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14.16 Resource RequestOrchestration - Content

Clinical Decision Support icon Work GroupMaturity Level: 4 Trial UseSecurity Category: Business Compartments: Device, Encounter, Group, Patient, Practitioner, RelatedPerson

A set of related requests that can be used to capture intended activities that have inter-dependencies such as "give this medication after that one".

14.16.1 Scope and Usage

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

The RequestOrchestration resource is used to represent a set of optional and related activities that may be performed for a specific patient or context. This resource is often, but not always, the result of applying a specific PlanDefinition to a particular patient. Other than differences that tie the RequestOrchestration to a particular subject and setting, the actionDefinition element of PlanDefinition is identical to the action element of the RequestOrchestration, allowing the same features and functionality to be used in both places to describe optionality of and relationships between activities in a workflow.

RequestOrchestrations can contain hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group.

14.16.2 References to this Resource

14.16.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. RequestOrchestration TU DomainResource A set of related requests

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

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

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

... replaces 0..* Reference(Any) Request(s) replaced by this request

... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... status ?!Σ 1..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)
... code Σ 0..1 CodeableConcept What's being requested/ordered
Binding: Action Code (Example)
... subject 0..1 Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Who the request orchestration is about
... encounter 0..1 Reference(Encounter) Created as part of
... authoredOn 0..1 dateTime When the request orchestration was authored
... author 0..1 Reference(Device | Practitioner | PractitionerRole) Device or practitioner that authored the request orchestration
... reason 0..* CodeableReference(Condition | Observation | DiagnosticReport | DocumentReference) Why the request orchestration is needed
Binding: Action Reason Code (Example)

... goal 0..* Reference(Goal) What goals

... note 0..* Annotation Additional notes about the response

... action C 0..* BackboneElement Proposed actions, if any
+ Rule: Must have resource or action but not both

.... linkId 0..1 string Pointer to specific item from the PlanDefinition
.... prefix 0..1 string User-visible prefix for the action (e.g. 1. or A.)
.... title 0..1 string User-visible title
.... description Σ 0..1 markdown Short description of the action
.... textEquivalent Σ 0..1 markdown Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
.... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (Required)
.... code 0..* CodeableConcept Code representing the meaning of the action or sub-actions
Binding: Action Code (Example)

.... documentation 0..* RelatedArtifact Supporting documentation for the intended performer of the action

.... goal 0..* Reference(Goal) What goals

.... condition 0..* BackboneElement Whether or not the action is applicable

..... kind 1..1 code applicability | start | stop
Binding: Action Condition Kind (Required)
..... expression 0..1 Expression Boolean-valued expression
.... input C 0..* BackboneElement Input data requirements
+ Rule: Input data elements must have a requirement or a relatedData, but not both

..... title 0..1 string User-visible title
..... requirement C 0..1 DataRequirement What data is provided
..... relatedData C 0..1 id What data is provided
.... output C 0..* BackboneElement Output data definition
+ Rule: Output data element must have a requirement or a relatedData, but not both

..... title 0..1 string User-visible title
..... requirement C 0..1 DataRequirement What data is provided
..... relatedData C 0..1 string What data is provided
.... relatedAction 0..* BackboneElement Relationship to another action

..... targetId 1..1 id What action this is related to
..... relationship 1..1 code before | before-start | before-end | concurrent | concurrent-with-start | concurrent-with-end | after | after-start | after-end
Binding: Action Relationship Type (Required)
..... endRelationship 0..1 code before | before-start | before-end | concurrent | concurrent-with-start | concurrent-with-end | after | after-start | after-end
Binding: Action Relationship Type (Required)
..... offset[x] 0..1 Time offset for the relationship
...... offsetDuration Duration
...... offsetRange Range
.... timing[x] 0..1 When the action should take place
..... timingDateTime dateTime
..... timingAge Age
..... timingPeriod Period
..... timingDuration Duration
..... timingRange Range
..... timingTiming Timing
.... location 0..1 CodeableReference(Location) Where it should happen
.... participant 0..* BackboneElement Who should perform the action

