PACIO Personal Functioning and Engagement Implementation Guide
2.0.0 - STU 2 United States of America flag

PACIO Personal Functioning and Engagement Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-pfe/ and changes regularly. See the Directory of published versions

Resource Profile: Personal Functioning and Engagement Device Request Profile

Official URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request Version: 2.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: PFEDeviceRequest

The purpose of the profile is to facilitate exchange of information related to a device request/order being made at a post-acute care setting to support a patient’s personal functioning and engagement. The US Core Device Profile inherits from the FHIR DeviceRequest resource; refer to it for scope and usage definitions.

This page has new content for PACIO PFE Version 3.0.0

Given that many Post-acute care (PAC) patients are covered via Medicare and/or Medicaid (cite, cite, cite), the PFE community intentionally and carefully developed the to support capture of documentation that can be critical for a device order/request to be covered by Medicare/Medicaid. While this profile is not a prior authorization or reimbursement workflow, it includes information that supports both (e.g., clinical justification). It is not intended to replace prior authorization or insurance profiles, but to complement them.

Example Usage Scenarios:

The following are example usage scenarios for this Profile:

  • Submit a new request for a device to support a patient’s physical and cognitive functioning and/or engagement in daily activities (aka functioning and engagement).
  • Query past device requests as part of gathering information about a patient’s prior functioning and engagement support.
  • Record or update an existing device request based on changes in a patient’s functional and engagement abilities.

How this resource was developed

This Profile was developed by the Personal Functioning and Engagement (PFE) subgroup of the Post-Acute Care InterOperability (PACIO) Project. The subgroup contains experts in: Assessing for and ordering devices (e.g., physical therapists, speech language pathologists), EHR implementation and interoperability, HL7 FHIR, and user-centered design. PACIO is sponsored by the US Centers for Medicare and Medicaid Services (CMS) and by the MITRE Corporation.

** Specific methods used: **

  • Needs assessment
    • PACIO community members identified challenges when requesting devices in Post-acute care (PAC) settings
  • Identify gaps in existing device request and related resources
    • Extraction of data elements within existing resources
      • FHIR profiles for Device, DeviceRequest, DeviceDefinition, DeviceAssociation (R6)
      • Da Vinci Payer Data Exchange IG PDex Device profile and Da Vinci Prior Authorization Support (PAS) IG PAS Device Request profile
      • Why look at Da Vinci specifically? "The HTI-4 final rule adopts three new certification criteria to support more efficient management of electronic prior authorization tasks and reduce administrative burden for providers. These criteria are based on Fast Healthcare Interoperability Resources (FHIR®) implementation specifications developed by the HL7® Da Vinci project.” (cite)
    • Identification of device request requirements by CMS and payors
    • Compare profile data elements and CMS/payor requirements
    • PFE community review of extracted data elements and comparison to CMS/payor requirements to identify gaps based on PAC practice
  • Identify an existing resource to use as foundation for a PFE Device Request profile
  • Build the PFE Device Request profile to address gaps and address PAC needs
    • MITRE team created an initial draft of the profile
    • PAC community iteratively provided feedback to improve profile drafts

Mandatory and Must Support Data Elements

The following data elements must always be present or must be supported if the data is present in the sending system (Must Support definition). They are presented below with a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Personal Functioning and Engagement Narrative History of Status must have:

  1. code[x]
  2. patient

Each Personal Functioning and Engagement Narrative History of Status must support:

  1. extension:location
  2. extension:device-user
  3. extnesion:clinical-justification
  4. status
  5. priority
  6. parameter
  7. encounter
  8. occurrence[x]
  9. authoredOn
  10. requester*
  11. insurance
  12. note

* see the Profile specific implementation guidance section below

Profile specific implementation guidance:

