SDOH Clinical Care
3.0.0 - STU 3

SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions

## Resource Profile: SDOHCCServiceRequest - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 2

Definitions for the SDOHCC-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 | For service requests that address SDOH conditions, observations or goals. A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
Short | A request for a service to address an SDOH condition, observation or goal.A request for a service to be performed
Comments | Many of the SDOHCC profiles reference one another. One flow supported by this IG is that QuestionnaireResponses result in Observations that can be used as evidence for Conditions that can lead to Goals, ServiceRequests and Procedures. However, alternatives paths are also possible.
Control | 0..*
Is Modifier | false
Must Support | 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.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()))
4. ServiceRequest.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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())
Slicing | This element introduces a set of slices on `ServiceRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. ServiceRequest.extension:pertainsToGoal
Slice Name | pertainsToGoal
Definition | Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a ServiceRequest to provide food vouchers pertainsToGoal of achieving food security.
Short | Pertains to SDOH goal
Comments | This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.
Control | 0..*
Type | Extension(Resource Pertains To Goal) (Extension Type: Reference(Goal))
Is Modifier | false
Must Support | true
Summary | false
Requirements | Indicates that the service request is related to the referenced SDOHCC Goal.
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()`) 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())
8. ServiceRequest.extension:pertainsToGoal.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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..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()`) 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())
Slicing | This element introduces a set of slices on `ServiceRequest.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. ServiceRequest.extension:pertainsToGoal.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal`
12. ServiceRequest.extension:pertainsToGoal.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1 This element is affected by the following invariants: ext-1
Type | Reference(SDOHCC Goal), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. 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())
16. ServiceRequest.basedOn
Definition | Plan/proposal/order fulfilled by this request.
Short | What request fulfills
Control | 0..*
Type | Reference(CarePlan, ServiceRequest, 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()))
Slicing | This element introduces a set of slices on `ServiceRequest.basedOn`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
18. ServiceRequest.basedOn:SupportedBasedOn
Slice Name | SupportedBasedOn
Definition | Plan/proposal/order fulfilled by this request.
Short | What request fulfills
Control | 0..*
Type | Reference(SDOHCC ServiceRequest, CarePlan, ServiceRequest, MedicationRequest)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows an organization (e.g., a Coordination Platform) to create a ServiceRequest for another organization (e.g., a Community Based Organization) based on a SDOHCC ServiceRequest from a referral source (e.g., a provider or a payor involved in care management).
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. 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. While all values are currently allowed, there may be a constraint on the values in future releases based on implementation feedback. 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()))
22. 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. While all values are currently allowed, there may be a contraint on the values in future releases based on implementation feedback. 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()))
24. ServiceRequest.category
Definition | A code that classifies the service for searching, sorting and display purposes (e.g., Education). 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 http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1 (example to `http://hl7.org/fhir/ValueSet/servicerequest-category` ) Classification of the requested service.
Type | CodeableConcept
Is Modifier | false
Must Support | true
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()))
Slicing | This element introduces a set of slices on `ServiceRequest.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
26. ServiceRequest.category:us-core
Slice Name | us-core
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 | The codes SHALL be taken from For example codes, see USCoreServiceRequestCategoryCodes (7.0.0)http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1 (required to `http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category|7.0.0` ) Note that other codes are permitted, see Required Bindings When Slicing by Value Sets Classification of the requested service.
Type | CodeableConcept
Is Modifier | false
Must Support | true
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()))
28. ServiceRequest.category:SDOHCC
Slice Name | SDOHCC
Definition | An SDOH category assigned to the requested service. A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").
