Clinical Practice Guidelines
2.0.0-ballot - ballot International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Resource Profile: CPGCommunicationRequest - Detailed Descriptions

Active as of 2023-12-19

Definitions for the cpg-communicationrequest resource profile.

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

0. CommunicationRequest
2. CommunicationRequest.extension
SlicingThis element introduces a set of slices on CommunicationRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. CommunicationRequest.extension:instantiatesCanonical
Slice NameinstantiatesCanonical
Definition

A link back to the definition that produced this recommendation. Typically a Plan or Activity Definition.

ShortSource
Control0..1
TypeExtension(Definition) (Extension Type: canonical(ActivityDefinition, Measure, OperationDefinition, PlanDefinition, Questionnaire))
Must Supporttrue
6. CommunicationRequest.extension:rationale
Slice Namerationale
Control0..1
TypeExtension(CPG Rationale Extension) (Extension Type: markdown)
Must Supporttrue
8. CommunicationRequest.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
10. CommunicationRequest.status
Must Supporttrue
12. CommunicationRequest.statusReason
Must Supporttrue
14. CommunicationRequest.category
Must Supporttrue
16. CommunicationRequest.priority
Must Supporttrue
18. CommunicationRequest.doNotPerform
Must Supporttrue
20. CommunicationRequest.subject
Must Supporttrue
22. CommunicationRequest.about
Definition

The pertinent positive or negative information relative to this recommendation.

ShortPertinent information
Comments

This will typically be the most relevant case features used in determining applicability, but could also be other patient-specific information relevant to interpreting or assessing appropriateness of the recommendation with respect to the patient.

Must Supporttrue
24. CommunicationRequest.encounter
Must Supporttrue
26. CommunicationRequest.requester
Must Supporttrue
28. CommunicationRequest.recipient
Must Supporttrue
30. CommunicationRequest.sender
Must Supporttrue

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

0. CommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

ShortA request for information to be sent to a receiver
Control0..*
Is Modifierfalse
Summaryfalse
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())
2. CommunicationRequest.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. CommunicationRequest.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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.

ShortExtensionAdditional 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 CommunicationRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. CommunicationRequest.extension:instantiatesCanonical
Slice NameinstantiatesCanonical
Definition

A link back to the definition that produced this recommendation. Typically a Plan or Activity Definition.

ShortSource
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Definition) (Extension Type: canonical(ActivityDefinition, Measure, OperationDefinition, PlanDefinition, Questionnaire))
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. CommunicationRequest.extension:rationale
Slice Namerationale
Definition

A clinician-friendly explanation for the recommendation; patient-friendly if the recommendation is patient-facing.

ShortCPG Rationale Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Rationale Extension) (Extension Type: markdown)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. CommunicationRequest.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())
12. CommunicationRequest.identifier
Definition

Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

ShortUnique identifier
Comments

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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. CommunicationRequest.status
Definition

The status of the proposal or order.

Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
Control1..1
BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1

The status of the communication request.

Typecode
Is Modifiertrue because This element is labelled 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()))
16. CommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

ShortReason for current status
Comments

This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].

Control0..1
Binding

Codes identifying the reason for the current state of a request.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate NamesSuspended Reason, Cancelled Reason
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. CommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

ShortMessage category
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

Control0..*
BindingFor example codes, see CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-category

Codes for general categories of communications such as alerts, instruction, etc.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. CommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Shortroutine | urgent | asap | stat
Control0..1
BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1

Codes indicating the relative importance of a communication request.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
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()))
22. CommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

ShortTrue if request is prohibiting action
Comments

The attributes provided with the request qualify what is not to be done.

Control0..1
Typeboolean
Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate Namesprohibited
Meaning if MissingIf do not perform is not specified, 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()))
24. CommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

ShortFocus of message
Control0..1
TypeReference(Patient, Group)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. CommunicationRequest.about
Definition

The pertinent positive or negative information relative to this recommendation.


Other resources that pertain to this communication request and to which this communication request should be associated.

ShortPertinent informationResources that pertain to this communication request
Comments

This will typically be the most relevant case features used in determining applicability, but could also be other patient-specific information relevant to interpreting or assessing appropriateness of the recommendation with respect to the patient.


Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.

Control0..*
TypeReference(Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. CommunicationRequest.encounter
Definition

The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

ShortEncounter created as part of
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

Control0..1
TypeReference(Encounter)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. CommunicationRequest.requester
Definition

The device, individual, or organization who initiated the request and has responsibility for its activation.

ShortWho/what is requesting service
Control0..1
TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate Namesauthor
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. CommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

ShortMessage recipient
Control0..*
TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. CommunicationRequest.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

ShortMessage sender
Control0..1
TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
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. CommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

ShortA request for information to be sent to a receiver
Control0..*
Is Modifierfalse
Summaryfalse
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())
2. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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

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. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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 CommunicationRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. CommunicationRequest.extension:instantiatesCanonical
Slice NameinstantiatesCanonical
Definition

A link back to the definition that produced this recommendation. Typically a Plan or Activity Definition.