  • *FHIR R4 DeviceRequest.requester allows Device, Practitioner, PractitionerRole, and Organization. FHIR R6 DeviceRequest.requester also allows CareTeam, Group, Patient, and RelatedPerson. Implementer MAY use the additional-requester extension for these additional requester types added in FHIR R6.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DeviceRequest 0..* DeviceRequest(4.0.1) Medical device request
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:location S 0..* CodeableConcept location
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (extensible)
Constraints: ext-1
.... extension:device-user S 0..* (Complex) Device user(s)
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user
Constraints: ext-1
.... extension:clinical-justification S 0..* (Complex) Clinical justification
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... groupIdentifier SΣ 0..1 Identifier Identifier of composite request
... status ?!SΣ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... Slices for code[x] SΣ 1..1 Device requested
Slice: Unordered, Open by type:$this
Binding: FHIRDeviceTypes (example): Codes for devices that can be requested.
.... codeReference Reference(Device)
.... codeCodeableConcept CodeableConcept
.... code[x]:codeCodeableConcept SΣ 0..1 CodeableConcept Device requested
Binding: PFEDeviceType (2.0.0) (extensible)
... parameter S 0..* BackboneElement Parameter(s) for device
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code 0..1 CodeableConcept Parameter code(s)
Binding: PFEDeviceParameterCodeVS (2.0.0) (preferred)
.... value[x] 0..1 Parameter value(s)
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject SΣ 1..1 Reference(US Core Patient Profile(6.1.0)) Patient
... encounter SΣ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] SΣ 0..1 Desired time or schedule for use
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn SΣ 0..1 dateTime When recorded
... requester SΣ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Device requester
.... Slices for extension Content/Rules for all slices
..... extension:additional-requester 0..1 Reference(CareTeam | Group | Patient | RelatedPerson) Cross-version extension for R6 requester targets not supported in R4.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester
Constraints: ext-1
... reasonCode Σ 0..* CodeableConcept Coded Reason for request
Binding: USCoreConditionCodes (7.0.0) (extensible)
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance S 0..* Reference(PAS Coverage(2.2.1) | PAS Claim Response(2.2.1)) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note S 0..* Annotation Notes or comments

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DeviceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
DeviceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
DeviceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
DeviceRequest.code[x] Base example FHIR Device Types 📍4.0.1 FHIR Std.
DeviceRequest.code[x]:codeCodeableConcept Base extensible Personal Functioning and Engagement Device Type Value Set 📍2.0.0 This IG
DeviceRequest.parameter.​code Base preferred Personal Functioning and Engagement Device Parameter Code Value Set 📍2.0.0 This IG
DeviceRequest.reasonCode Base extensible US Core Condition Codes 📍7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error DeviceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DeviceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DeviceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error DeviceRequest.implicitRules, DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.basedOn, DeviceRequest.groupIdentifier, DeviceRequest.status, DeviceRequest.intent, DeviceRequest.priority, DeviceRequest.code[x], DeviceRequest.code[x]:codeCodeableConcept, DeviceRequest.parameter, DeviceRequest.parameter.modifierExtension, DeviceRequest.parameter.code, DeviceRequest.parameter.value[x], DeviceRequest.subject, DeviceRequest.encounter, DeviceRequest.occurrence[x], DeviceRequest.authoredOn, DeviceRequest.requester, DeviceRequest.requester.extension:additional-requester, DeviceRequest.reasonCode, DeviceRequest.reasonReference, DeviceRequest.insurance, DeviceRequest.supportingInfo, DeviceRequest.note All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.parameter.modifierExtension, DeviceRequest.requester.extension:additional-requester Must have either extensions or value[x], not both extension.exists() != value.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DeviceRequest 0..* DeviceRequest(4.0.1) Medical device request
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:location S 0..* CodeableConcept location
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (extensible)
.... extension:device-user S 0..* (Complex) Device user(s)
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user
.... extension:clinical-justification S 0..* (Complex) Clinical justification
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification
... basedOn 0..* Reference(Resource) What request fulfills
... groupIdentifier S 0..1 Identifier Identifier of composite request
... priority S 0..1 code routine | urgent | asap | stat
... Slices for code[x] S 1..1 Reference(Device), CodeableConcept Device requested
Slice: Unordered, Open by type:$this
.... code[x]:codeCodeableConcept S 0..1 CodeableConcept Device requested
Binding: PFEDeviceType (2.0.0) (extensible)
... parameter S 0..* BackboneElement Parameter(s) for device
.... code 0..1 CodeableConcept Parameter code(s)
Binding: PFEDeviceParameterCodeVS (2.0.0) (preferred)
.... value[x] 0..1 CodeableConcept, Quantity, Range, boolean Parameter value(s)
... subject S 1..1 Reference(US Core Patient Profile(6.1.0)) Patient
... encounter S 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] S 0..1 dateTime, Period, Timing Desired time or schedule for use
... authoredOn S 0..1 dateTime When recorded
... requester S 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Device requester
.... Slices for extension Content/Rules for all slices
..... extension:additional-requester 0..1 Reference(CareTeam | Group | Patient | RelatedPerson) Cross-version extension for R6 requester targets not supported in R4.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester
... performerType 0..0 Filler role
... performer 0..0 Requested Filler
... reasonCode 0..* CodeableConcept Coded Reason for request
Binding: USCoreConditionCodes (7.0.0) (extensible)
... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance S 0..* Reference(PAS Coverage(2.2.1) | PAS Claim Response(2.2.1)) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note S 0..* Annotation Notes or comments