Short | e.g., food-insecurity | transportation-insecurityClassification 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 | The codes SHALL be taken from For example codes, see SDOHCC ValueSet SDOH Category http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1 (required to `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` ) Codes for high-level SDOH categories. Classification of the requested service.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Codes from this value set can be used to assign one or more SDOH categories (e.g., food-insecurity, transportation-insecurity, etc.) to a service request. It is recommended that SDOH category codes be used to facilitate searching for service requests that address SDOH conditions, observations, or goals. 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()))
30. 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 http://hl7.org/fhir/ValueSet/request-priority|4.0.1 (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
Must Support | true
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()))
32. 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 | 0..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
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()))
34. 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 | The codes SHALL be taken from For example codes, see USCoreProcedureCodes (7.0.0)http://hl7.org/fhir/ValueSet/procedure-code|4.0.1 (required to `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0` )
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()))
36. 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 http://hl7.org/fhir/ValueSet/servicerequest-orderdetail|4.0.1 (example to `http://hl7.org/fhir/ValueSet/servicerequest-orderdetail` ) 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()))
Slicing | This element introduces a set of slices on `ServiceRequest.orderDetail`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ coding
38. ServiceRequest.orderDetail:SubjectContactDetail
Slice Name | SubjectContactDetail
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..1* This element is affected by the following invariants: prr-1
Binding | For example codes, see ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail|4.0.1 (example to `http://hl7.org/fhir/ValueSet/servicerequest-orderdetail` ) Codified order entry details which are based on order context.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows flagging of a service request where the subject of the request explictly designates that they do not want to be contacted (e.g., in domestic violence cases where contact may place subject at risk).
Alternate Names | detailed instructions
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes", "code" : "contacting-subject-prohibited" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. 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(Group, US Core Patient Profile, US Core Location Profile, Patient, Group, Location, Device)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. 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(US Core Encounter Profile, 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()))
44. 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: Period, dateTime, 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 | Choice of: Period, dateTime
Summary | true
Alternate Names | schedule
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. 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()))
48. 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(US Core RelatedPerson Profile, Device, SDOHCC PractitionerRole, US Core Practitioner Profile, US Core Patient Profile, US Core Organization Profile, 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()))
50. 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(HealthcareService, Device, RelatedPerson, US Core Patient Profile, US Core Practitioner Profile, SDOHCC PractitionerRole, US Core Organization Profile, US Core CareTeam Profile, Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | request recipient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. 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 | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or serviceExplanation/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. Information represented by ServiceRequest.reasonCode may overlap significantly with information represented by ServiceRequest.reasonReference. Multiple approaches to representing the same information may negatively impact interoperability. Therefore, where similar information could be provided by either ServiceRequest.reasonCode or ServiceRequest.reasonReference, it is recommended that ServiceRequest.reasonReference be used to provide a reason for why a service request was made.. 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 | Unless not suitable, these codes SHALL be taken from For example codes, see USCoreConditionCodes (7.0.0)http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1 (extensible to `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0` )
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()))
54. 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 | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested serviceExplanation/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. Additionally, see Comment on reasonCode. 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, 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()))
Slicing | This element introduces a set of slices on `ServiceRequest.reasonReference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
56. ServiceRequest.reasonReference:SupportedReasonReference
Slice Name | SupportedReasonReference
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 | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested serviceExplanation/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. 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(SDOHCC Condition, SDOHCC Observation Screening Response, SDOHCC Observation Assessment, Condition, Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | When a service request is justified by one or more SDOH conditions or observations, ServiceRequest.reasonReference should reference instances that comply with the SDOHCC Condition profile, or one of the SDOHCC Observation profiles. However, references to other instance types are also possible.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. ServiceRequest.supportingInfo
Definition | Additional clinical information about the patient that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. 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, 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()))
Slicing | This element introduces a set of slices on `ServiceRequest.supportingInfo`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
60. ServiceRequest.supportingInfo:SupportedSupportingInfo
Slice Name | SupportedSupportingInfo
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(SDOHCC Consent, Resource)
Is Modifier | false
Must Support | true
Summary | false
Requirements | When a service request is supported by a SDOH consent, ServiceRequest.supportingInfo should reference instances that comply with the SDOHCC Consent profile. However, references to other instance types are also possible.
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()))
62. 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. 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..0*
Type | Reference(Specimen, Specimen)
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.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..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` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept
Is Modifier | false
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 | For service requests that address SDOH conditions, observations or goals.
Short | A request for a service to address an SDOH condition, observation or goal.
Comments | Many of the SDOHCC profiles reference one another. One flow supported by this IG is that QuestionnaireResponses result in Observations that can be used as evidence for Conditions that can lead to Goals, ServiceRequests and Procedures. However, alternatives paths are also possible.
