De-Identified, Anonymized FHIR Profiles Library
0.1.0 - STU1 Release 1 - Standard for Trial-Use

De-Identified, Anonymized FHIR Profiles Library, published by HL7 International / Cross Group Projects. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-dapl/ and changes regularly. See the Directory of published versions

## Resource Profile: UDSPlusServiceRequest - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 1

Definitions for the uds-plus-servicerequest resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. ServiceRequest
Definition | The UDS+ profile is based on the ServiceRequest resource and establishes the core elements, extensions, vocabularies and value sets for representing ServiceRequests for UDS+ program. A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
Short | De-Identified UDS Plus ServiceRequestA request for a service to be performed
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | diagnostic request, referral, referral request, transfer of care request
Invariants | dom-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()) prr-1: orderDetail SHALL only be present if code is present (`orderDetail.empty() or code.exists()`) prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.id
Definition | De-dentified ServiceRequest resource identifier. The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | The de-identified ServiceRequest identifier created by the health center to send data to UDS+ Data ReceiverLogical 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.
Control | 0..1
Type | id string
Is Modifier | false
Must Support | true
Summary | true
4. ServiceRequest.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ServiceRequest.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.
Short | Cannot include any text in the resource as part of the de-identified data.Text 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.
Control | 0..01
Type | Narrative
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ServiceRequest.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.
Short | Cannot include any contained resources in the resource as part of the de-identified data.Contained, 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.
Control | 0..0*
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
10. ServiceRequest.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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. ServiceRequest.status
Definition | The status of the order.
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown
Comments | The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/request-status|4.0.1` ) The status of a service order.
Type | code
Is Modifier | true because This element is labeled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ServiceRequest.intent
Definition | Whether the request is a proposal, plan, an original order or a reflex order.
Short | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Comments | This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from RequestIntent http://hl7.org/fhir/ValueSet/request-intent|4.0.1 (required to `http://hl7.org/fhir/ValueSet/request-intent|4.0.1` ) The kind of service request.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ServiceRequest.doNotPerform
Definition | Set this to true if the record is saying that the service/procedure should NOT be performed.
Short | True if service/procedure should not be performed
Comments | In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.
Control | 10..1
Type | boolean
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.
Meaning if Missing | If missing, the request is a positive request e.g. "do perform"
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ServiceRequest.code
Definition | A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.
Short | What is being requested/ordered
Comments | Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see US Core Procedure Codes http://hl7.org/fhir/ValueSet/procedure-code|4.0.1 (extensible to `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code` ) The set of codes indicating the ServiceRequests Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Alternate Names | service requested
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ServiceRequest.subject
Definition | On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).
Short | Individual or Entity the service is ordered for
Control | 1..1
Type | Reference(De-Identified UDS Plus Patient, Patient, Group, Location, Device)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ServiceRequest.encounter
Definition | An encounter that provides additional information about the healthcare context in which this request is made.
Short | Encounter in which the request was created
Control | 0..1
Type | Reference(De-Identified UDS Plus Encounter, Encounter)
Is Modifier | false
Must Support | true
Summary | true
Alternate Names | context
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ServiceRequest.occurrence[x]
Definition | The date/time at which the requested service should occur.
Short | When service should occur
Control | 0..1
Type | Choice of: dateTime, Period, Timing
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | schedule
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ServiceRequest.authoredOn
Definition | When the request transitioned to being actionable.
Short | Date request signed
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Alternate Names | orderedOn
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ServiceRequest.requester
Definition | The individual who initiated the request and has responsibility for its activation.
Short | Who/what is requesting service
Comments | This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.
Control | 0..1
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | author, orderer
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. ServiceRequest.bodySite
Definition | Anatomic location where the procedure should be performed. This is the target site.
Short | Location on Body
Comments | Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.
Control | 0..*
Binding | For example codes, see SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site|4.0.1 (example to `http://hl7.org/fhir/ValueSet/body-site|4.0.1` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Knowing where the procedure is performed is important for tracking if multiple sites are possible.
Alternate Names | location
Invariants | ele-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 foundhere

