PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

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• Detailed Descriptions
• Mappings
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Resource Profile: ADI PMO ServiceRequest

This profile is used to represent both a patient authored care plan (PACP) and a practitioner authored portable medical order (PMO).

Usage:

• Derived from this Resource Profile: ADI PMO Additional orders or instructions ServiceRequest, ADI PMO Cardiopulmonary Resuscitation ServiceRequest, ADI PMO Initial Treatment ServiceRequest, ADI PMO Medically Assisted Hydration Service Request and ADI PMO Medically Assisted Nutrition Service Request
• Refer to this Resource Profile: ADI PMO Care Plan and ADI PMO Composition

Formal Views of Profile Content

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

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

This structure is derived from USCoreServiceRequestProfile

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	USCoreServiceRequestProfile	A request for a service to be performed
status		1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Required Pattern: active
intent		1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order
category		1..*	CodeableConcept	(USCDI) Classification of service
encounter		0..0
requester		1..1	Reference(US Core Practitioner Profile)	(USCDI) Who/what is requesting service
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. Required Pattern: active
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	1..1	Reference(US Core Practitioner Profile)	(USCDI) Who/what is requesting service
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.status	required	Pattern: active http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. Required Pattern: active
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	1..1	Reference(US Core Practitioner Profile S)	(USCDI) Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	Σ	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	(USCDI) US Core Profile that supports the requested service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
ServiceRequest.status	required	Pattern: active http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail from the FHIR Standard
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
ServiceRequest.performerType	example	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 2 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)

Differential View

This structure is derived from USCoreServiceRequestProfile

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	USCoreServiceRequestProfile	A request for a service to be performed
status		1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Required Pattern: active
intent		1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order
category		1..*	CodeableConcept	(USCDI) Classification of service
encounter		0..0
requester		1..1	Reference(US Core Practitioner Profile)	(USCDI) Who/what is requesting service
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. Required Pattern: active
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	1..1	Reference(US Core Practitioner Profile)	(USCDI) Who/what is requesting service
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.status	required	Pattern: active http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. Required Pattern: active
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	1..1	Reference(US Core Practitioner Profile S)	(USCDI) Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	Σ	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	(USCDI) US Core Profile that supports the requested service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
ServiceRequest.status	required	Pattern: active http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Pattern: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail from the FHIR Standard
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
ServiceRequest.performerType	example	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 2 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)

Other representations of profile: CSV, Excel, Schematron