2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## Resource Profile: US Quality Core Device Not Requested

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

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

Usage

See the patterns page for implementation and usage patterns.

The DeviceRequest and DeviceNotRequested profiles represent the positive and negative statements for a device request.

The following example illustrates accessing DeviceRequest not requested data:

      define "Venous Foot Pumps Not Ordered":
    [DeviceNotRequested: "Venous Foot Pumps (VFP)"] DeviceNotOrdered
      where (DeviceNotOrdered.doNotPerformReason() in "Medical Reason"
        or DeviceNotOrdered.doNotPerformReason() in "Patient Refusal"
      )

### Examples

Negation Example with valueset | Device not indicated; indicates that none of the devices in the given "not done value set" were requested.
Negation Example with code | Device not indicated; indicates that a specific device, by code, was not requested.

For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.

USCDI+ Quality Elements:

- code[x]: (USCDI+ Quality) Device requested

Usages:

- Examples for this Profile: DeviceRequest/negation-example and DeviceRequest/negation-with-code-example
- CapabilityStatements using this Profile: US Quality Core Client CapabilityStatement and US Quality Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceRequest | C | 0..* | DeviceRequest | Medical device request Constraints: dnr-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:doNotPerformReason |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:doNotPerform | ?! | 1..1 | (Complex) | Extension URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform"
value[x] |  | 1..1 | boolean | Value of extension Fixed Value: true
status | ?!Σ | 0..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes representing the status of the request.
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of diagnostic request.
code[x] | Σ C | 1..1 | CodeableConcept | (USCDI+ Quality) Device requested Binding: FHIRDeviceTypes (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:doNotPerformValueSet | C | 0..1 | canonical(ValueSet) | What was not done URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Focus of request
authoredOn | Σ | 1..1 | dateTime | When recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
DeviceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
DeviceRequest.code[x] | Base | preferred | FHIR Device Types | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dnr-1 | error | DeviceRequest | to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`
dom-2 | error | DeviceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceRequest | 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 | error | DeviceRequest | 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 | error | DeviceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DeviceRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceRequest | C | 0..* | DeviceRequest | Medical device request Constraints: dnr-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:doNotPerformReason |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Slices for modifierExtension |  |  |  | Content/Rules for all slices
modifierExtension:doNotPerform | ?! | 1..1 | (Complex) | Extension URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
value[x] |  | 1..1 | boolean | Value of extension Fixed Value: true
status |  | 0..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent |  | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
code[x] | C | 1..1 | CodeableConcept | (USCDI+ Quality) Device requested Binding: FHIRDeviceTypes (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:doNotPerformValueSet | C | 0..1 | canonical(ValueSet) | What was not done URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject |  | 1..1 | Reference(US Quality Core Patient) | Focus of request
authoredOn |  | 1..1 | dateTime | When recorded
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DeviceRequest.code[x] | Base | preferred | FHIR Device Types | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dnr-1 | error | DeviceRequest | to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceRequest | C | 0..* | DeviceRequest | Medical device request Constraints: dnr-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:doNotPerformReason |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:doNotPerform | ?! | 1..1 | (Complex) | Extension URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform"
value[x] |  | 1..1 | boolean | Value of extension Fixed Value: true
identifier | Σ | 0..* | Identifier | External Request identifier
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(Resource) | What request fulfills
priorRequest | Σ | 0..* | Reference(Resource) | What request replaces
groupIdentifier | Σ | 0..1 | Identifier | Identifier of composite request
status | ?!Σ | 0..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes representing the status of the request.
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of diagnostic request.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
code[x] | Σ C | 1..1 | CodeableConcept | (USCDI+ Quality) Device requested Binding: FHIRDeviceTypes (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:doNotPerformValueSet | C | 0..1 | canonical(ValueSet) | What was not done URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
parameter |  | 0..* | BackboneElement | Device details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 0..1 | CodeableConcept | Device detail Binding Description: (example): A code that identifies the device detail.
value[x] |  | 0..1 |  | Value of detail
valueCodeableConcept |  |  | CodeableConcept |
valueQuantity |  |  | Quantity |
valueRange |  |  | Range |
valueBoolean |  |  | boolean |
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Focus of request
encounter | Σ | 0..1 | Reference(Encounter) | Encounter motivating request
occurrence[x] | Σ | 0..1 |  | Desired time or schedule for use
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
authoredOn | Σ | 1..1 | dateTime | When recorded
requester | Σ | 0..1 | Reference(Device | Practitioner | PractitionerRole | Organization) | Who/what is requesting diagnostics
performerType | Σ | 0..1 | CodeableConcept | Filler role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested Filler
reasonCode | Σ | 0..* | CodeableConcept | Coded Reason for request Binding: Condition/Problem/DiagnosisCodes (example): Diagnosis or problem codes justifying the reason for requesting the device.
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Linked Reason for request
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
supportingInfo |  | 0..* | Reference(Resource) | Additional clinical information
note |  | 0..* | Annotation | Notes or comments
relevantHistory |  | 0..* | Reference(Provenance) | Request provenance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DeviceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
DeviceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
DeviceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
DeviceRequest.code[x] | Base | preferred | FHIR Device Types | 📦4.0.1 | FHIR Std.
DeviceRequest.parameter.​code | Base | example |  | Not State | Unknown
DeviceRequest.performerType | Base | example | Participant Roles | 📍4.0.1 | FHIR Std.
DeviceRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dnr-1 | error | DeviceRequest | to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`
dom-2 | error | DeviceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceRequest | 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 | error | DeviceRequest | 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 | error | DeviceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DeviceRequest