..... type 0..1 code careteam | device | group | healthcareservice | location | organization | patient | practitioner | practitionerrole | relatedperson
Binding: Action Participant Type (Required)
..... typeCanonical 0..1 canonical(CapabilityStatement) Who or what can participate
..... typeReference 0..1 Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) Who or what can participate
..... role 0..1 CodeableConcept E.g. Nurse, Surgeon, Parent, etc
Binding: Action Participant Role icon (Example)
..... function 0..1 CodeableConcept E.g. Author, Reviewer, Witness, etc
Binding: Action Participant Function (Example)
..... actor[x] 0..1 Who/what is participating?
...... actorCanonical canonical(CapabilityStatement)
...... actorReference Reference(CareTeam | Device | DeviceDefinition | Endpoint | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
.... type 0..1 CodeableConcept create | update | remove | fire-event
Binding: Action Type (Extensible)
.... groupingBehavior 0..1 code visual-group | logical-group | sentence-group
Binding: Action Grouping Behavior (Required)
.... selectionBehavior 0..1 code any | all | all-or-none | exactly-one | at-most-one | one-or-more
Binding: Action Selection Behavior (Required)
.... requiredBehavior 0..1 code must | could | must-unless-documented
Binding: Action Required Behavior (Required)
.... precheckBehavior 0..1 code yes | no
Binding: Action Precheck Behavior (Required)
.... cardinalityBehavior 0..1 code single | multiple
Binding: Action Cardinality Behavior (Required)
.... resource C 0..1 Reference(Any) The target of the action
.... definition[x] 0..1 Description of the activity to be performed
..... definitionCanonical canonical(ActivityDefinition | ObservationDefinition | PlanDefinition | Questionnaire | SpecimenDefinition)
..... definitionUri uri
.... transform 0..1 canonical(StructureMap) Transform to apply the template
.... dynamicValue 0..* BackboneElement Dynamic aspects of the definition

..... path 0..1 string The path to the element to be set dynamically
..... expression 0..1 Expression An expression that provides the dynamic value for the customization
.... action 0..* see action Sub action


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

14.16.3.1 Terminology Bindings

Path ValueSet Type Documentation
RequestOrchestration.status RequestStatus Required

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

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

Identifies the level of importance to be assigned to actioning the request.
RequestOrchestration.code ActionCode Example

Provides examples of actions to be performed.
RequestOrchestration.reason ActionReasonCode Example

Provides examples of reasons for actions to be performed.
RequestOrchestration.action.priority RequestPriority Required

Identifies the level of importance to be assigned to actioning the request.
RequestOrchestration.action.code ActionCode Example

Provides examples of actions to be performed.
RequestOrchestration.action.condition.kind ActionConditionKind Required

Defines the kinds of conditions that can appear on actions.
RequestOrchestration.action.relatedAction.relationship ActionRelationshipType Required

Defines the types of relationships between actions.
RequestOrchestration.action.relatedAction.endRelationship ActionRelationshipType Required

Defines the types of relationships between actions.
RequestOrchestration.action.participant.type ActionParticipantType Required

The type of participant for the action.
RequestOrchestration.action.participant.role ActionParticipantRole icon Example

Either a practitioner role or a relationship type. Note from UTG import - may have been a temporary entry that subsequently disappeared from the FHIR source; unable to locate. Version set to 0.1.0
RequestOrchestration.action.participant.function ActionParticipantFunction Example

The function performed by the participant for the action.
RequestOrchestration.action.type ActionType Extensible

The type of action to be performed.
RequestOrchestration.action.groupingBehavior ActionGroupingBehavior Required

Defines organization behavior of a group.
RequestOrchestration.action.selectionBehavior ActionSelectionBehavior Required

Defines selection behavior of a group.
RequestOrchestration.action.requiredBehavior ActionRequiredBehavior Required

Defines expectations around whether an action or action group is required.
RequestOrchestration.action.precheckBehavior ActionPrecheckBehavior Required

Defines selection frequency behavior for an action or group.
RequestOrchestration.action.cardinalityBehavior ActionCardinalityBehavior Required

Defines behavior for an action or a group for how many times that item may be repeated.