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
DeviceRequest.code[x]:codeCodeableConcept Base extensible Personal Functioning and Engagement Device Type Value Set 📍2.0.0 This IG
DeviceRequest.parameter.​code Base preferred Personal Functioning and Engagement Device Parameter Code Value Set 📍2.0.0 This IG
DeviceRequest.reasonCode Base extensible US Core Condition Codes 📍7.0.0 US Core v7.0
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DeviceRequest 0..* DeviceRequest(4.0.1) Medical device request
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:location S 0..* CodeableConcept location
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (extensible)
Constraints: ext-1
.... extension:device-user S 0..* (Complex) Device user(s)
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user
Constraints: ext-1
.... extension:clinical-justification S 0..* (Complex) Clinical justification
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier External Request identifier
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) What request fulfills
... priorRequest Σ 0..* Reference(Resource) What request replaces
... groupIdentifier SΣ 0..1 Identifier Identifier of composite request
... status ?!SΣ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... Slices for code[x] SΣ 1..1 Device requested
Slice: Unordered, Open by type:$this
Binding: FHIRDeviceTypes (example): Codes for devices that can be requested.
.... codeReference Reference(Device)
.... codeCodeableConcept CodeableConcept
.... code[x]:codeCodeableConcept SΣ 0..1 CodeableConcept Device requested
Binding: PFEDeviceType (2.0.0) (extensible)
... parameter S 0..* BackboneElement Parameter(s) for device
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code 0..1 CodeableConcept Parameter code(s)
Binding: PFEDeviceParameterCodeVS (2.0.0) (preferred)
.... value[x] 0..1 Parameter value(s)
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject SΣ 1..1 Reference(US Core Patient Profile(6.1.0)) Patient
... encounter SΣ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] SΣ 0..1 Desired time or schedule for use
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn SΣ 0..1 dateTime When recorded
... requester SΣ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Device requester
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:additional-requester 0..1 Reference(CareTeam | Group | Patient | RelatedPerson) Cross-version extension for R6 requester targets not supported in R4.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... reasonCode Σ 0..* CodeableConcept Coded Reason for request
Binding: USCoreConditionCodes (7.0.0) (extensible)
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance S 0..* Reference(PAS Coverage(2.2.1) | PAS Claim Response(2.2.1)) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note S 0..* Annotation Notes or comments
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DeviceRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DeviceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
DeviceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
DeviceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
DeviceRequest.code[x] Base example FHIR Device Types 📍4.0.1 FHIR Std.
DeviceRequest.code[x]:codeCodeableConcept Base extensible Personal Functioning and Engagement Device Type Value Set 📍2.0.0 This IG
DeviceRequest.parameter.​code Base preferred Personal Functioning and Engagement Device Parameter Code Value Set 📍2.0.0 This IG
DeviceRequest.requester.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
