Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

Resource Profile: MODIServiceRequest - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the dh-servicerequest-modi-1 resource profile.

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

0. ServiceRequest
Definition

A record of a request for a diagnostic imaging service to be performed.

ShortRequest for diagnostic imaging service
Invariantsinv-dh-srr-01: If present, a performer shall at least have a reference or display or a valid identifier (performer.exists() implies performer.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
2. ServiceRequest.extension:targetBodyStructure
Slice NametargetBodyStructure
Control0..
TypeExtension(Procedure Target Body Structure) (Extension Type: Reference(BodyStructure))
Must Supporttrue
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())
4. ServiceRequest.extension:hl7V2MessageBase64
Slice Namehl7V2MessageBase64
Control0..1
TypeExtension(ADHA HL7 V2 as Base64) (Extension Type: base64Binary)
Must Supporttrue
6. ServiceRequest.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
Must Supporttrue
8. ServiceRequest.status
Shortdraft | active | revoked | completed
Must Supporttrue
10. ServiceRequest.intent
Fixed Valueorder
12. ServiceRequest.category
ShortClassification of the service requested as diagnostic imaging + modality where available
Comments

A fixed category denoting Diagnostic imaging service identifies the type of order and supports macro handling of requests. A second category to provide the modality should be provided where possible.

Control1..?
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
  • 14. ServiceRequest.category:diagImg
    Slice NamediagImg
    ShortDiagnostic imaging service
    Control1..1
    Pattern Value{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "708175003"
      }]
    }
    16. ServiceRequest.code
    Control1..?
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://snomed.info/sct"
      }]
    }
    18. ServiceRequest.subject
    Control1..?
    TypeReference(ADHA Core Patient)
    Must Supporttrue
    20. ServiceRequest.subject.reference
    Control1..?
    22. ServiceRequest.authoredOn
    Control1..?
    Must Supporttrue
    24. ServiceRequest.requester
    Control1..?
    TypeReference(ADHA Authoring PractitionerRole)
    Must Supporttrue
    26. ServiceRequest.requester.reference
    Control1..?
    28. ServiceRequest.performer
    TypeReference(ADHA Core PractitionerRole, ADHA Core HealthcareService)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    30. ServiceRequest.reasonCode
    BindingThe codes SHOULD be taken from Reason for Request .
    (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1)
    Must Supporttrue
    32. ServiceRequest.supportingInfo
    Must Supporttrue
    34. ServiceRequest.bodySite
    BindingThe codes SHALL be taken from Body Site .
    (required to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
    Must Supporttrue
    36. ServiceRequest.note
    Must Supporttrue

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

    0. ServiceRequest
    Definition

    A record of a request for a diagnostic imaging service to be performed.


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

    ShortRequest for diagnostic imaging serviceA 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())
    inv-dh-srr-01: If present, a performer shall at least have a reference or display or a valid identifier (performer.exists() implies performer.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).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..1
    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:targetBodyStructure
    Slice NametargetBodyStructure
    Definition

    The target body site used for this procedure. Multiple locations are allowed.

    ShortThe target point for this procedure
    Control0..*
    TypeExtension(Procedure Target Body Structure) (Extension Type: Reference(BodyStructure))
    Is Modifierfalse
    Must Supporttrue
    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())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    6. ServiceRequest.extension:hl7V2MessageBase64
    Slice Namehl7V2MessageBase64
    Definition

    The actual content of a HL7 V2 message conveyed directly as data inline, base64 encoded.

    ShortHL7 V2 message conveyed directly as data inline, base64 encoded
    Control0..1
    TypeExtension(ADHA HL7 V2 as Base64) (Extension Type: base64Binary)
    Is Modifierfalse
    Must Supporttrue
    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())
    8. ServiceRequest.modifierExtension
    Definition

    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).

    ShortExtensions 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..*
    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())
    10. 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)
    Control10..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier(Identifier, AU Local Order Identifier)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. ServiceRequest.status
    Definition

    The status of the order.

    Shortdraft | active | revoked | completeddraft | 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.


    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 RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

    The status of a service order.

