Virtually Healthcare HL7 FHIR Implementation Guide
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Virtually Healthcare HL7 FHIR Implementation Guide, published by Virtually Healthcare. This guide is not an authorized publication; it is the continuous build for version 0.1.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Virtually-Healthcare/Virtually-Healthcare-FHIR-Implementation-Guide/ and changes regularly. See the Directory of published versions

Resource Profile: ServiceRequestReferral - Detailed Descriptions

Draft as of 2024-11-06

Definitions for the ServiceRequest-Referral resource profile.

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

0. ServiceRequest

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

0. ServiceRequest
Definition

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

ShortA request for a service to be performed
Control0..*
Is Modifierfalse
Alternate Namesdiagnostic request, referral, referral request, transfer of care request
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
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.

ShortA 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.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ServiceRequest.extension:sourceOfServiceRequest
Slice NamesourceOfServiceRequest
Definition

This represents the source of referral.

ShortThis represents the source of referral
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.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Extension UK Core Source Of Service Request) (Extension Type: CodeableConcept)
Is Modifierfalse
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. ServiceRequest.extension:additionalContact
Slice NameadditionalContact
Definition

Details of an additional contact, who should be contacted regarding questions arising from the service request.

ShortDetails of an additional contact
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.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Extension UK Core Additional Contact) (Extension Type: Reference(Organization, Practitioner, PractitionerRole))
Is Modifierfalse
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. ServiceRequest.extension:coverage
Slice Namecoverage
Definition

The funding category for the Service Request.

ShortThe funding category for the Service Request
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.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Extension UK Core Coverage) (Extension Type: CodeableConcept)
Is Modifierfalse
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. 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).

ShortExtensions 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.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Standard StatusNormative (from Trial Use)
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 Namesextensions, user content
Invariantsele-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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. ServiceRequest.identifier
    Definition

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

    ShortIdentifiers 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.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • pattern @ system
    • 14. ServiceRequest.identifier:CommonResourceIdentifiers
      Slice NameCommonResourceIdentifiers
      Definition

      An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


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

      ShortCommon Resource IdentifiersIdentifiers 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.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeIdentifier(Common Resource Identifiers)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. ServiceRequest.basedOn
      Definition

      Plan/proposal/order fulfilled by this request.

      ShortWhat request fulfills
      Comments

      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeReference(CarePlan, ServiceRequest, MedicationRequest)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Alternate Namesfulfills
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
      18. ServiceRequest.status
      Definition

      The status of the order.

      Shortdraft | 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.


      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.

      Control1..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from RequestStatushttp://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.

      Typecode
      Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ServiceRequest.intent
      Definition

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

      Shortproposal | 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.

      Control1..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from RequestIntenthttp://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.

      Typecode
      Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ServiceRequest.category
      Definition

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

      ShortClassification 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.

      Control0..*
      This element is affected by the following invariants: ele-1
      BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category
      (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

      Classification of the requested service.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Standard StatusNormative (from Trial Use)
      Summarytrue
      Requirements

      Used for filtering what service request are retrieved and displayed.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ coding.system
      • 24. ServiceRequest.category:genomicsWholeCaseSequencing
        Slice NamegenomicsWholeCaseSequencing
        Definition

        A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases


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

        ShortClassification of Genomics serviceClassification 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.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see UK Core Genome Sequencing Categoryhttp://hl7.org/fhir/ValueSet/servicerequest-category
        (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory)

        Classification of the requested service.

        TypeCodeableConcept
        Is Modifierfalse
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Requirements

        Used for filtering what service request are retrieved and displayed.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. ServiceRequest.priority
        Definition

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

        Shortroutine | urgent | asap | stat
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from RequestPriorityhttp://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.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Meaning if MissingIf missing, this task should be performed with normal priority
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. ServiceRequest.priority.extension:priorityReason
        Slice NamepriorityReason
        Definition

        A SNOMED CT concept representing the reason a Service Request is urgent

        ShortA SNOMED CT concept representing the reason a Service Request is urgent.
        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.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Priority Reason) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Standard StatusNormative (from Trial Use)
        Alternate Namesextensions, user content
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        30. ServiceRequest.doNotPerform
        Definition

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

        ShortTrue 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.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeboolean
        Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        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 MissingIf missing, the request is a positive request e.g. "do perform"
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. ServiceRequest.code
        Definition

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

        ShortWhat 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.

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHOULD be taken from For example codes, see UK Core Procedure Codehttp://hl7.org/fhir/ValueSet/procedure-code
        (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode)

        A set of codes that define a procedure or a procedure with explicit context. Selected from the SNOMED CT UK coding system.


        Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Alternate Namesservice requested
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. 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.

