A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

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.

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.

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).

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.

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.

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

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.

The status of the order.

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

The status of a service order.

Whether the request is a proposal, plan, an original order or a reflex order.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

The kind of service request.

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

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.

Classification of the requested service.

Used for filtering what service request are retrieved and displayed.

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

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.

此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。

Used for filtering what service request are retrieved and displayed.

Set this to true if the record is saying that the service/procedure should NOT be performed.

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.

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.

A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

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.

此資料項目實作者可視實務專案需求只綁定以下slices中的任一值集。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

定義代碼中符號意義的代碼系統識別

URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。

需要明確說明符號定義的來源

系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。

需要參照系統中的一個特定代碼

遵循系統的規則以呈現代碼含義的表示法

需要能為不了解此系統的讀者呈現可讀的代碼含義

輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。

很多時候，此文字表述與其中一個代碼的顯示名稱相同。

專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。

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).

An encounter that provides additional information about the healthcare context in which this request is made.

The date/time at which the requested service should occur.

When the request transitioned to being actionable.

The individual who initiated the request and has responsibility for its activation.

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.

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

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).

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.

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.

Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

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.

Any other notes and comments made about the service request. For example, internal billing notes.

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

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.

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.

The base language in which the resource is written.

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).

A human language.

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.

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.

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.

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.

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.

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.

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).

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.

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.

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

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.

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.

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.

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.

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

Plan/proposal/order fulfilled by this request.

The request takes the place of the referenced completed or terminated request(s).

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.

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.

Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

The status of the order.

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

The status of a service order.

Whether the request is a proposal, plan, an original order or a reflex order.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

The kind of service request.

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

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.

Classification of the requested service.

Used for filtering what service request are retrieved and displayed.

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

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.

此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。

Used for filtering what service request are retrieved and displayed.

Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

Identifies the level of importance to be assigned to actioning the request.

Set this to true if the record is saying that the service/procedure should NOT be performed.

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.

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.

A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

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.

此資料項目實作者可視實務專案需求只綁定以下slices中的任一值集。

resource中資料項目的唯一ID（用於內部參照）。這可以是任何不含空格的字串。

擴充的資料項目

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

由專門術語系統（terminology system）所定義之代碼的參照

代碼可以在列舉清單（enumerations）或代碼清單（code lists）中非常隨意地定義，直至有非常正式的定義，例如：SNOMED CT—更多資訊見HL7 v3核心原則（Core Principles ）。編碼的排序是未定義的因而 必須沒有（SHALL NOT） 被用來推斷意義。一般來說，最多只有一個編碼值（coding values）會被標記為UserSelected = true。

允許代碼系統中的替代編碼，以及翻譯到其他編碼系統。

resource中資料項目的唯一ID（用於內部參照），這可以是任何不含空格的字串。

可用於表示不屬於此資料項目基本定義的附加資訊。為了擴充的使用安全和可管理，對擴充的定義和使用有一套嚴格的管理。儘管任何實作者都可以定義一個擴充，但作為擴充定義的一部分，有一套要求 必須（SHALL） 滿足。

無論使用或定義擴充的機構或管轄區，任何應用程式、專案或標準使用擴充都不背負任何污名（stigma）。使用擴充是允許FHIR規範為每個人保留一個核心的簡易性。

定義代碼中符號意義的代碼系統識別

URI可以是一個OID（urn:oid:...）或一個UUID（urn:uuid:...）；OID和UUID 必須（SHALL） 參照HL7 OID註冊中心；否則，URI應該來自HL7的FHIR定義的特殊URI列表，或者它應該參照一些明確建立的系统定義。

需要明確說明符號定義的來源

選擇此代碼時使用的代碼系統版本；請注意，一個維護良好的代碼系統不需要版本報告，因為代碼的意義在不同系統版本中是一致的；然而，不能始終保證這點，當不能保證意義一致時， 必須（SHALL） 將版本資訊也一併作交換。

如果專門術語沒有明確定義應該使用什麼字串來識別代碼系統的版本，建議使用版本正式發布的日期（用FHIR日期格式表示）作為版本日期。

系統定義的語法之符號；符號可能是一個預先定義的代碼，也可能是代碼系統定義的語法中的表達式（如後組合配對／後組合式）。

需要參照系統中的一個特定代碼

遵循系統的規則以呈現代碼含義的表示法

需要能為不了解此系統的讀者呈現可讀的代碼含義

表明此編碼是由使用者直接選擇，例如：從可用項目（代碼或顯示名稱）的清單中選擇。

在一系列備選方案中，直接選擇的代碼是新翻譯最合適的起點；關於「直接選擇」的確切意義，存在模糊不清之處，可能需要貿易夥伴的同意，以更完整澄清此資料項目的使用及其後果。

已被確定為一個臨床安全準則—此確切的系統／代碼對(code pair)是被明確選擇的，而不是由系統根據一些規則或是程式語言處理判斷。

輸入資料的使用者所見／所選／所說的人類可讀文字表述，和（或）其代表使用者的預期含義。

很多時候，此文字表述與其中一個代碼的顯示名稱相同。

專門術語中的代碼並不總是能捕捉人類使用的細微差別的正確意義，或者根本就沒有合適的代碼；這些情況下，文字表述被用來捕捉來源的全部意義。

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.

For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

Codified order entry details which are based on order context.

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).

When ordering a service the number of service items may need to be specified separately from the the service item.

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).

An encounter that provides additional information about the healthcare context in which this request is made.

The date/time at which the requested service should occur.

If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

When the request transitioned to being actionable.

The individual who initiated the request and has responsibility for its activation.

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.

Desired type of performer for doing the requested service.

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”.

Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

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).

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.

A location type where services are delivered.

A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

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.

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.

Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

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.

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

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.

To represent information about how the services are to be delivered use the instructions element.

One or more specimens that the laboratory procedure will use.

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.

Anatomic location where the procedure should be performed. This is the target site.

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.

Codes describing anatomical locations. May include laterality.

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

Any other notes and comments made about the service request. For example, internal billing notes.

Instructions in terms that are understood by the patient or consumer.

Key events in the history of the request.

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.