US Quality Core Implementation Guide
1.0.0-ballot - STU 1 - ballot United States of America flag

US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions

Resource Profile: US Quality Core ServiceRequest

Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-servicerequest Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: USQualityCoreServiceRequest
Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.48

Profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

The ServiceRequest profile defines the conformance expectations for a ServiceRequest, regardless of whether it is a positive or negative statement. The ServiceRequested and ServiceNotRequested profiles represent the positive and negative statements for a service request.

To create an expression indicating the existence of a service request, use the profile USQualityCoreServiceRequested; to specifically request information that a ServiceRequest intentionally did not occur for a medical, patient or system reason, use the profile USQualityCoreServiceProhibited.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

Profile element Description USCDI+ Quality Data Element(s)
authoredOn Date request signed Orders: Clinical Test Order, Orders: Diagnostic Imaging Order, Orders: Laboratory Order, Orders: Procedure Order, Referrals: Referral Date and Time
code What is being requested/ordered Orders: Clinical Test Order, Orders: Diagnostic Imaging Order, Orders: Laboratory Order, Orders: Procedure Order, Procedures: SDOH Interventions
code.extension:codeOptions Url of a value set of candidate services Medical Devices: Device Type, Orders: Clinical Test Order, Orders: Diagnostic Imaging Order, Orders: Laboratory Order, Orders: Procedure Order
doNotPerform True if service/procedure should not be performed Orders: Clinical Test Order, Orders: Diagnostic Imaging Order, Orders: Laboratory Order
intent proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Orders: Clinical Test Order, Orders: Diagnostic Imaging Order, Orders: Laboratory Order, Orders: Procedure Order
reasonCode Explanation/Justification for procedure or service Procedures: Procedure Reason Code, Procedures: Reason for Referral
reasonReference Explanation/Justification for service or service Procedures: Procedure Reason Code, Procedures: Reason for Referral
requester Who/what is requesting service Provenance: Author
status draft | active | on-hold | revoked | completed | entered-in-error | unknown Orders: Clinical Test Order, Orders: Diagnostic Imaging Order, Orders: Laboratory Order, Orders: Procedure Order, Referrals: Referral Status

Because this profile is derived directly or indirectly from US Core, systems are also expected to support the Must Support and Additional USCDI requirements specified by the US Core profile this profile inherits from. For more information about those requirements, refer to the US Core ServiceRequest Profile. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(9.0.0) A request for a service to be performed
Constraints: prr-1, srq-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... Slices for category SΣ 0..* CodeableConcept Classification of service
Slice: Unordered, Open by value:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
... doNotPerform ?!Σ 0..1 boolean (USCDI+ Quality) True if service/procedure should not be performed
... code SΣC 1..1 CodeableConcept (USCDI+ Quality) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... subject SΣ 1..1 Reference(US Quality Core Patient) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(US Quality Core Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 When service should occur
.... occurrencePeriod Period S
.... occurrenceDateTime dateTime
.... occurrenceTiming Timing
... authoredOn SΣ 0..1 dateTime (USCDI+ Quality) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Core Device Profile(9.0.0)) (USCDI+ Quality) Who/what is requesting service
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile(9.0.0) | US Quality Core Simple Observation) (USCDI+ Quality) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦9.0.0 US Core v9.0
ServiceRequest.code Base extensible US Core Procedure Codes 📦9.0.0 US Core v9.0
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(9.0.0) A request for a service to be performed
Constraints: srq-1
... status 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent 1..1 code (USCDI+ Quality) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
... doNotPerform 0..1 boolean (USCDI+ Quality) True if service/procedure should not be performed
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... subject 1..1 Reference(US Quality Core Patient) Individual or Entity the service is ordered for
... encounter 0..1 Reference(US Quality Core Encounter) Encounter in which the request was created
... authoredOn 0..1 dateTime (USCDI+ Quality) Date request signed
... requester 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Core Device Profile(9.0.0)) (USCDI+ Quality) Who/what is requesting service
... reasonCode 0..* CodeableConcept (USCDI+ Quality) Explanation/Justification for procedure or service
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile(9.0.0) | US Quality Core Simple Observation) (USCDI+ Quality) Explanation/Justification for service or service

