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Patient Care icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the CommunicationRequest resource.

CommunicationRequest
Element Id CommunicationRequest
Definition

A request to convey information from a sender to a recipient.

Short Display A request to convey information from a sender to a recipient
Cardinality 0..*
Type DomainResource
Summary false
CommunicationRequest.identifier
Element Id CommunicationRequest.identifier
Definition

Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Short Display Unique identifier
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Summary true
Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

CommunicationRequest.basedOn
Element Id CommunicationRequest.basedOn
Definition

A plan or proposal that is fulfilled in whole or in part by this request.

Short Display Fulfills plan or proposal
Cardinality 0..*
Type Reference(Any)
Requirements

Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

Alternate Names fulfills
Summary true
CommunicationRequest.replaces
Element Id CommunicationRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

Short Display Request(s) replaced by this request
Cardinality 0..*
Type Reference(CommunicationRequest)
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Names supersedes; prior
Summary true
Comments

The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.

CommunicationRequest.groupIdentifier
Element Id CommunicationRequest.groupIdentifier
Definition

A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time.

Short Display Composite request this is part of
Cardinality 0..1
Type Identifier
Alternate Names grouperId
Summary true
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.

CommunicationRequest.status
Element Id CommunicationRequest.status
Definition

The status of the proposal or order.

Short Display draft | active | on-hold | revoked | completed | entered-in-error | unknown
Cardinality 1..1
Terminology Binding RequestStatus (Required)
Type code
Is Modifier true (Reason: This element is labelled 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.)
Summary true
CommunicationRequest.statusReason
Element Id CommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

Short Display Reason for current status
Cardinality 0..1
Terminology Binding CommunicationRequest Status Reason (Example)
Type CodeableConcept
Alternate Names Suspended Reason; Cancelled Reason
Summary false
Comments

This is generally only used for "exception" statuses such as "on-hold" or "revoked". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here.

CommunicationRequest.intent
Element Id CommunicationRequest.intent
Definition

Indicates the level of authority/intentionality associated with the CommunicationRequest and where the request fits into the workflow chain.

Short Display proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Cardinality 1..1
Terminology Binding RequestIntent (Required)
Type code
Is Modifier true (Reason: 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)
Requirements

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

Summary true
Comments

This element is expected to be immutable. E.g. A "proposal" instance should never change to be a "plan" instance or "order" instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.

One exception to this is that the granularity of CommunicationRequest.intent is allowed to change. For example, a Request identified as an "order" might later be clarified to be a "filler-order". Or, in rarer cases (to meet recipient constraints), the reverse might also occur.

CommunicationRequest.category
Element Id CommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

Short Display Message category
Cardinality 0..*
Terminology Binding Communication Category (Example)
Type CodeableConcept
Summary false
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

CommunicationRequest.priority
Element Id CommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Short Display routine | urgent | asap | stat
Cardinality 0..1
Terminology Binding RequestPriority (Required)
Type code
Meaning if Missing If missing, this task should be performed with normal priority
Summary true
CommunicationRequest.doNotPerform
Element Id CommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

Short Display True if request is prohibiting action
Cardinality 0..1
Type boolean
Is Modifier true (Reason: If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.)
Meaning if Missing If do not perform is not specified, the request is a positive request e.g. "do perform"
Alternate Names prohibited
Summary true
Comments

The attributes provided with the request qualify what is not to be done.

CommunicationRequest.medium
Element Id CommunicationRequest.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Short Display A channel of communication
Cardinality 0..*
Terminology Binding ParticipationMode icon (Example)
Type CodeableConcept
Summary false
CommunicationRequest.subject
Element Id CommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

Short Display Focus of message
Cardinality 0..1
Type Reference(Patient | Group)
Alternate Names patient
Summary false
CommunicationRequest.about
Element Id CommunicationRequest.about
Definition

Other resources that pertain to this communication request and to which this communication request should be associated.

Short Display Resources that pertain to this communication request
Cardinality 0..*
Type Reference(Any)
Summary false
Comments

Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.

CommunicationRequest.encounter
Element Id CommunicationRequest.encounter
Definition

The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

Short Display The Encounter during which this CommunicationRequest was created
Cardinality 0..1
Type Reference(Encounter)
Summary true
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

CommunicationRequest.payload
Element Id CommunicationRequest.payload
Definition

Text, attachment(s), or resource(s) to be communicated to the recipient.

Short Display Message payload
Cardinality 0..*
Summary false
CommunicationRequest.payload.content[x]
Element Id CommunicationRequest.payload.content[x]
Definition

The content (or for multi-part communications, one portion of the communication) to be communicated.

Short Display Message part content
Cardinality 1..1
Type Attachment|Reference(Any)|CodeableConcept
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary false
Comments

The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

If the content isn't codified, contentCodeableConcept.text can be used.

When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

CommunicationRequest.occurrence[x]
Element Id CommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

Short Display When scheduled
Cardinality 0..1
Type dateTime|Period
[x] Note See Choice of Datatypes for further information about how to use [x]
Alternate Names timing
Summary true
CommunicationRequest.authoredOn
Element Id CommunicationRequest.authoredOn
Definition

For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

Short Display When request transitioned to being actionable
Cardinality 0..1
Type dateTime
Alternate Names createdOn
Summary true
CommunicationRequest.requester
Element Id CommunicationRequest.requester
Definition

The device, individual, or organization who asks for the information to be shared.

Short Display Who asks for the information to be shared
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
Alternate Names author
Summary true
CommunicationRequest.recipient
Element Id CommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

Short Display Who to share the information with
Cardinality 0..*
Type Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService | Endpoint)
Summary false
CommunicationRequest.informationProvider
Element Id CommunicationRequest.informationProvider
Definition

The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

Short Display Who should share the information
Cardinality 0..*
Type Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint)
Summary true
Comments

Entities being requested to provide the information.

CommunicationRequest.reason
Element Id CommunicationRequest.reason
Definition

Describes why the request is being made in coded or textual form.

Short Display Why is communication needed?
Cardinality 0..*
Terminology Binding v3 Code System ActReason icon (Example)
Type CodeableReference(Any)
Summary true
Comments

Textual reasons can be captured using reasonCode.text.

CommunicationRequest.note
Element Id CommunicationRequest.note
Definition

Comments made about the request by the requester, sender, recipient, subject or other participants.

Short Display Comments made about communication request
Cardinality 0..*
Type Annotation
Summary false