        ShortAdditional order information
        Comments

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

        Control0..*
        This element is affected by the following invariants: ele-1, prr-1
        BindingThe codes SHOULD be taken from For example codes, see UK Core Procedure Codehttp://hl7.org/fhir/ValueSet/servicerequest-orderdetail
        (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode)

        Codified order entry details which are based on order context.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Alternate Namesdetailed instructions
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. 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).

        ShortIndividual or Entity the service is ordered for
        Comments

        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeReference(Patient, Group, Location, Device)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        38. ServiceRequest.subject.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control0..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. ServiceRequest.authoredOn
        Definition

        When the request transitioned to being actionable.

        ShortDate request signed
        Control0..1
        This element is affected by the following invariants: ele-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate NamesorderedOn
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. ServiceRequest.requester
        Definition

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

        ShortWho/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.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Alternate Namesauthor, orderer
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))

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

        0. ServiceRequest
        Definition

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

        ShortA request for a service to be performed
        Control0..*
        Alternate Namesdiagnostic request, referral, referral request, transfer of care request
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        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.

        ShortLogical 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.

        Control0..1
        Typeid
        Summarytrue
        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.

        ShortMetadata about the resource
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeMeta
        Summarytrue
        Invariantsele-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.

        ShortA 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.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-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.

        ShortLanguage 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).

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Invariantsele-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.

        ShortText 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.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeNarrative
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-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.

        ShortContained, 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.

        Control0..*
        TypeResource
        Alternate Namesinline resources, anonymous resources, contained resources
        14. ServiceRequest.extension
        Definition

        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.

        ShortAdditional 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.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Standard StatusNormative (from Trial Use)
        Alternate Namesextensions, user content
        Invariantsele-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())
        SlicingThis 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:sourceOfServiceRequest
          Slice NamesourceOfServiceRequest
          Definition

          This represents the source of referral.

          ShortThis represents the source of referral
          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.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Source Of Service Request) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-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:additionalContact
          Slice NameadditionalContact
          Definition

          Details of an additional contact, who should be contacted regarding questions arising from the service request.

          ShortDetails of an additional contact
          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.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Additional Contact) (Extension Type: Reference(Organization, Practitioner, PractitionerRole))
          Is Modifierfalse
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-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())
          20. ServiceRequest.extension:coverage
          Slice Namecoverage
          Definition

          The funding category for the Service Request.

          ShortThe funding category for the Service Request
          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.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Coverage) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-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())
          22. 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).

          ShortExtensions 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.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Standard StatusNormative (from Trial Use)
          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 Namesextensions, user content
          Invariantsele-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())
          SlicingThis element introduces a set of slices on ServiceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 24. ServiceRequest.identifier
            Definition

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

            ShortIdentifiers 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.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..*
            This element is affected by the following invariants: ele-1
            TypeIdentifier
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • pattern @ system
            • 26. ServiceRequest.identifier:CommonResourceIdentifiers
              Slice NameCommonResourceIdentifiers
              Definition

              An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

              ShortCommon Resource Identifiers
              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.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeIdentifier(Common Resource Identifiers)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. 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.

              ShortInstantiates 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.

              Control0..*
              This element is affected by the following invariants: ele-1
              Typecanonical(ActivityDefinition, PlanDefinition)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. 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.

              ShortInstantiates external protocol or definition
              Comments

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

              Control0..*
              This element is affected by the following invariants: ele-1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. ServiceRequest.basedOn
              Definition

              Plan/proposal/order fulfilled by this request.

              ShortWhat request fulfills
              Comments

              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeReference(CarePlan, ServiceRequest, MedicationRequest)
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Alternate Namesfulfills
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
              34. ServiceRequest.replaces
              Definition

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

              ShortWhat request replaces
              Comments

              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeReference(ServiceRequest)
              Summarytrue
              Alternate Namessupersedes, prior, renewed order
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
              36. 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.

              ShortComposite 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.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeIdentifier
              Summarytrue
              Requirements

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

              Alternate NamesgrouperId, groupIdentifier
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. ServiceRequest.status
              Definition

              The status of the order.

              Shortdraft | 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.

              Control1..1
              This element is affected by the following invariants: ele-1
              BindingThe codes SHALL be taken from RequestStatus
              (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

              The status of a service order.

              Typecode
              Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. ServiceRequest.intent
              Definition

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

              Shortproposal | 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.

              Control1..1
              This element is affected by the following invariants: ele-1
              BindingThe codes SHALL be taken from RequestIntent
              (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

              The kind of service request.

              Typecode
              Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. ServiceRequest.category
              Definition

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

              ShortClassification 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.

              Control0..*
              This element is affected by the following invariants: ele-1
              BindingFor example codes, see ServiceRequestCategoryCodes
              (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

              Classification of the requested service.