0. ServiceRequest
Definition | The UDS+ profile is based on the ServiceRequest resource and establishes the core elements, extensions, vocabularies and value sets for representing ServiceRequests for UDS+ program.
Short | De-Identified UDS Plus ServiceRequest
2. ServiceRequest.id
Definition | De-dentified ServiceRequest resource identifier.
Short | The de-identified ServiceRequest identifier created by the health center to send data to UDS+ Data Receiver
Must Support | true
4. ServiceRequest.text
Short | Cannot include any text in the resource as part of the de-identified data.
Control | 0..0
Must Support | false
6. ServiceRequest.contained
Short | Cannot include any contained resources in the resource as part of the de-identified data.
Control | 0..0
Must Support | false
8. ServiceRequest.status
Control | 1..1
Must Support | true
10. ServiceRequest.intent
Control | 1..1
Must Support | true
12. ServiceRequest.doNotPerform
Control | 1..1
Must Support | true
14. ServiceRequest.code
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from US Core Procedure Codes (extensible to `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code` ) The set of codes indicating the ServiceRequests
Must Support | true
16. ServiceRequest.subject
Control | 1..1
Type | Reference(De-Identified UDS Plus Patient)
Must Support | true
18. ServiceRequest.encounter
Control | 0..1
Type | Reference(De-Identified UDS Plus Encounter)
Must Support | true
20. ServiceRequest.occurrence[x]
Control | 0..1
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
22. ServiceRequest.authoredOn
Control | 0..1
Must Support | true
24. ServiceRequest.requester
Control | 0..1
Must Support | true
26. ServiceRequest.bodySite
Control | 0..*
Must Support | true

