identifier token Composite request this is part of DeviceRequest.groupIdentifier
identifier token Business identifier for request/order DeviceRequest.identifier 65 Resources
instantiates-canonical reference Instantiates FHIR protocol or definition DeviceRequest.instantiatesCanonical
(PlanDefinition, ActivityDefinition)
instantiates-uri uri Instantiates external protocol or definition DeviceRequest.instantiatesUri
insurance reference Associated insurance coverage DeviceRequest.insurance
(ClaimResponse, Coverage)
intent token proposal | plan | original-order |reflex-order DeviceRequest.intent
patient reference Individual the service is ordered for DeviceRequest.subject.where(resolve() is Patient)
(Patient)		 65 Resources
performer reference Desired performer for service DeviceRequest.performer.reference
performer-code token Desired performer for service DeviceRequest.performer.concept
prior-request reference Request takes the place of referenced completed or terminated requests DeviceRequest.replaces
(DeviceRequest)
requester reference Who/what is requesting service DeviceRequest.requester
(Practitioner, Organization, Device, PractitionerRole)
status token entered-in-error | draft | active |suspended | completed DeviceRequest.status
subject reference Individual the service is ordered for DeviceRequest.subject
(Group, Device, Patient, Location)