    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()))
    14. ServiceRequest.intent
    Definition

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

    Shortproposal | 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.

    Control1..1
    BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

    The kind of service request.

    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
    Summarytrue
    Fixed Valueorder
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. ServiceRequest.category
    Definition

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

    ShortClassification of the service requested as diagnostic imaging + modality where availableClassification of service
    Comments

    A fixed category denoting Diagnostic imaging service identifies the type of order and supports macro handling of requests. A second category to provide the modality should be provided where possible.


    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
    Must Supporttrue
    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 areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 18. ServiceRequest.category:diagImg
      Slice NamediagImg
      Definition

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

      ShortDiagnostic imaging serviceClassification 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
      Summarytrue
      Requirements

      Used for filtering what service request are retrieved and displayed.

      Pattern Value{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "708175003"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. 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..1
      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()))
      22. 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

      A pathology order is preferred to be a member of the RCPA - SPIA Requesting Pathology Terminology Reference Set (NCTS). An imaging order is preferred to be a member of the Imaging Procedure value set.


      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
      BindingFor example codes, see Evaluation Procedure .http://hl7.org/fhir/ValueSet/procedure-code
      (example to https://healthterminologies.gov.au/fhir/ValueSet/evaluation-procedure-1)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate Namesservice requested
      Pattern Value{
        "coding" : [{
          "system" : "http://snomed.info/sct"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. 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(ADHA Core Patient, 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()))
      26. ServiceRequest.subject.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-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()))
      28. 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()))
      30. ServiceRequest.requester
      Definition

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

      ShortAuthorising individual, organisation or program (e.g. National Bowel Cancer Screening Program)Who/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(ADHA Authoring PractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate Namesauthor, orderer
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. ServiceRequest.requester.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control10..1
      This element is affected by the following invariants: ref-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()))
      34. 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..*
      This element is affected by the following invariants: inv-dh-srr-01
      TypeReference(ADHA Core PractitionerRole, ADHA Core HealthcareService, Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Alternate Namesrequest recipient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. 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.


      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..*
      BindingThe codes SHOULD be taken from For example codes, see Reason for Request .http://hl7.org/fhir/ValueSet/procedure-reason
      (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. 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(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()))
      40. 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..*
      BindingThe codes SHALL be taken from For example codes, see Body Site .http://hl7.org/fhir/ValueSet/body-site
      (required to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      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()))
      42. ServiceRequest.note
      Definition

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

      ShortComments
      Control0..*
      TypeAnnotation
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      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

      A record of a request for a diagnostic imaging service to be performed.

      ShortRequest for diagnostic imaging service
      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())
      inv-dh-srr-01: If present, a performer shall at least have a reference or display or a valid identifier (performer.exists() implies performer.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).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..1
      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 areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. ServiceRequest.extension:targetBodyStructure
        Slice NametargetBodyStructure
        Definition

        The target body site used for this procedure. Multiple locations are allowed.

        ShortThe target point for this procedure
        Control0..*
        TypeExtension(Procedure Target Body Structure) (Extension Type: Reference(BodyStructure))
        Is Modifierfalse
        Must Supporttrue
        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:hl7V2MessageBase64
        Slice Namehl7V2MessageBase64
        Definition

        The actual content of a HL7 V2 message conveyed directly as data inline, base64 encoded.

        ShortHL7 V2 message conveyed directly as data inline, base64 encoded
        Control0..1
        TypeExtension(ADHA HL7 V2 as Base64) (Extension Type: base64Binary)
        Is Modifierfalse
        Must Supporttrue
        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())
        20. ServiceRequest.modifierExtension
        Definition

        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).

        ShortExtensions 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..*
        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())
        22. 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)
        Control1..*
        This element is affected by the following invariants: ele-1
        TypeIdentifier(Identifier, AU Local Order Identifier)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. 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()))
        26. 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()))
        28. 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()))
        30. 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()))
        32. 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()))
        34. ServiceRequest.status
        Definition

        The status of the order.

        Shortdraft | active | revoked | completed
        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 RequestStatus
        (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

        The status of a service order.