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

0. ServiceRequest
Definition | The UDS+ profile is based on the ServiceRequest resource and establishes the core elements, extensions, vocabularies and value sets for representing ServiceRequests for UDS+ program.
Short | De-Identified UDS Plus ServiceRequest
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | diagnostic request, referral, referral request, transfer of care request
Invariants | dom-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()`) prr-1: orderDetail SHALL only be present if code is present (`orderDetail.empty() or code.exists()`)
2. ServiceRequest.id
Definition | De-dentified ServiceRequest resource identifier.
Short | The de-identified ServiceRequest identifier created by the health center to send data to UDS+ Data Receiver
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.
Control | 0..1
Type | id
Is Modifier | false
Must Support | true
Summary | true
4. ServiceRequest.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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. ServiceRequest.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. ServiceRequest.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. ServiceRequest.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.
Short | Cannot include any text in the resource as part of the de-identified data.
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.
Control | 0..0
Type | Narrative
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. ServiceRequest.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.
Short | Cannot include any contained resources in the resource as part of the de-identified data.
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.
Control | 0..0
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. ServiceRequest.extension
Definition | 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
16. ServiceRequest.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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. ServiceRequest.identifier
Definition | Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.
Short | Identifiers assigned to this order
Comments | The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. ServiceRequest.instantiatesCanonical
Definition | The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.
Short | Instantiates FHIR protocol or definition
Comments | Note: 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.
Control | 0..*
Type | canonical(ActivityDefinition, PlanDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. ServiceRequest.instantiatesUri
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.
Short | Instantiates external protocol or definition
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Control | 0..*
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. ServiceRequest.basedOn
Definition | Plan/proposal/order fulfilled by this request.
Short | What request fulfills
Control | 0..*
Type | Reference(CarePlan, ServiceRequest, MedicationRequest)
Is Modifier | false
Summary | true
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. ServiceRequest.replaces
Definition | The request takes the place of the referenced completed or terminated request(s).
Short | What request replaces
Control | 0..*
Type | Reference(ServiceRequest)
Is Modifier | false
Summary | true
Alternate Names | supersedes, prior, renewed order
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. ServiceRequest.requisition
Definition | A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.
Short | Composite Request ID
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.
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.
Alternate Names | grouperId, groupIdentifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. ServiceRequest.status
Definition | The status of the order.
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown
Comments | The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus (required to `http://hl7.org/fhir/ValueSet/request-status|4.0.1` ) The status of a service order.
Type | code
Is Modifier | true because This element is labeled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. ServiceRequest.intent
Definition | Whether the request is a proposal, plan, an original order or a reflex order.
Short | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Comments | This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Control | 1..1
Binding | The codes SHALL be taken from RequestIntent (required to `http://hl7.org/fhir/ValueSet/request-intent|4.0.1` ) The kind of service request.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. ServiceRequest.category
Definition | A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").
Short | Classification of service
Comments | There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.
Control | 0..*
Binding | For example codes, see ServiceRequestCategoryCodes (example to `http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1` ) Classification of the requested service.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Used for filtering what service request are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. ServiceRequest.priority
Definition | Indicates how quickly the ServiceRequest should be addressed with respect to other requests.
Short | routine | urgent | asap | stat
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority (required to `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` ) Identifies the level of importance to be assigned to actioning the request.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Meaning if Missing | If missing, this task should be performed with normal priority
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. ServiceRequest.doNotPerform
Definition | Set this to true if the record is saying that the service/procedure should NOT be performed.
Short | True if service/procedure should not be performed
Comments | In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.
Control | 1..1
Type | boolean
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.
Meaning if Missing | If missing, the request is a positive request e.g. "do perform"
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. ServiceRequest.code
Definition | A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.
Short | What is being requested/ordered
Comments | Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from US Core Procedure Codes (extensible to `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code` ) The set of codes indicating the ServiceRequests
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Alternate Names | service requested
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. ServiceRequest.orderDetail
Definition | Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.
Short | Additional order information
Comments | For information from the medical record intended to support the delivery of the requested services, use the `supportingInformation` element.
Control | 0..* This element is affected by the following invariants: prr-1
Binding | For example codes, see ServiceRequestOrderDetailsCodes (example to `http://hl7.org/fhir/ValueSet/servicerequest-orderdetail|4.0.1` ) Codified order entry details which are based on order context.
Type | CodeableConcept
Is Modifier | false
Summary | true
Alternate Names | detailed instructions
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. ServiceRequest.quantity[x]
Definition | An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).
Short | Service amount
Control | 0..1
Type | Choice of: Quantity, Ratio, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | When ordering a service the number of service items may need to be specified separately from the the service item.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. ServiceRequest.subject
Definition | On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).
Short | Individual or Entity the service is ordered for
Control | 1..1
Type | Reference(De-Identified UDS Plus Patient)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. ServiceRequest.encounter
Definition | An encounter that provides additional information about the healthcare context in which this request is made.
Short | Encounter in which the request was created
Control | 0..1
Type | Reference(De-Identified UDS Plus Encounter)
Is Modifier | false
Must Support | true
Summary | true
Alternate Names | context
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. ServiceRequest.occurrence[x]
Definition | The date/time at which the requested service should occur.
Short | When service should occur
Control | 0..1
Type | Choice of: dateTime, Period, Timing
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | schedule
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. ServiceRequest.asNeeded[x]
Definition | If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.
Short | Preconditions for service
Control | 0..1
Binding | For example codes, see SNOMEDCTMedicationAsNeededReasonCodes (example to `http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1` ) A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
Type | Choice of: boolean, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. ServiceRequest.authoredOn
Definition | When the request transitioned to being actionable.
Short | Date request signed
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Alternate Names | orderedOn
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. ServiceRequest.requester
Definition | The individual who initiated the request and has responsibility for its activation.
Short | Who/what is requesting service
Comments | This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.
Control | 0..1
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | author, orderer
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. ServiceRequest.performerType
Definition | Desired type of performer for doing the requested service.
Short | Performer role
Comments | This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.
Control | 0..1
Binding | For example codes, see ParticipantRoles (example to `http://hl7.org/fhir/ValueSet/participant-role|4.0.1` ) Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
Type | CodeableConcept
Is Modifier | false
Summary | true
Alternate Names | specialty
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. ServiceRequest.performer
Definition | The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.
Short | Requested performer
Comments | If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
Is Modifier | false
Summary | true
Alternate Names | request recipient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. ServiceRequest.locationCode
Definition | The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.
Short | Requested location
Control | 0..*
Binding | For example codes, see ServiceDeliveryLocationRoleType (example to `http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType` ) A location type where services are delivered.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. ServiceRequest.locationReference
Definition | A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.
Short | Requested location
Control | 0..*
Type | Reference(Location)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. ServiceRequest.reasonCode
Definition | An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in `supportingInfo`.
Short | Explanation/Justification for procedure or service
Comments | This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the CT Scan example.
Control | 0..*
Binding | For example codes, see ProcedureReasonCodes (example to `http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1` ) Diagnosis or problem codes justifying the reason for requesting the service investigation.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. ServiceRequest.reasonReference
Definition | Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in `supportingInfo`.
Short | Explanation/Justification for service or service
Comments | This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the CT Scan example.
Control | 0..*
Type | Reference(Condition, Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. ServiceRequest.insurance
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.
Short | Associated insurance coverage
Control | 0..*
Type | Reference(Coverage, ClaimResponse)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. ServiceRequest.supportingInfo
Definition | Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.
Short | Additional clinical information
Comments | To represent information about how the services are to be delivered use the `instructions` element.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Alternate Names | Ask at order entry question, AOE
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. ServiceRequest.specimen
Definition | One or more specimens that the laboratory procedure will use.
Short | Procedure Samples
Comments | Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
Control | 0..*
Type | Reference(Specimen)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. ServiceRequest.bodySite
Definition | Anatomic location where the procedure should be performed. This is the target site.
Short | Location on Body
Comments | Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.
Control | 0..*
Binding | For example codes, see SNOMEDCTBodyStructures (example to `http://hl7.org/fhir/ValueSet/body-site|4.0.1` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Knowing where the procedure is performed is important for tracking if multiple sites are possible.
Alternate Names | location
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. ServiceRequest.note
Definition | Any other notes and comments made about the service request. For example, internal billing notes.
Short | Comments
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. ServiceRequest.patientInstruction
Definition | Instructions in terms that are understood by the patient or consumer.
Short | Patient or consumer-oriented instructions
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. ServiceRequest.relevantHistory
Definition | Key events in the history of the request.
Short | Request provenance
Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
Control | 0..*
Type | Reference(Provenance)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)