              TypeCodeableConcept
              Must Supporttrue
              Standard StatusNormative (from Trial Use)
              Summarytrue
              Requirements

              Used for filtering what service request are retrieved and displayed.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ coding.system
              • 44. ServiceRequest.category:genomicsWholeCaseSequencing
                Slice NamegenomicsWholeCaseSequencing
                Definition

                A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases

                ShortClassification of Genomics 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.

                Control0..*
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from UK Core Genome Sequencing Category
                (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory)

                Classification of the requested service.

                TypeCodeableConcept
                Standard StatusNormative (from Trial Use)
                Summarytrue
                Requirements

                Used for filtering what service request are retrieved and displayed.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. ServiceRequest.category:genomicsWholeCaseSequencing.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                XML FormatIn the XML format, this property is represented as an attribute.
                48. ServiceRequest.category:genomicsWholeCaseSequencing.extension
                Definition

                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.

                ShortAdditional 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.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Standard StatusNormative (from Trial Use)
                Alternate Namesextensions, user content
                Invariantsele-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())
                SlicingThis element introduces a set of slices on ServiceRequest.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 50. ServiceRequest.category:genomicsWholeCaseSequencing.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeCoding
                  Standard StatusNormative (from Trial Use)
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. ServiceRequest.category:genomicsWholeCaseSequencing.coding.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  XML FormatIn the XML format, this property is represented as an attribute.
                  54. ServiceRequest.category:genomicsWholeCaseSequencing.coding.extension
                  Definition

                  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.

                  ShortAdditional 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.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Standard StatusNormative (from Trial Use)
                  Alternate Namesextensions, user content
                  Invariantsele-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())
                  SlicingThis element introduces a set of slices on ServiceRequest.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 56. ServiceRequest.category:genomicsWholeCaseSequencing.coding.system
                    Definition

                    The identification of the code system that defines the meaning of the symbol in the code.

                    ShortIdentity of the terminology system
                    Comments

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be unambiguous about the source of the definition of the symbol.

                    Fixed Valuehttps://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    58. ServiceRequest.category:genomicsWholeCaseSequencing.coding.version
                    Definition

                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                    ShortVersion of the system - if relevant
                    Comments

                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                    NoteThis is a business version Id, not a resource version Id (see discussion)
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    60. ServiceRequest.category:genomicsWholeCaseSequencing.coding.code
                    Definition

                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                    ShortSymbol in syntax defined by the system
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to refer to a particular code in the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. ServiceRequest.category:genomicsWholeCaseSequencing.coding.display
                    Definition

                    A representation of the meaning of the code in the system, following the rules of the system.

                    ShortRepresentation defined by the system
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. ServiceRequest.category:genomicsWholeCaseSequencing.coding.userSelected
                    Definition

                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                    ShortIf this coding was chosen directly by the user
                    Comments

                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeboolean
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. ServiceRequest.category:genomicsWholeCaseSequencing.text
                    Definition

                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                    ShortPlain text representation of the concept
                    Comments

                    Very often the text is the same as a displayName of one of the codings.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. ServiceRequest.priority
                    Definition

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

                    Shortroutine | urgent | asap | stat
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe 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.

                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Meaning if MissingIf missing, this task should be performed with normal priority
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. ServiceRequest.priority.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    XML FormatIn the XML format, this property is represented as an attribute.
                    72. ServiceRequest.priority.extension
                    Definition

                    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.

                    ShortAdditional 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.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Standard StatusNormative (from Trial Use)
                    Alternate Namesextensions, user content
                    Invariantsele-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())
                    SlicingThis element introduces a set of slices on ServiceRequest.priority.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 74. ServiceRequest.priority.extension:priorityReason
                      Slice NamepriorityReason
                      Definition

                      A SNOMED CT concept representing the reason a Service Request is urgent

                      ShortA SNOMED CT concept representing the reason a Service Request is urgent.
                      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.

                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Extension UK Core Priority Reason) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Standard StatusNormative (from Trial Use)
                      Alternate Namesextensions, user content
                      Invariantsele-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())
                      76. ServiceRequest.priority.value
                      Definition

                      Primitive value for code

                      ShortPrimitive value for code
                      Control0..1
                      Typecode
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Max Length:1048576
                      78. ServiceRequest.doNotPerform
                      Definition

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

                      ShortTrue 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.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typeboolean
                      Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      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 MissingIf missing, the request is a positive request e.g. "do perform"
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      80. ServiceRequest.code
                      Definition

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

                      ShortWhat 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.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      BindingThe codes SHOULD be taken from UK Core Procedure Code
                      (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode)

                      A set of codes that define a procedure or a procedure with explicit context. Selected from the SNOMED CT UK coding system.

                      TypeCodeableConcept
                      Must Supporttrue
                      Summarytrue
                      Alternate Namesservice requested
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      82. 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.

