# US Quality Core ServiceRequest - 2026 US Quality Core Implementation Guide v0.5.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Quality Core ServiceRequest**

## Resource Profile: US Quality Core ServiceRequest 

| | |
| :--- | :--- |
| *Official URL*:http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicerequest | *Version*:0.5.0 |
| Active as of 2026-05-15 | *Computable Name*:USQualityCoreServiceRequest |

 
Profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. 

### Guidance

  Reference Guidance for use of the Service Request profile can be found [here.](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-servicerequest.html#mandatory-and-must-support-data-elements) 
* See the [Social Determinants of Health (SDOH)](https://hl7.org/fhir/us/core/sdoh.html) Guidance Page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
* The `ServiceRequest.category` binding must support at a minimum the [US Core ServiceRequest Category Codes](http://hl7.org/fhir/us/core/STU6.1/ValueSet-us-core-servicerequest-category.html). However, this valueset can be treated as [extensible](http://hl7.org/fhir/R4/terminologies.html#extensible) and other category codes can be used instead.
* The `ServiceRequest.code` valueset is broad to accommodate a wide variety of use cases and should be constrained to a subset for a particular use case or domain. (for example, LOINC for laboratory orders.)
* The `ServiceRequest.subject` is Must Support with Must Support reference to US Quality Core Patient
  

**Usage**
To create an expression specifically requesting information that a ServiceRequest intentionally did not occur for a medical, patient or system reason, use the profile [USQualityCore-Servicenotrequested](StructureDefinition-us-quality-core-servicenotrequested.md).

The following example illustrates the use of the ServiceRequest profile:

```
define "Intermittent Pneumatic Compression Devices Ordered":
  ["ServiceRequest": "Application of intermittent pneumatic compression devices (IPC)"] DeviceOrdered
    where DeviceOrdered.status in { 'active', 'completed', 'on-hold' }
```

  See the [patterns](patterns.md) page for implementation and usage patterns.  

### Examples

 

| |
| :--- |
| [Request for Appendectomy Example](ServiceRequest-example.md) |
| [Request for Myringotomy Procedure Example](ServiceRequest-myringotomy-example.md) |

 

**USCDI+ Quality Elements:**

* status: (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
* intent: (USCDI+ Quality) (USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
* code: (USCDI+ Quality) (USCDI) What is being requested/ordered
* authoredOn: (USCDI+ Quality) (USCDI) Date request signed
* reasonCode: (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
* reasonReference: (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

**Usages:**

* Refer to this Profile: [US Quality Core Claim](StructureDefinition-us-quality-core-claim.md), [US Quality Core DiagnosticReport Profile for Laboratory Results Reporting](StructureDefinition-us-quality-core-diagnosticreport-lab.md), [US Quality Core ImagingStudy](StructureDefinition-us-quality-core-imagingstudy.md), [US Quality Core Procedure](StructureDefinition-us-quality-core-procedure.md) and [US Quality Core Procedure Not Done](StructureDefinition-us-quality-core-procedurenotdone.md)
* Examples for this Profile: [ServiceRequest/appropriateness-example](ServiceRequest-appropriateness-example.md), [ServiceRequest/elective-example](ServiceRequest-elective-example.md), [ServiceRequest/example](ServiceRequest-example.md) and [ServiceRequest/myringotomy-example](ServiceRequest-myringotomy-example.md)
* CapabilityStatements using this Profile: [US Quality Core Client CapabilityStatement](CapabilityStatement-us-quality-core-client.md) and [US Quality Core Server CapabilityStatement](CapabilityStatement-us-quality-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/fhir.onc.us-quality-core|current/StructureDefinition/StructureDefinition-us-quality-core-servicerequest.json)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-quality-core-servicerequest.csv), [Excel](StructureDefinition-us-quality-core-servicerequest.xlsx), [Schematron](StructureDefinition-us-quality-core-servicerequest.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-quality-core-servicerequest",
  "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicerequest",
  "version" : "0.5.0",
  "name" : "USQualityCoreServiceRequest",
  "title" : "US Quality Core ServiceRequest",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-05-15",
  "publisher" : "Office of the National Coordinator for Health Information Technology (ONC)",
  "contact" : [{
    "name" : "Office of the National Coordinator for Health Information Technology (ONC)",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.healthit.gov/feedback"
    }]
  }],
  "description" : "Profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }],
    "text" : "USA"
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "quick",
    "uri" : "http://siframework.org/cqf",
    "name" : "Quality Improvement and Clinical Knowledge (QUICK)"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "ServiceRequest",
  "baseDefinition" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest|6.1.0",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "ServiceRequest",
      "path" : "ServiceRequest",
      "constraint" : [{
        "key" : "dom-7",
        "severity" : "error",
        "human" : "if doNotPerform is present, it SHALL be false",
        "expression" : "doNotPerform.empty() or doNotPerform=false"
      }]
    },
    {
      "id" : "ServiceRequest.status",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.status",
      "short" : "(USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown"
    },
    {
      "id" : "ServiceRequest.intent",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.intent",
      "short" : "(USCDI+ Quality) (USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option"
    },
    {
      "id" : "ServiceRequest.category",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.category",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "$this"
        }],
        "rules" : "open"
      },
      "short" : "(USCDI) Classification of service"
    },
    {
      "id" : "ServiceRequest.doNotPerform",
      "path" : "ServiceRequest.doNotPerform",
      "short" : "True if service/procedure should not be performed",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "boolean"
      }],
      "fixedBoolean" : false
    },
    {
      "id" : "ServiceRequest.code",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.code",
      "short" : "(USCDI+ Quality) (USCDI) What is being requested/ordered"
    },
    {
      "id" : "ServiceRequest.subject",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.subject",
      "short" : "(USCDI) Individual or Entity the service is ordered for",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient"]
      }]
    },
    {
      "id" : "ServiceRequest.occurrence[x]",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.occurrence[x]",
      "short" : "(USCDI) When service should occur",
      "type" : [{
        "code" : "dateTime"
      },
      {
        "code" : "Period"
      },
      {
        "code" : "Timing"
      }]
    },
    {
      "id" : "ServiceRequest.authoredOn",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.authoredOn",
      "short" : "(USCDI+ Quality) (USCDI) Date request signed",
      "min" : 0,
      "max" : "1"
    },
    {
      "id" : "ServiceRequest.requester",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.requester",
      "short" : "(USCDI)",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitioner",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitionerrole",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0"]
      }]
    },
    {
      "id" : "ServiceRequest.reasonCode",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.reasonCode",
      "short" : "(USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service"
    },
    {
      "id" : "ServiceRequest.reasonReference",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.reasonReference",
      "short" : "(USCDI+ Quality) (USCDI) Explanation/Justification for service or service",
      "definition" : "Indicates another resource that provides a justification for why this service is being requested.   May relate to the resources referred to in `supportingInfo`.",
      "comment" : "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](servicerequest-example-di.html).",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "ServiceRequest.reasonReference",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"]
      }],
      "isModifier" : false,
      "isSummary" : true
    }]
  }
}

```