        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()))
        36. ServiceRequest.intent
        Definition

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

        Shortproposal | 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.

        Control1..1
        BindingThe codes SHALL be taken from RequestIntent
        (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

        The kind of service request.

        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
        Summarytrue
        Fixed Valueorder
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. ServiceRequest.category
        Definition

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

        ShortClassification of the service requested as diagnostic imaging + modality where available
        Comments

        A fixed category denoting Diagnostic imaging service identifies the type of order and supports macro handling of requests. A second category to provide the modality should be provided where possible.

        Control1..*
        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.

        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 areUnordered and Open, and can be differentiated using the following discriminators:
        • pattern @ $this
        • 40. ServiceRequest.category:diagImg
          Slice NamediagImg
          Definition

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

          ShortDiagnostic imaging 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
          Summarytrue
          Requirements

          Used for filtering what service request are retrieved and displayed.

          Pattern Value{
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "708175003"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. 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
          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()))
          44. 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..1
          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()))
          46. 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

          A pathology order is preferred to be a member of the RCPA - SPIA Requesting Pathology Terminology Reference Set (NCTS). An imaging order is preferred to be a member of the Imaging Procedure value set.

          Control1..1
          BindingFor example codes, see Evaluation Procedure .
          (example to https://healthterminologies.gov.au/fhir/ValueSet/evaluation-procedure-1)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate Namesservice requested
          Pattern Value{
            "coding" : [{
              "system" : "http://snomed.info/sct"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. 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()))
          50. 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] NoteSeeChoice of Data Typesfor 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()))
          52. 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(ADHA Core Patient)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. ServiceRequest.subject.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
          56. ServiceRequest.subject.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.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 58. ServiceRequest.subject.reference
            Definition

            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

            Control1..1
            This element is affected by the following invariants: ref-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()))
            60. ServiceRequest.subject.type
            Definition

            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

            ShortType the reference refers to (e.g. "Patient")
            Comments

            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from ResourceType
            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

            Aa resource (or, for logical models, the URI of the logical model).

            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()))
            62. ServiceRequest.subject.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. ServiceRequest.subject.display
            Definition

            Plain text narrative that identifies the resource in addition to the resource reference.

            ShortText alternative for the resource
            Comments

            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

            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()))
            66. 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()))
            68. 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Alternate Namesschedule
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. 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] NoteSeeChoice of Data Typesfor 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()))
            72. 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()))
            74. ServiceRequest.requester
            Definition

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

            ShortAuthorising individual, organisation or program (e.g. National Bowel Cancer Screening Program)
            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(ADHA Authoring PractitionerRole)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Alternate Namesauthor, orderer
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. ServiceRequest.requester.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
            78. ServiceRequest.requester.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.requester.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 80. ServiceRequest.requester.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control1..1
              This element is affected by the following invariants: ref-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()))
              82. ServiceRequest.requester.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

              Aa resource (or, for logical models, the URI of the logical model).

              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()))
              84. ServiceRequest.requester.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. ServiceRequest.requester.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              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()))
              88. 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
              BindingThe codes SHOULD be taken from Practitioner Role .
              (preferred to https://healthterminologies.gov.au/fhir/ValueSet/practitioner-role-1)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Alternate Namesspecialty
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. 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..*
              This element is affected by the following invariants: inv-dh-srr-01
              TypeReference(ADHA Core PractitionerRole, ADHA Core HealthcareService)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Alternate Namesrequest recipient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              92. 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()))
              94. 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()))
              96. 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..*
              BindingThe codes SHOULD be taken from Reason for Request .
              (preferred to https://healthterminologies.gov.au/fhir/ValueSet/reason-for-request-1)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. 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()))
              100. 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()))
              102. 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(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()))
              104. 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..*
              TypeReference(AU Base Specimen)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. 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..*
              BindingThe codes SHALL be taken from Body Site .
              (required to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              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()))
              108. ServiceRequest.note
              Definition

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

              ShortComments
              Control0..*
              TypeAnnotation
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. 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()))
              112. 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()))