2. ServiceRequest.extension
Slicing | This element introduces a set of slices on `ServiceRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
4. ServiceRequest.extension:pertainsToGoal
Slice Name | pertainsToGoal
Definition | Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a ServiceRequest to provide food vouchers pertainsToGoal of achieving food security.
Short | Pertains to SDOH goal
Control | 0..*
Type | Extension(Resource Pertains To Goal) (Extension Type: Reference(Goal))
Must Support | true
Requirements | Indicates that the service request is related to the referenced SDOHCC Goal.
6. ServiceRequest.extension:pertainsToGoal.value[x]
Type | Reference(SDOHCC Goal)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
8. ServiceRequest.basedOn
Type | Reference(CarePlan, ServiceRequest)
Slicing | This element introduces a set of slices on `ServiceRequest.basedOn`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
10. ServiceRequest.basedOn:SupportedBasedOn
Slice Name | SupportedBasedOn
Control | 0..*
Type | Reference(SDOHCC ServiceRequest)
Must Support | true
Requirements | Allows an organization (e.g., a Coordination Platform) to create a ServiceRequest for another organization (e.g., a Community Based Organization) based on a SDOHCC ServiceRequest from a referral source (e.g., a provider or a payor involved in care management).
12. ServiceRequest.status
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. While all values are currently allowed, there may be a constraint on the values in future releases based on implementation feedback.
14. ServiceRequest.intent
Comments | This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. While all values are currently allowed, there may be a contraint on the values in future releases based on implementation feedback.
16. ServiceRequest.category
Definition | A code that classifies the service for searching, sorting and display purposes (e.g., Education).
18. ServiceRequest.category:SDOHCC
Slice Name | SDOHCC
Definition | An SDOH category assigned to the requested service.
Short | e.g., food-insecurity | transportation-insecurity
Control | 0..*
Binding | The codes SHALL be taken from SDOHCC ValueSet SDOH Category (required to `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` ) Codes for high-level SDOH categories.
Must Support | true
Requirements | Codes from this value set can be used to assign one or more SDOH categories (e.g., food-insecurity, transportation-insecurity, etc.) to a service request. It is recommended that SDOH category codes be used to facilitate searching for service requests that address SDOH conditions, observations, or goals.
20. ServiceRequest.priority
Must Support | true
22. ServiceRequest.code
Binding | The codes SHALL be taken from USCoreProcedureCodes (7.0.0) (required to `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0` )
24. ServiceRequest.orderDetail
Slicing | This element introduces a set of slices on `ServiceRequest.orderDetail`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ coding
26. ServiceRequest.orderDetail:SubjectContactDetail
Slice Name | SubjectContactDetail
Control | 0..1
Must Support | true
Requirements | Allows flagging of a service request where the subject of the request explictly designates that they do not want to be contacted (e.g., in domestic violence cases where contact may place subject at risk).
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes", "code" : "contacting-subject-prohibited" }] }`
28. ServiceRequest.subject
Type | Reference(Group, US Core Patient Profile, US Core Location Profile)
30. ServiceRequest.occurrence[x]
Type | Choice of: Period, dateTime, Timing
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
32. ServiceRequest.requester
Type | Reference(US Core RelatedPerson Profile, Device, SDOHCC PractitionerRole, US Core Practitioner Profile, US Core Patient Profile, US Core Organization Profile)
34. ServiceRequest.performer
Type | Reference(HealthcareService, Device, RelatedPerson, US Core Patient Profile, US Core Practitioner Profile, SDOHCC PractitionerRole, US Core Organization Profile, US Core CareTeam Profile)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
36. ServiceRequest.reasonCode
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. Information represented by ServiceRequest.reasonCode may overlap significantly with information represented by ServiceRequest.reasonReference. Multiple approaches to representing the same information may negatively impact interoperability. Therefore, where similar information could be provided by either ServiceRequest.reasonCode or ServiceRequest.reasonReference, it is recommended that ServiceRequest.reasonReference be used to provide a reason for why a service request was made..
38. ServiceRequest.reasonReference
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. Additionally, see Comment on reasonCode.
Slicing | This element introduces a set of slices on `ServiceRequest.reasonReference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
40. ServiceRequest.reasonReference:SupportedReasonReference
Slice Name | SupportedReasonReference
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.