DeviceRequest.reasonCode Base extensible US Core Condition Codes 📍7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error DeviceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DeviceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DeviceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error DeviceRequest.meta, DeviceRequest.implicitRules, DeviceRequest.language, DeviceRequest.text, DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.identifier, DeviceRequest.instantiatesCanonical, DeviceRequest.instantiatesUri, DeviceRequest.basedOn, DeviceRequest.priorRequest, DeviceRequest.groupIdentifier, DeviceRequest.status, DeviceRequest.intent, DeviceRequest.priority, DeviceRequest.code[x], DeviceRequest.code[x]:codeCodeableConcept, DeviceRequest.parameter, DeviceRequest.parameter.extension, DeviceRequest.parameter.modifierExtension, DeviceRequest.parameter.code, DeviceRequest.parameter.value[x], DeviceRequest.subject, DeviceRequest.encounter, DeviceRequest.occurrence[x], DeviceRequest.authoredOn, DeviceRequest.requester, DeviceRequest.requester.extension, DeviceRequest.requester.extension:additional-requester, DeviceRequest.requester.reference, DeviceRequest.requester.type, DeviceRequest.requester.identifier, DeviceRequest.requester.display, DeviceRequest.reasonCode, DeviceRequest.reasonReference, DeviceRequest.insurance, DeviceRequest.supportingInfo, DeviceRequest.note, DeviceRequest.relevantHistory All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.parameter.extension, DeviceRequest.parameter.modifierExtension, DeviceRequest.requester.extension, DeviceRequest.requester.extension:additional-requester Must have either extensions or value[x], not both extension.exists() != value.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DeviceRequest 0..* DeviceRequest(4.0.1) Medical device request
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:location S 0..* CodeableConcept location
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (extensible)
Constraints: ext-1
.... extension:device-user S 0..* (Complex) Device user(s)
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user
Constraints: ext-1
.... extension:clinical-justification S 0..* (Complex) Clinical justification
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... groupIdentifier SΣ 0..1 Identifier Identifier of composite request
... status ?!SΣ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... Slices for code[x] SΣ 1..1 Device requested
Slice: Unordered, Open by type:$this
Binding: FHIRDeviceTypes (example): Codes for devices that can be requested.
.... codeReference Reference(Device)
.... codeCodeableConcept CodeableConcept
.... code[x]:codeCodeableConcept SΣ 0..1 CodeableConcept Device requested
Binding: PFEDeviceType (2.0.0) (extensible)
... parameter S 0..* BackboneElement Parameter(s) for device
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code 0..1 CodeableConcept Parameter code(s)
Binding: PFEDeviceParameterCodeVS (2.0.0) (preferred)
.... value[x] 0..1 Parameter value(s)
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject SΣ 1..1 Reference(US Core Patient Profile(6.1.0)) Patient
... encounter SΣ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] SΣ 0..1 Desired time or schedule for use
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn SΣ 0..1 dateTime When recorded
... requester SΣ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Device requester
.... Slices for extension Content/Rules for all slices
..... extension:additional-requester 0..1 Reference(CareTeam | Group | Patient | RelatedPerson) Cross-version extension for R6 requester targets not supported in R4.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester
Constraints: ext-1
... reasonCode Σ 0..* CodeableConcept Coded Reason for request
Binding: USCoreConditionCodes (7.0.0) (extensible)
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance S 0..* Reference(PAS Coverage(2.2.1) | PAS Claim Response(2.2.1)) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note S 0..* Annotation Notes or comments