                      ShortAdditional order information
                      Comments

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

                      Control0..*
                      This element is affected by the following invariants: ele-1, prr-1
                      BindingThe codes SHOULD be taken from UK Core Procedure Code
                      (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode)

                      Codified order entry details which are based on order context.

                      TypeCodeableConcept
                      Summarytrue
                      Alternate Namesdetailed instructions
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      84. 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).

                      ShortService amount
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeChoice of: Quantity, Ratio, Range
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      86. 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).

                      ShortIndividual or Entity the service is ordered for
                      Comments

                      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      TypeReference(Patient, Group, Location, Device)
                      Must Supporttrue
                      Must Support TypesNo must-support rules about the choice of types/profiles
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                      88. ServiceRequest.subject.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      90. ServiceRequest.subject.extension
                      Definition

                      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.

                      ShortAdditional 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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-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())
                      SlicingThis element introduces a set of slices on ServiceRequest.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 92. ServiceRequest.subject.reference
                        Definition

                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                        ShortLiteral reference, Relative, internal or absolute URL
                        Comments

                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                        Control0..1
                        This element is affected by the following invariants: ref-1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        94. ServiceRequest.subject.type
                        Definition

                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                        ShortType the reference refers to (e.g. "Patient")
                        Comments

                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                        Aa resource (or, for logical models, the URI of the logical model).

                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        96. ServiceRequest.subject.identifier
                        Definition

                        An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                        ShortAn identifier intended for computation
                        Comments

                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier(NHS, HCSN and CHI Numbers)
                        Is Modifierfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        98. ServiceRequest.subject.display
                        Definition

                        Plain text narrative that identifies the resource in addition to the resource reference.

                        ShortText alternative for the resource
                        Comments

                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        100. ServiceRequest.encounter
                        Definition

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

                        ShortEncounter in which the request was created
                        Comments

                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeReference(Encounter)
                        Summarytrue
                        Alternate Namescontext
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        102. ServiceRequest.occurrence[x]
                        Definition

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

                        ShortWhen service should occur
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeChoice of: dateTime, Period, Timing
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Alternate Namesschedule
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. 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.

                        ShortPreconditions for service
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingFor 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.

                        TypeChoice of: boolean, CodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        106. ServiceRequest.authoredOn
                        Definition

                        When the request transitioned to being actionable.

                        ShortDate request signed
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypedateTime
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Alternate NamesorderedOn
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        108. ServiceRequest.requester
                        Definition

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

                        ShortWho/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.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summarytrue
                        Alternate Namesauthor, orderer
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        110. ServiceRequest.performerType
                        Definition

                        Desired type of performer for doing the requested service.

                        ShortPerformer 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”.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        BindingFor 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.

                        TypeCodeableConcept
                        Summarytrue
                        Alternate Namesspecialty
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        112. ServiceRequest.performer
                        Definition

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

                        ShortRequested 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).

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
                        Summarytrue
                        Alternate Namesrequest recipient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        114. 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.

                        ShortRequested location
                        Comments

                        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        BindingFor example codes, see ServiceDeliveryLocationRoleType
                        (example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

                        A location type where services are delivered.

                        TypeCodeableConcept
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        116. 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.

                        ShortRequested location
                        Comments

                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Location)
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        118. 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.

                        ShortExplanation/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.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHOULD be taken from UK Core Service Request Reason Code
                        (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode)

                        A set of codes that define a reason for a service request.

                        TypeCodeableConcept
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        120. 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.

                        ShortExplanation/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 as shown in the CT Scan example.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        122. ServiceRequest.insurance
                        Definition

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

                        ShortAssociated insurance coverage
                        Comments

                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Coverage, ClaimResponse)
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        124. ServiceRequest.supportingInfo
                        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.

                        ShortAdditional clinical information
                        Comments

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

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Resource)
                        Alternate NamesAsk at order entry question, AOE
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        126. ServiceRequest.specimen
                        Definition

                        One or more specimens that the laboratory procedure will use.

                        ShortProcedure 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.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Specimen)
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                        128. ServiceRequest.bodySite
                        Definition

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

                        ShortLocation 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.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHOULD be taken from SNOMEDCTBodyStructures
                        (preferred to http://hl7.org/fhir/ValueSet/body-site)

                        Codes describing anatomical locations. May include laterality.

                        TypeCodeableConcept
                        Summarytrue
                        Requirements

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

                        Alternate Nameslocation
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        130. ServiceRequest.note
                        Definition

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

                        ShortComments
                        Comments

                        For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeAnnotation
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        132. ServiceRequest.patientInstruction
                        Definition

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

                        ShortPatient or consumer-oriented instructions
                        Comments

                        Note that FHIR strings SHALL NOT exceed 1MB in size

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        134. ServiceRequest.relevantHistory
                        Definition

                        Key events in the history of the request.

                        ShortRequest 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.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeReference(Provenance)
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))