Control | 0..*
Type | Reference(SDOHCC Condition, SDOHCC Observation Screening Response, SDOHCC Observation Assessment)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | When a service request is justified by one or more SDOH conditions or observations, ServiceRequest.reasonReference should reference instances that comply with the SDOHCC Condition profile, or one of the SDOHCC Observation profiles. However, references to other instance types are also possible.
42. ServiceRequest.supportingInfo
Definition | Additional clinical information about the patient that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations.
Slicing | This element introduces a set of slices on `ServiceRequest.supportingInfo`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
44. ServiceRequest.supportingInfo:SupportedSupportingInfo
Slice Name | SupportedSupportingInfo
Control | 0..*
Type | Reference(SDOHCC Consent)
Must Support | true
Requirements | When a service request is supported by a SDOH consent, ServiceRequest.supportingInfo should reference instances that comply with the SDOHCC Consent profile. However, references to other instance types are also possible.
46. ServiceRequest.specimen
Control | 0..0
48. ServiceRequest.bodySite
Control | 0..0

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

0. ServiceRequest
Definition | For service requests that address SDOH conditions, observations or goals.
Short | A request for a service to address an SDOH condition, observation or goal.
Comments | Many of the SDOHCC profiles reference one another. One flow supported by this IG is that QuestionnaireResponses result in Observations that can be used as evidence for Conditions that can lead to Goals, ServiceRequests and Procedures. However, alternatives paths are also possible.
Control | 0..*
Is Modifier | false
Must Support | 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 | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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
Is Modifier | false
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` ) 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 | 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..1
Type | Narrative
Is Modifier | 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 | 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..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. ServiceRequest.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
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()`)
Slicing | This element introduces a set of slices on `ServiceRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. ServiceRequest.extension:pertainsToGoal
Slice Name | pertainsToGoal
Definition | Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a ServiceRequest to provide food vouchers pertainsToGoal of achieving food security.
Short | Pertains to SDOH goal
Comments | This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.
Control | 0..*
Type | Extension(Resource Pertains To Goal) (Extension Type: Reference(Goal))
Is Modifier | false
Must Support | true
Summary | false
Requirements | Indicates that the service request is related to the referenced SDOHCC Goal.
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.extension:pertainsToGoal.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
20. ServiceRequest.extension:pertainsToGoal.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
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()`)
Slicing | This element introduces a set of slices on `ServiceRequest.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. ServiceRequest.extension:pertainsToGoal.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal`
24. ServiceRequest.extension:pertainsToGoal.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1 This element is affected by the following invariants: ext-1
Type | Reference(SDOHCC Goal)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. 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()`)
28. 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())`)
30. 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())`)
32. 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())`)
34. ServiceRequest.basedOn
Definition | Plan/proposal/order fulfilled by this request.
Short | What request fulfills
Control | 0..*
Type | Reference(CarePlan, ServiceRequest)
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())`)
Slicing | This element introduces a set of slices on `ServiceRequest.basedOn`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
36. ServiceRequest.basedOn:SupportedBasedOn
Slice Name | SupportedBasedOn
Definition | Plan/proposal/order fulfilled by this request.
Short | What request fulfills
Control | 0..*
Type | Reference(SDOHCC ServiceRequest)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows an organization (e.g., a Coordination Platform) to create a ServiceRequest for another organization (e.g., a Community Based Organization) based on a SDOHCC ServiceRequest from a referral source (e.g., a provider or a payor involved in care management).
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. 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())`)
40. 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())`)
42. 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. While all values are currently allowed, there may be a constraint on the values in future releases based on implementation feedback.
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())`)
44. 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. While all values are currently allowed, there may be a contraint on the values in future releases based on implementation feedback.
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())`)
46. ServiceRequest.category
Definition | A code that classifies the service for searching, sorting and display purposes (e.g., Education).
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` ) Classification of the requested service.
Type | CodeableConcept
Is Modifier | false
Must Support | true
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())`)
Slicing | This element introduces a set of slices on `ServiceRequest.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this
48. ServiceRequest.category:us-core
Slice Name | us-core
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 | The codes SHALL be taken from USCoreServiceRequestCategoryCodes (7.0.0) (required to `http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category|7.0.0` ) Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
Type | CodeableConcept
Is Modifier | false
Must Support | true
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())`)
50. ServiceRequest.category:SDOHCC
Slice Name | SDOHCC
Definition | An SDOH category assigned to the requested service.