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DeviceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
DeviceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
DeviceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
DeviceRequest.code[x] Base example FHIR Device Types 📍4.0.1 FHIR Std.
DeviceRequest.code[x]:codeCodeableConcept Base extensible Personal Functioning and Engagement Device Type Value Set 📍2.0.0 This IG
DeviceRequest.parameter.​code Base preferred Personal Functioning and Engagement Device Parameter Code Value Set 📍2.0.0 This IG
DeviceRequest.reasonCode Base extensible US Core Condition Codes 📍7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error DeviceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DeviceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DeviceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error DeviceRequest.implicitRules, DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.basedOn, DeviceRequest.groupIdentifier, DeviceRequest.status, DeviceRequest.intent, DeviceRequest.priority, DeviceRequest.code[x], DeviceRequest.code[x]:codeCodeableConcept, DeviceRequest.parameter, DeviceRequest.parameter.modifierExtension, DeviceRequest.parameter.code, DeviceRequest.parameter.value[x], DeviceRequest.subject, DeviceRequest.encounter, DeviceRequest.occurrence[x], DeviceRequest.authoredOn, DeviceRequest.requester, DeviceRequest.requester.extension:additional-requester, DeviceRequest.reasonCode, DeviceRequest.reasonReference, DeviceRequest.insurance, DeviceRequest.supportingInfo, DeviceRequest.note All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.parameter.modifierExtension, DeviceRequest.requester.extension:additional-requester Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DeviceRequest 0..* DeviceRequest(4.0.1) Medical device request
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:location S 0..* CodeableConcept location
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (extensible)
.... extension:device-user S 0..* (Complex) Device user(s)
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user
.... extension:clinical-justification S 0..* (Complex) Clinical justification
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification
... basedOn 0..* Reference(Resource) What request fulfills
... groupIdentifier S 0..1 Identifier Identifier of composite request
... priority S 0..1 code routine | urgent | asap | stat
... Slices for code[x] S 1..1 Reference(Device), CodeableConcept Device requested
Slice: Unordered, Open by type:$this
.... code[x]:codeCodeableConcept S 0..1 CodeableConcept Device requested
Binding: PFEDeviceType (2.0.0) (extensible)
... parameter S 0..* BackboneElement Parameter(s) for device
.... code 0..1 CodeableConcept Parameter code(s)
Binding: PFEDeviceParameterCodeVS (2.0.0) (preferred)
.... value[x] 0..1 CodeableConcept, Quantity, Range, boolean Parameter value(s)
... subject S 1..1 Reference(US Core Patient Profile(6.1.0)) Patient
... encounter S 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] S 0..1 dateTime, Period, Timing Desired time or schedule for use
... authoredOn S 0..1 dateTime When recorded
... requester S 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Device requester
.... Slices for extension Content/Rules for all slices
..... extension:additional-requester 0..1 Reference(CareTeam | Group | Patient | RelatedPerson) Cross-version extension for R6 requester targets not supported in R4.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester
... performerType 0..0 Filler role
... performer 0..0 Requested Filler
... reasonCode 0..* CodeableConcept Coded Reason for request
Binding: USCoreConditionCodes (7.0.0) (extensible)
... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance S 0..* Reference(PAS Coverage(2.2.1) | PAS Claim Response(2.2.1)) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note S 0..* Annotation Notes or comments