ShortSource
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Definition) (Extension Type: canonical(ActivityDefinition, Measure, OperationDefinition, PlanDefinition, Questionnaire))
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. CommunicationRequest.extension:rationale
Slice Namerationale
Definition

A clinician-friendly explanation for the recommendation; patient-friendly if the recommendation is patient-facing.

ShortCPG Rationale Extension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CPG Rationale Extension) (Extension Type: markdown)
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())
20. CommunicationRequest.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. CommunicationRequest.identifier
Definition

Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

ShortUnique identifier
Comments

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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. CommunicationRequest.basedOn
Definition

A plan or proposal that is fulfilled in whole or in part by this request.

ShortFulfills plan or proposal
Control0..*
TypeReference(Resource)
Is Modifierfalse
Summarytrue
Requirements

Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

Alternate Namesfulfills
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. CommunicationRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

ShortRequest(s) replaced by this request
Comments

The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.

Control0..*
TypeReference(CommunicationRequest)
Is Modifierfalse
Summarytrue
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Namessupersedes, prior
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. CommunicationRequest.groupIdentifier
Definition

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

ShortComposite request this is part of
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
Alternate NamesgrouperId
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. CommunicationRequest.status
Definition

The status of the proposal or order.

Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
Control1..1
BindingThe codes SHALL be taken from RequestStatus

The status of the communication request.

Typecode
Is Modifiertrue because This element is labelled 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()))
32. CommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

ShortReason for current status
Comments

This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].

Control0..1
Binding

Codes identifying the reason for the current state of a request.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate NamesSuspended Reason, Cancelled Reason
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. CommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

ShortMessage category
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

Control0..*
BindingFor example codes, see CommunicationCategory

Codes for general categories of communications such as alerts, instruction, etc.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. CommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Shortroutine | urgent | asap | stat
Control0..1
BindingThe codes SHALL be taken from RequestPriority

Codes indicating the relative importance of a communication request.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
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()))
38. CommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

ShortTrue if request is prohibiting action
Comments

The attributes provided with the request qualify what is not to be done.

Control0..1
Typeboolean
Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Alternate Namesprohibited
Meaning if MissingIf do not perform is not specified, 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()))
40. CommunicationRequest.medium
Definition

A channel that was used for this communication (e.g. email, fax).

ShortA channel of communication
Control0..*
BindingFor example codes, see ParticipationMode

Codes for communication mediums such as phone, fax, email, in person, etc.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. CommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

ShortFocus of message
Control0..1
TypeReference(Patient, Group)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. CommunicationRequest.about
Definition

The pertinent positive or negative information relative to this recommendation.

ShortPertinent information
Comments

This will typically be the most relevant case features used in determining applicability, but could also be other patient-specific information relevant to interpreting or assessing appropriateness of the recommendation with respect to the patient.

Control0..*
TypeReference(Resource)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. CommunicationRequest.encounter
Definition

The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

ShortEncounter created as part of
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

Control0..1
TypeReference(Encounter)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. CommunicationRequest.payload
Definition

Text, attachment(s), or resource(s) to be communicated to the recipient.

ShortMessage payload
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. CommunicationRequest.payload.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
52. CommunicationRequest.payload.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())
54. CommunicationRequest.payload.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
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 element that contains them
Summarytrue
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, modifiers
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())
56. CommunicationRequest.payload.content[x]
Definition

The communicated content (or for multi-part communications, one portion of the communication).

ShortMessage part content
Control1..1
TypeChoice of: string, Attachment, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
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()))
58. CommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

ShortWhen scheduled
Control0..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for 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 Namestiming
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. CommunicationRequest.authoredOn
Definition

For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

ShortWhen request transitioned to being actionable
Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamescreatedOn
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. CommunicationRequest.requester
Definition

The device, individual, or organization who initiated the request and has responsibility for its activation.

ShortWho/what is requesting service
Control0..1
TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate Namesauthor
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. CommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

ShortMessage recipient
Control0..*
TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. CommunicationRequest.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

ShortMessage sender
Control0..1
TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. CommunicationRequest.reasonCode
Definition

Describes why the request is being made in coded or textual form.

ShortWhy is communication needed?
Comments

Textual reasons can be captured using reasonCode.text.

Control0..*
BindingFor example codes, see v3 Code System ActReason

Codes for describing reasons for the occurrence of a communication.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. CommunicationRequest.reasonReference
Definition

Indicates another resource whose existence justifies this request.

ShortWhy is communication needed?
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()))
72. CommunicationRequest.note
Definition

Comments made about the request by the requester, sender, recipient, subject or other participants.

ShortComments made about communication request
Control0..*
TypeAnnotation
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))