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(9.0.0) A request for a service to be performed
Constraints: prr-1, srq-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Identifiers assigned to this order
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
... replaces Σ 0..* Reference(ServiceRequest) What request replaces
... requisition Σ 0..1 Identifier Composite Request ID
... status ?!SΣ 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!SΣ 1..1 code (USCDI+ Quality) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... Slices for category SΣ 0..* CodeableConcept Classification of service
Slice: Unordered, Open by value:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!Σ 0..1 boolean (USCDI+ Quality) True if service/procedure should not be performed
... code SΣC 1..1 CodeableConcept (USCDI+ Quality) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: The name of the test, procedure, or service to be performed.
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject SΣ 1..1 Reference(US Quality Core Patient) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(US Quality Core Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 When service should occur
.... occurrencePeriod Period S
.... occurrenceDateTime dateTime
.... occurrenceTiming Timing
... asNeeded[x] Σ 0..1 Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
.... asNeededBoolean boolean
.... asNeededCodeableConcept CodeableConcept
... authoredOn SΣ 0..1 dateTime (USCDI+ Quality) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Core Device Profile(9.0.0)) (USCDI+ Quality) Who/what is requesting service
... performerType Σ 0..1 CodeableConcept Performer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested performer
... locationCode Σ 0..* CodeableConcept Requested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
... locationReference Σ 0..* Reference(Location) Requested location
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile(9.0.0) | US Quality Core Simple Observation) (USCDI+ Quality) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦9.0.0 US Core v9.0
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base extensible US Core Procedure Codes 📦9.0.0 US Core v9.0
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📍4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📍4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📍4.0.1 FHIR Std.
ServiceRequest.locationCode Base example ServiceDeliveryLocationRoleType 📦3.0.0 THO v7.2
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

Summary

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(9.0.0) A request for a service to be performed
Constraints: prr-1, srq-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... Slices for category SΣ 0..* CodeableConcept Classification of service
Slice: Unordered, Open by value:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
... doNotPerform ?!Σ 0..1 boolean (USCDI+ Quality) True if service/procedure should not be performed
... code SΣC 1..1 CodeableConcept (USCDI+ Quality) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... subject SΣ 1..1 Reference(US Quality Core Patient) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(US Quality Core Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 When service should occur
.... occurrencePeriod Period S
.... occurrenceDateTime dateTime
.... occurrenceTiming Timing
... authoredOn SΣ 0..1 dateTime (USCDI+ Quality) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Core Device Profile(9.0.0)) (USCDI+ Quality) Who/what is requesting service
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile(9.0.0) | US Quality Core Simple Observation) (USCDI+ Quality) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦9.0.0 US Core v9.0
ServiceRequest.code Base extensible US Core Procedure Codes 📦9.0.0 US Core v9.0
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(9.0.0) A request for a service to be performed
Constraints: srq-1
... status 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent 1..1 code (USCDI+ Quality) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
... doNotPerform 0..1 boolean (USCDI+ Quality) True if service/procedure should not be performed
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... subject 1..1 Reference(US Quality Core Patient) Individual or Entity the service is ordered for
... encounter 0..1 Reference(US Quality Core Encounter) Encounter in which the request was created
... authoredOn 0..1 dateTime (USCDI+ Quality) Date request signed
... requester 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Core Device Profile(9.0.0)) (USCDI+ Quality) Who/what is requesting service
... reasonCode 0..* CodeableConcept (USCDI+ Quality) Explanation/Justification for procedure or service
... reasonReference 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile(9.0.0) | US Quality Core Simple Observation) (USCDI+ Quality) Explanation/Justification for service or service

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(9.0.0) A request for a service to be performed
Constraints: prr-1, srq-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Identifiers assigned to this order
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
... replaces Σ 0..* Reference(ServiceRequest) What request replaces
... requisition Σ 0..1 Identifier Composite Request ID
... status ?!SΣ 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!SΣ 1..1 code (USCDI+ Quality) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... Slices for category SΣ 0..* CodeableConcept Classification of service
Slice: Unordered, Open by value:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted in other slices, see Required Bindings When Slicing by Value Sets
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!Σ 0..1 boolean (USCDI+ Quality) True if service/procedure should not be performed
... code SΣC 1..1 CodeableConcept (USCDI+ Quality) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate services
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: The name of the test, procedure, or service to be performed.
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject SΣ 1..1 Reference(US Quality Core Patient) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(US Quality Core Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 When service should occur
.... occurrencePeriod Period S
.... occurrenceDateTime dateTime
.... occurrenceTiming Timing
... asNeeded[x] Σ 0..1 Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
.... asNeededBoolean boolean
.... asNeededCodeableConcept CodeableConcept
... authoredOn SΣ 0..1 dateTime (USCDI+ Quality) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Core Device Profile(9.0.0)) (USCDI+ Quality) Who/what is requesting service
... performerType Σ 0..1 CodeableConcept Performer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested performer
... locationCode Σ 0..* CodeableConcept Requested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
... locationReference Σ 0..* Reference(Location) Requested location
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns | US Quality Core DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile(9.0.0) | US Quality Core Simple Observation) (USCDI+ Quality) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦9.0.0 US Core v9.0
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base extensible US Core Procedure Codes 📦9.0.0 US Core v9.0
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📍4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📍4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📍4.0.1 FHIR Std.
ServiceRequest.locationCode Base example ServiceDeliveryLocationRoleType 📦3.0.0 THO v7.2
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦9.0.0 US Core v9.0
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
srq-1 error ServiceRequest To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()

Summary

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Element Conformance Indicators by Profile Layer

Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.