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
DeviceRequest.code[x]:codeCodeableConcept Base extensible Personal Functioning and Engagement Device Type Value Set 📍2.0.0 This IG
DeviceRequest.parameter.​code Base preferred Personal Functioning and Engagement Device Parameter Code Value Set 📍2.0.0 This IG
DeviceRequest.reasonCode Base extensible US Core Condition Codes 📍7.0.0 US Core v7.0

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. DeviceRequest 0..* DeviceRequest(4.0.1) Medical device request
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:location S 0..* CodeableConcept location
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (extensible)
Constraints: ext-1
.... extension:device-user S 0..* (Complex) Device user(s)
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user
Constraints: ext-1
.... extension:clinical-justification S 0..* (Complex) Clinical justification
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier External Request identifier
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) What request fulfills
... priorRequest Σ 0..* Reference(Resource) What request replaces
... groupIdentifier SΣ 0..1 Identifier Identifier of composite request
... status ?!SΣ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.
... priority SΣ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... Slices for code[x] SΣ 1..1 Device requested
Slice: Unordered, Open by type:$this
Binding: FHIRDeviceTypes (example): Codes for devices that can be requested.
.... codeReference Reference(Device)
.... codeCodeableConcept CodeableConcept
.... code[x]:codeCodeableConcept SΣ 0..1 CodeableConcept Device requested
Binding: PFEDeviceType (2.0.0) (extensible)
... parameter S 0..* BackboneElement Parameter(s) for device
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code 0..1 CodeableConcept Parameter code(s)
Binding: PFEDeviceParameterCodeVS (2.0.0) (preferred)
.... value[x] 0..1 Parameter value(s)
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject SΣ 1..1 Reference(US Core Patient Profile(6.1.0)) Patient
... encounter SΣ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] SΣ 0..1 Desired time or schedule for use
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn SΣ 0..1 dateTime When recorded
... requester SΣ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Device requester
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:additional-requester 0..1 Reference(CareTeam | Group | Patient | RelatedPerson) Cross-version extension for R6 requester targets not supported in R4.
URL: http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... reasonCode Σ 0..* CodeableConcept Coded Reason for request
Binding: USCoreConditionCodes (7.0.0) (extensible)
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance S 0..* Reference(PAS Coverage(2.2.1) | PAS Claim Response(2.2.1)) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note S 0..* Annotation Notes or comments
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DeviceRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DeviceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
DeviceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
DeviceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
DeviceRequest.code[x] Base example FHIR Device Types 📍4.0.1 FHIR Std.
DeviceRequest.code[x]:codeCodeableConcept Base extensible Personal Functioning and Engagement Device Type Value Set 📍2.0.0 This IG
DeviceRequest.parameter.​code Base preferred Personal Functioning and Engagement Device Parameter Code Value Set 📍2.0.0 This IG
DeviceRequest.requester.​type Base extensible ResourceType 📍4.0.1 FHIR Std.
DeviceRequest.reasonCode Base extensible US Core Condition Codes 📍7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error DeviceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DeviceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DeviceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DeviceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error DeviceRequest.meta, DeviceRequest.implicitRules, DeviceRequest.language, DeviceRequest.text, DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.identifier, DeviceRequest.instantiatesCanonical, DeviceRequest.instantiatesUri, DeviceRequest.basedOn, DeviceRequest.priorRequest, DeviceRequest.groupIdentifier, DeviceRequest.status, DeviceRequest.intent, DeviceRequest.priority, DeviceRequest.code[x], DeviceRequest.code[x]:codeCodeableConcept, DeviceRequest.parameter, DeviceRequest.parameter.extension, DeviceRequest.parameter.modifierExtension, DeviceRequest.parameter.code, DeviceRequest.parameter.value[x], DeviceRequest.subject, DeviceRequest.encounter, DeviceRequest.occurrence[x], DeviceRequest.authoredOn, DeviceRequest.requester, DeviceRequest.requester.extension, DeviceRequest.requester.extension:additional-requester, DeviceRequest.requester.reference, DeviceRequest.requester.type, DeviceRequest.requester.identifier, DeviceRequest.requester.display, DeviceRequest.reasonCode, DeviceRequest.reasonReference, DeviceRequest.insurance, DeviceRequest.supportingInfo, DeviceRequest.note, DeviceRequest.relevantHistory All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error DeviceRequest.extension, DeviceRequest.extension:location, DeviceRequest.extension:device-user, DeviceRequest.extension:clinical-justification, DeviceRequest.modifierExtension, DeviceRequest.parameter.extension, DeviceRequest.parameter.modifierExtension, DeviceRequest.requester.extension, DeviceRequest.requester.extension:additional-requester Must have either extensions or value[x], not both extension.exists() != value.exists()

 

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