Canadian Baseline
1.2.0 - CI Build
Canadian Baseline
1.2.0 - CI Build
Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-servicerequest | Version: 1.2.0 | |||
| Draft as of 2024-12-13 | Computable Name: ServiceRequestProfile | |||
Proposed constraints on the ServiceRequest resource for the minimal set of data required to request for service such as diagnostic investigations, treatments, or operations to be performed
This Service Request Profile is based upon the core FHIR ServiceRequest resource and created to define the minimal set of data required to request for service such as diagnostic investigations, treatments, or operations to be performed.
This profile defines a service request structure that includes core localisation concepts for use as a diagnostic service request in a Canadian context.
All elements or attributes defined in FHIR have cardinality as part of their definition - a minimum number of required appearances and a maximum number.
Most elements in FHIR specification have a minimum cardinality of 0, which means that they may be missing from a resource when it is exchanged between systems.
In this Canadian Baseline ServiceRequest Profile following elements are required:
In situations where the minimum cardinality of an element or attribute is 1 and information is missing and the Responder knows the precise reason for the absence of data, Responders SHALL send the reason for the missing information using values (such as NullFlavor) from the value set where they exist or using the DataAbsentReason extension.
Some elements are labeled as MustSupport meaning that implementations that produce or consume resources SHALL provide "support" for the element in some meaningful way (see Must Support definition).
Following elements are marked as Must Support in the Canadian ServiceRequest profile.
Must Support elements:
This profile may be used to share relevant information required to support a referral or a transfer of care request from one practitioner to another in which a referral is sent directly to a specific health service described in a shared Health Services Directory.
A ServiceRequest can be supplemented with service-specific clinical decision support information and any other additionally required data, for example, available appointment slots.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  ServiceRequest |
C | 0..* | ServiceRequest | ServiceRequest Profile dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management prr-1: orderDetail SHALL only be present if code is present |
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
 identifier |
SΣ | 0..* | Identifier | Identifiers assigned to this order ele-1: All FHIR elements must have a @value or children |
 basedOn |
Σ | 0..* | Reference(ServiceRequest Profile for Results Reporting | MedicationRequest Profile) | What request fulfills ele-1: All FHIR elements must have a @value or children |
| replaces |
Σ | 0..* | Reference(ServiceRequest Profile for Results Reporting) | What request replaces ele-1: All FHIR elements must have a @value or children |
| requisition |
SΣ | 0..1 | Identifier | Composite Request ID ele-1: All FHIR elements must have a @value or children |
| status |
?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. ele-1: All FHIR elements must have a @value or children |
| intent |
?!SΣ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. ele-1: All FHIR elements must have a @value or children |
| category |
SΣ | 0..* | CodeableConcept | Classification of service Binding: ServiceRequestCategoryCodes (preferred) ele-1: All FHIR elements must have a @value or children |
| doNotPerform |
?!Σ | 0..1 | boolean | True if service/procedure should not be performed ele-1: All FHIR elements must have a @value or children |
 code |
Σ | 0..1 | CodeableConcept | What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred. ele-1: All FHIR elements must have a @value or children |
   Slices for coding |
SΣ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children |
   coding:LabOrder |
Σ | 0..* | Coding | Laboratory procedure code Binding: https://fhir.infoway-inforoute.ca/ValueSet/pCLOCD (preferred): The pan-Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French. ele-1: All FHIR elements must have a @value or children |
  system |
Σ | 1..1 | uri | Identity of the terminology system ele-1: All FHIR elements must have a @value or children |
 code |
Σ | 1..1 | code | Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children |
 coding:@default |
Σ | 0..* | Coding | Code defined by a terminology system ele-1: All FHIR elements must have a @value or children |
| system |
Σ | 1..1 | uri | Identity of the terminology system ele-1: All FHIR elements must have a @value or children |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system ele-1: All FHIR elements must have a @value or children |
| subject |
SΣ | 1..1 | Reference(Patient Profile | Location Profile | Device Profile (Implantable)) | Individual or Entity the service is ordered for ele-1: All FHIR elements must have a @value or children |
| encounter |
Σ | 0..1 | Reference(Encounter Profile) | Encounter in which the request was created ele-1: All FHIR elements must have a @value or children |
| authoredOn |
SΣ | 0..1 | dateTime | Date request signed ele-1: All FHIR elements must have a @value or children |
| requester |
SΣ | 1..1 | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable)) | Who/what is requesting service ele-1: All FHIR elements must have a @value or children |
| performer |
SΣ | 0..* | Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Organization Profile | Patient Profile | Device Profile (Implantable)) | Requested performer ele-1: All FHIR elements must have a @value or children |
| locationReference |
Σ | 0..* | Reference(Location Profile) | Requested location ele-1: All FHIR elements must have a @value or children |
| reasonCode |
Σ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (preferred) ele-1: All FHIR elements must have a @value or children |
 reasonReference |
Σ | 0..* | Reference(Condition Profile | Observation Profile (General Use) | DiagnosticReport Profile for Laboratory Results Reporting | Diagnostic Report for Report and Note Exchange Profile | DocumentReference Profile for metadata about the document) | Explanation/Justification for service or service ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| ServiceRequest.status | required | RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1from the FHIR Standard | |
| ServiceRequest.intent | required | RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1from the FHIR Standard | |
| ServiceRequest.category | preferred | ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-categoryfrom the FHIR Standard | |
| ServiceRequest.code | example | ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-codefrom the FHIR Standard | |
| ServiceRequest.code.coding:LabOrder | preferred | https://fhir.infoway-inforoute.ca/ValueSet/pCLOCDhttps://fhir.infoway-inforoute.ca/ValueSet/pCLOCD | |
| ServiceRequest.reasonCode | preferred | ProcedureReasonCodeshttp://hl7.org/fhir/ValueSet/procedure-reasonfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | ServiceRequest | 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 | ServiceRequest | 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 | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | ServiceRequest | 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() | |
| prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists() |
Other representations of profile: CSV, Excel, Schematron
The ServiceRequest.category element conveys a code that classifies the service for searching, sorting and display purposes.
It may use Canada Health Infoway defined InterventionCodeSubsetCare value set to represent the care procedures performed by a Provider.
The ServiceRequest.code element identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.
If the service identified by the ServiceRequest.category is laboratory procedure the pan-Canadian LOINC Observation Code Database (pCLOCD) is preferred. pCLOCD is the Canadian version of the LOINC(tm) database.
The ServiceRequest.reasonCode element in this profile uses the same ProcedureReasonCodes value set as defined by the FHIR standard.
The binding is chagned from Example to Preferred. Implementers are encouraged to draw codes from the specified code system for interoperability purposes.