Element conformance indicators organized by the profile layer where they are first introduced
Profile element FHIR US Core US Quality Core
status Mandatory Must Support USCDI+ Quality
intent Mandatory Must Support USCDI+ Quality
category Must Support
category:us-core Must Support
doNotPerform USCDI+ Quality
code Mandatory Must Support USCDI+ Quality
code.extension:codeOptions USCDI+ Quality
code.text Additional USCDI
subject Mandatory Must Support
encounter Must Support
occurrence[x] Must Support
authoredOn Must Support USCDI+ Quality
requester Must Support USCDI+ Quality
reasonCode Additional USCDI USCDI+ Quality
reasonReference Additional USCDI USCDI+ Quality

Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.

Mandatory US Quality Core Server Search Parameters

The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.

Because this profile derives directly or indirectly from US Core, servers SHALL also support all mandatory searches described in the US Core Server CapabilityStatement requirements for ServiceRequest. When possible, this guide reuses mandatory searches from US Core and notes them with the EXISTING US CORE REQUIREMENT flag. While US Quality Core may restate US Core requirements to highlight searches directly relevant to USCDI+ Quality data access, US Core requirements not restated here remain applicable.

See the US Quality Core Server CapabilityStatement for complete requirements for the underlying ServiceRequest resource and Search Requirement Selection for how this focused set was selected.

Servers supporting this profile SHALL support the following search parameters and search parameter combinations:

  1. SHALL support searching for a ServiceRequest resource by id using the _id search parameter. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on _id (e.g._id=[id],[id],...).

    GET [base]/ServiceRequest?_id=[id]

    Example:

    GET [base]/ServiceRequest?_id=example

    Implementation Notes: Fetches a bundle of US Quality Core ServiceRequest resources matching the specified search criteria. See how to search by token.

    Rationale for inclusion: Supports retrieval of a known ServiceRequest resource by id.

  2. SHALL support searching for all ServiceRequest resources for a patient using the patient search parameter. EXISTING US CORE REQUIREMENT

    GET [base]/ServiceRequest?patient={Patient/}[id]

    Example:

    GET [base]/ServiceRequest?patient=Patient/example

    Implementation Notes: Fetches a bundle of US Quality Core ServiceRequest resources matching the specified search criteria. See how to search by reference.

    Rationale for inclusion: Supports patient-scoped retrieval of ServiceRequest resources for USCDI+ Quality workflows.

  3. SHALL support searching for all ServiceRequest resources for a patient using the combination of the patient and category search parameters. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on category (e.g.category={system|}[search_code],{system|}[search_code],...).

    GET [base]/ServiceRequest?patient={Patient/}[id]&category={system|}[search_code]

    Example:

    GET [base]/ServiceRequest?patient=Patient/example&category=http://snomed.info/sct|387713003

    Implementation Notes: Fetches a bundle of US Quality Core ServiceRequest resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports patient-scoped retrieval of ServiceRequest resources filtered by category for USCDI+ Quality workflows.

  4. SHALL support searching for all ServiceRequest resources for a patient using the combination of the patient, category, and authored search parameters. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on category (e.g.category={system|}[search_code],{system|}[search_code],...).

    • Including optional support for AND search on authored (e.g.authored=[date]&authored=[date]&...).

    • Including support for these authored comparators: "gt", "lt", "ge", "le".

    GET [base]/ServiceRequest?patient={Patient/}[id]&category={system|}[search_code]&authored={gt|lt|ge|le}[dateTime]

    Example:

    GET [base]/ServiceRequest?patient=Patient/example&category=http://snomed.info/sct|387713003&authored=ge2020-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of US Quality Core ServiceRequest resources matching the specified search criteria. See how to search by reference, how to search by token, and how to search by date.

    Rationale for inclusion: Supports patient-scoped retrieval of ServiceRequest resources filtered by category and authored date so quality workflows can constrain results to relevant reporting periods.

  5. SHALL support searching for all ServiceRequest resources for a patient using the combination of the patient and code search parameters. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on code (e.g.code={system|}[search_code],{system|}[search_code],...).

    GET [base]/ServiceRequest?patient={Patient/}[id]&code={system|}[search_code]

    Example:

    GET [base]/ServiceRequest?patient=Patient/example&code=http://snomed.info/sct|80146002

    Implementation Notes: Fetches a bundle of US Quality Core ServiceRequest resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports patient-scoped retrieval of ServiceRequest resources filtered by code for USCDI+ Quality workflows.

  6. SHALL support searching for all ServiceRequest resources for a patient using the combination of the patient and do-not-perform search parameters.

    • Including optional support for OR search on do-not-perform (e.g.do-not-perform=[true|false],[true|false],...).

    GET [base]/ServiceRequest?patient={Patient/}[id]&do-not-perform=[true|false]

    Example:

    GET [base]/ServiceRequest?patient=Patient/example&do-not-perform=true

    Implementation Notes: Fetches a bundle of US Quality Core ServiceRequest resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports patient-scoped retrieval of ServiceRequest resources filtered by a do-not-perform indicator to support negation workflows.