HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/case-reporting/ and changes regularly. See the Directory of published versions

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Resource Profile: eICR ServiceRequest

This ServiceRequest profile represents eICR laboratory orders and other diagnostics for the eICR event.

Usage:

• Refer to this Resource Profile: Electronic Initial Case Report Composition
• Examples for this Resource Profile: ServiceRequest/servicerequest-eicr-eve-everywoman-zika and ServiceRequest/servicerequest-eicr-zika

Formal Views of Profile Content

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

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

This structure is derived from ServiceRequest

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	S	0..*	ServiceRequest	eICR ServiceRequest
identifier	S	1..*	Identifier	Identifiers assigned to this order
code	S	1..1	CodeableConcept	What is being requested/ordered Binding: LOINCDiagnosticReportCodes (extensible): LOINC Diagnostic Report Codes
subject		1..1	Reference(Patient)	Individual or Entity the service is ordered for
occurrence[x]	S	0..1	dateTime, Period, Timing	When service should occur
authoredOn	S	0..1	dateTime	Date request signed
requester	S	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
performer	S	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
bodySite	S	0..*	CodeableConcept	Location on Body
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
ServiceRequest.code	extensible	LOINCDiagnosticReportCodes (a valid code from LOINC)

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	SC	0..*	ServiceRequest	eICR ServiceRequest
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifiers assigned to this order
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: LOINCDiagnosticReportCodes (extensible): LOINC Diagnostic Report Codes
subject	Σ	1..1	Reference(Patient)	Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		When service should occur
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
bodySite	SΣ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.code	extensible	LOINCDiagnosticReportCodes (a valid code from LOINC)
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

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()

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	SC	0..*	ServiceRequest	eICR ServiceRequest
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
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
category	Σ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: LOINCDiagnosticReportCodes (extensible): LOINC Diagnostic Report Codes
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	Σ	1..1	Reference(Patient)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		When service should occur
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	SΣ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.priority	required	RequestPriority
ServiceRequest.code	extensible	LOINCDiagnosticReportCodes (a valid code from LOINC)
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerType	example	ParticipantRoles
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	example	ProcedureReasonCodes
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

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()

This structure is derived from ServiceRequest

Summary

Mandatory: 2 elements
Must-Support: 7 elements

Differential View

This structure is derived from ServiceRequest

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	S	0..*	ServiceRequest	eICR ServiceRequest
identifier	S	1..*	Identifier	Identifiers assigned to this order
code	S	1..1	CodeableConcept	What is being requested/ordered Binding: LOINCDiagnosticReportCodes (extensible): LOINC Diagnostic Report Codes
subject		1..1	Reference(Patient)	Individual or Entity the service is ordered for
occurrence[x]	S	0..1	dateTime, Period, Timing	When service should occur
authoredOn	S	0..1	dateTime	Date request signed
requester	S	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
performer	S	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
bodySite	S	0..*	CodeableConcept	Location on Body
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
ServiceRequest.code	extensible	LOINCDiagnosticReportCodes (a valid code from LOINC)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	SC	0..*	ServiceRequest	eICR ServiceRequest
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifiers assigned to this order
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: LOINCDiagnosticReportCodes (extensible): LOINC Diagnostic Report Codes
subject	Σ	1..1	Reference(Patient)	Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		When service should occur
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
bodySite	SΣ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.code	extensible	LOINCDiagnosticReportCodes (a valid code from LOINC)
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	SC	0..*	ServiceRequest	eICR ServiceRequest
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
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
category	Σ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: LOINCDiagnosticReportCodes (extensible): LOINC Diagnostic Report Codes
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	Σ	1..1	Reference(Patient)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		When service should occur
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	SΣ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.priority	required	RequestPriority
ServiceRequest.code	extensible	LOINCDiagnosticReportCodes (a valid code from LOINC)
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerType	example	ParticipantRoles
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	example	ProcedureReasonCodes
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

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()

This structure is derived from ServiceRequest

Summary

Mandatory: 2 elements
Must-Support: 7 elements

Other representations of profile: CSV, Excel, Schematron