Summary

Mandatory: 5 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
- http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform (Modifier)
- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceRequest | C | 0..* | DeviceRequest | Medical device request Constraints: dnr-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:doNotPerformReason |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:doNotPerform | ?! | 1..1 | (Complex) | Extension URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform"
value[x] |  | 1..1 | boolean | Value of extension Fixed Value: true
status | ?!Σ | 0..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes representing the status of the request.
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of diagnostic request.
code[x] | Σ C | 1..1 | CodeableConcept | (USCDI+ Quality) Device requested Binding: FHIRDeviceTypes (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:doNotPerformValueSet | C | 0..1 | canonical(ValueSet) | What was not done URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Focus of request
authoredOn | Σ | 1..1 | dateTime | When recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
DeviceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
DeviceRequest.code[x] | Base | preferred | FHIR Device Types | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dnr-1 | error | DeviceRequest | to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`
dom-2 | error | DeviceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceRequest | 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 | error | DeviceRequest | 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 | error | DeviceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from DeviceRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceRequest | C | 0..* | DeviceRequest | Medical device request Constraints: dnr-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:doNotPerformReason |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Slices for modifierExtension |  |  |  | Content/Rules for all slices
modifierExtension:doNotPerform | ?! | 1..1 | (Complex) | Extension URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
value[x] |  | 1..1 | boolean | Value of extension Fixed Value: true
status |  | 0..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent |  | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
code[x] | C | 1..1 | CodeableConcept | (USCDI+ Quality) Device requested Binding: FHIRDeviceTypes (preferred)
Slices for extension |  |  |  | Content/Rules for all slices
extension:doNotPerformValueSet | C | 0..1 | canonical(ValueSet) | What was not done URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject |  | 1..1 | Reference(US Quality Core Patient) | Focus of request
authoredOn |  | 1..1 | dateTime | When recorded
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DeviceRequest.code[x] | Base | preferred | FHIR Device Types | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dnr-1 | error | DeviceRequest | to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceRequest | C | 0..* | DeviceRequest | Medical device request Constraints: dnr-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:doNotPerformReason |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:doNotPerform | ?! | 1..1 | (Complex) | Extension URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform"
value[x] |  | 1..1 | boolean | Value of extension Fixed Value: true
identifier | Σ | 0..* | Identifier | External Request identifier
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(Resource) | What request fulfills
priorRequest | Σ | 0..* | Reference(Resource) | What request replaces
groupIdentifier | Σ | 0..1 | Identifier | Identifier of composite request
status | ?!Σ | 0..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes representing the status of the request.
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of diagnostic request.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
code[x] | Σ C | 1..1 | CodeableConcept | (USCDI+ Quality) Device requested Binding: FHIRDeviceTypes (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:doNotPerformValueSet | C | 0..1 | canonical(ValueSet) | What was not done URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
parameter |  | 0..* | BackboneElement | Device details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 0..1 | CodeableConcept | Device detail Binding Description: (example): A code that identifies the device detail.
value[x] |  | 0..1 |  | Value of detail
valueCodeableConcept |  |  | CodeableConcept |
valueQuantity |  |  | Quantity |
valueRange |  |  | Range |
valueBoolean |  |  | boolean |
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Focus of request
encounter | Σ | 0..1 | Reference(Encounter) | Encounter motivating request
occurrence[x] | Σ | 0..1 |  | Desired time or schedule for use
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
authoredOn | Σ | 1..1 | dateTime | When recorded
requester | Σ | 0..1 | Reference(Device | Practitioner | PractitionerRole | Organization) | Who/what is requesting diagnostics
performerType | Σ | 0..1 | CodeableConcept | Filler role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested Filler
reasonCode | Σ | 0..* | CodeableConcept | Coded Reason for request Binding: Condition/Problem/DiagnosisCodes (example): Diagnosis or problem codes justifying the reason for requesting the device.
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Linked Reason for request
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
supportingInfo |  | 0..* | Reference(Resource) | Additional clinical information
note |  | 0..* | Annotation | Notes or comments
relevantHistory |  | 0..* | Reference(Provenance) | Request provenance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DeviceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
DeviceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
DeviceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
DeviceRequest.code[x] | Base | preferred | FHIR Device Types | 📦4.0.1 | FHIR Std.
DeviceRequest.parameter.​code | Base | example |  | Not State | Unknown
DeviceRequest.performerType | Base | example | Participant Roles | 📍4.0.1 | FHIR Std.
DeviceRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dnr-1 | error | DeviceRequest | to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`
dom-2 | error | DeviceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceRequest | 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 | error | DeviceRequest | 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 | error | DeviceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from DeviceRequest

Summary

Mandatory: 5 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
- http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform (Modifier)
- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Other representations of profile: CSV, Excel, Schematron