Short | e.g., food-insecurity | transportation-insecurity
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 | The codes SHALL be taken from SDOHCC ValueSet SDOH Category (required to `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` ) Codes for high-level SDOH categories.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Codes from this value set can be used to assign one or more SDOH categories (e.g., food-insecurity, transportation-insecurity, etc.) to a service request. It is recommended that SDOH category codes be used to facilitate searching for service requests that address SDOH conditions, observations, or goals.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. 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
Must Support | true
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())`)
54. 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 | 0..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
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())`)
56. 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 | The codes SHALL be taken from USCoreProcedureCodes (7.0.0) (required to `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0` )
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())`)
58. 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` ) 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())`)
Slicing | This element introduces a set of slices on `ServiceRequest.orderDetail`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ coding
60. ServiceRequest.orderDetail:SubjectContactDetail
Slice Name | SubjectContactDetail
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..1 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` ) Codified order entry details which are based on order context.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows flagging of a service request where the subject of the request explictly designates that they do not want to be contacted (e.g., in domestic violence cases where contact may place subject at risk).
Alternate Names | detailed instructions
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes", "code" : "contacting-subject-prohibited" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. 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())`)
64. 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(Group, US Core Patient Profile, US Core Location Profile)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. 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(US Core Encounter Profile)
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())`)
68. 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: Period, dateTime, 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 | Choice of: Period, dateTime
Summary | true
Alternate Names | schedule
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. 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` ) 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())`)
72. 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())`)
74. 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(US Core RelatedPerson Profile, Device, SDOHCC PractitionerRole, US Core Practitioner Profile, US Core Patient Profile, US Core Organization Profile)
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())`)
76. 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` ) 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())`)
78. 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(HealthcareService, Device, RelatedPerson, US Core Patient Profile, US Core Practitioner Profile, SDOHCC PractitionerRole, US Core Organization Profile, US Core CareTeam Profile)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | request recipient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. 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 (3.0.0) (example to `http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType|3.0.0` ) 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())`)
82. 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())`)
84. 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 | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: 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. Information represented by ServiceRequest.reasonCode may overlap significantly with information represented by ServiceRequest.reasonReference. Multiple approaches to representing the same information may negatively impact interoperability. Therefore, where similar information could be provided by either ServiceRequest.reasonCode or ServiceRequest.reasonReference, it is recommended that ServiceRequest.reasonReference be used to provide a reason for why a service request was made..
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from USCoreConditionCodes (7.0.0) (extensible to `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0` )
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())`)
86. 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 | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested 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. Additionally, see Comment on reasonCode.
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())`)
Slicing | This element introduces a set of slices on `ServiceRequest.reasonReference`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
88. ServiceRequest.reasonReference:SupportedReasonReference
Slice Name | SupportedReasonReference
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 | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested 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.
Control | 0..*
Type | Reference(SDOHCC Condition, SDOHCC Observation Screening Response, SDOHCC Observation Assessment)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Requirements | When a service request is justified by one or more SDOH conditions or observations, ServiceRequest.reasonReference should reference instances that comply with the SDOHCC Condition profile, or one of the SDOHCC Observation profiles. However, references to other instance types are also possible.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. 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())`)
92. ServiceRequest.supportingInfo
Definition | Additional clinical information about the patient that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations.
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())`)
Slicing | This element introduces a set of slices on `ServiceRequest.supportingInfo`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
94. ServiceRequest.supportingInfo:SupportedSupportingInfo
Slice Name | SupportedSupportingInfo
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(SDOHCC Consent)
Is Modifier | false
Must Support | true
Summary | false
Requirements | When a service request is supported by a SDOH consent, ServiceRequest.supportingInfo should reference instances that comply with the SDOHCC Consent profile. However, references to other instance types are also possible.
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())`)
96. 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..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())`)
98. 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..0
Binding | For example codes, see SNOMEDCTBodyStructures (example to `http://hl7.org/fhir/ValueSet/body-site` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept
Is Modifier | false
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())`)
100. 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())`)
102. 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())`)
104. 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())`)