14.16.3.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img pld-0Rule RequestOrchestration.action.inputInput data elements must have a requirement or a relatedData, but not bothrequirement.exists() xor relatedData.exists()
img pld-1Rule RequestOrchestration.action.outputOutput data element must have a requirement or a relatedData, but not bothrequirement.exists() xor relatedData.exists()
img rqg-1Rule RequestOrchestration.actionMust have resource or action but not bothresource.exists() implies action.exists().not()

14.16.4 Usage

The RequestOrchestration resource is used when there are temporal, co-occurrence or other dependencies between one or more steps of an overall workflow. For example, "do procedure A or procedure B, but not both" or "do procedure A after procedure B" or "Act on this ServiceRequest, then use the value of that observation in the calculation of the dose of this subsequent MedicationRequest". RequestOrchestrations that define actions (i.e. that are more than just narrative representations) will always reference other Request resources with an intent of "option".

Each "option" request can only be interpreted in the context of a RequestOrchestration that references it. This is because the RequestOrchestration defines the context in which the option request may/should/must occur, including any triggers, timing constraints, choices, sequencing requirements, etc. Typically such "option" requests will be contained resources due to this dependency. However, in some cases "option" requests may be stand-alone if they are immutable or tightly tied to a ActivityDefinition such that the option resources can safely be referenced without a risk of their content/intent changing

Elements in the "option" requests may include extensions for timing or other elements that allow calculation based on information found in the RequestOrchestration or other referenced "option" resources, as well as to expose elements within the "option" resource for referencing in other "option" resources. These extensions are:

  • TODO

The RequestOrchestration and all of its referenced "option" Requests are treated as a single integrated Request whose status is the status of the RequestOrchestration. If there is a need to manage statuses of the different parts, separately, refer to the guidance here.

14.16.4.1 Documenting Choices

A RequestOrchestration can be used to document (wholly or in part) options that are to be chosen by the order filler when actually delivering care. There is no expectation for systems that fulfill a RequestOrchestration to specifically document which choices were made among the options defined. However, if this is needed, it could be accomplished with a 'filler-order' RequestOrchestration basedOn the 'original-order' RequestOrchestration that narrows the order to reflect the filling clinician's choices.

NOTE: The 'intent' of the requests referenced by a RequestOrchestration are never changed from Option to Order or some other value to convey 'selection'.

14.16.4.2 Completion

A RequestOrchestration is deemed to be complete when the requirements of the request options needed to satisfy at least one path through the overall request have been met or when the author of the RequestOrchestration deems it to be sufficiently complete.

14.16.5 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
action-resource reference A resource in an action of the request orchestration RequestOrchestration.action.resource
(Any)
author reference The author of the request orchestration RequestOrchestration.author
(Practitioner, Device, PractitionerRole)
authored date The date the request orchestration was authored RequestOrchestration.authoredOn
based-on reference What this request fullfills. RequestOrchestration.basedOn
(Any)
code token The code of the request orchestration RequestOrchestration.code 21 Resources
encounter reference The encounter the request orchestration applies to RequestOrchestration.encounter
(Encounter)		 29 Resources
group-identifier token The group identifier for the request orchestration RequestOrchestration.groupIdentifier
identifier token External identifiers for the request orchestration RequestOrchestration.identifier 65 Resources
instantiates-canonical reference The FHIR-based definition from which the request orchestration is realized RequestOrchestration.instantiatesCanonical
instantiates-uri uri The external definition from which the request orchestration is realized RequestOrchestration.instantiatesUri
intent token The intent of the request orchestration RequestOrchestration.intent
participant reference The participant in the requests in the orchestration RequestOrchestration.action.participant.actor.ofType(Reference) | RequestOrchestration.action.participant.actor.ofType(canonical)
(Group, Organization, CareTeam, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson, Practitioner, Endpoint, CapabilityStatement, DeviceDefinition, Location)
patient reference The identity of a patient to search for request orchestrations RequestOrchestration.subject.where(resolve() is Patient)
(Patient)		 65 Resources
priority token The priority of the request orchestration RequestOrchestration.priority
status token The status of the request orchestration RequestOrchestration.status
subject reference The subject that the request orchestration is about RequestOrchestration.subject
(Practitioner, Group, Organization, CareTeam, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson, Location)