CH ORF (R4)
2.0.0 - ci-build Switzerland flag

CH ORF (R4), published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7ch/ch-orf/ and changes regularly. See the Directory of published versions

Resource Profile: ChOrfServiceRequest - Detailed Descriptions

Active as of 2023-11-30

Definitions for the ch-orf-servicerequest resource profile.

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

0. ServiceRequest
ShortCH ORF ServiceRequest
2. ServiceRequest.extension
SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. ServiceRequest.extension:locationAndTime
Slice NamelocationAndTime
Control0..*
TypeExtension(CH ORF Location and Time) (Extension Type: Reference)
Must Supporttrue
6. ServiceRequest.extension:requestedEncounterDetails
Slice NamerequestedEncounterDetails
Control0..1
TypeExtension(CH ORF Requested Encounter Details) (Extension Type: Reference)
Must Supporttrue
8. ServiceRequest.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
10. ServiceRequest.identifier:placerOrderIdentifier
Slice NameplacerOrderIdentifier
ShortPlacer Order Identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
Must Supporttrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;PLAC&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
12. ServiceRequest.identifier:placerOrderIdentifier.system
Must Supporttrue
14. ServiceRequest.identifier:placerOrderIdentifier.value
Control1..?
Must Supporttrue
16. ServiceRequest.identifier:fillerOrderIdentifier
Slice NamefillerOrderIdentifier
ShortFiller Order Identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
Must Supporttrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;FILL&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
18. ServiceRequest.identifier:fillerOrderIdentifier.system
Must Supporttrue
20. ServiceRequest.identifier:fillerOrderIdentifier.value
Control1..?
Must Supporttrue
22. ServiceRequest.status
Must Supporttrue
24. ServiceRequest.intent
Must Supporttrue
26. ServiceRequest.priority
ShortOrder priority
Must Supporttrue
28. ServiceRequest.subject
Definition

The principle target of a particular form content is one patient (for obstetrical and neonatal use cases see...).

ShortPatient
TypeReference(CH Core Patient)
Must Supporttrue
30. ServiceRequest.requester
ShortThe person/organization responsible for the form content
TypeReference(CH Core PractitionerRole)
Must Supporttrue
32. ServiceRequest.insurance
TypeReference(CH ORF Coverage)
Must Supporttrue
34. ServiceRequest.note
Must Supporttrue
36. ServiceRequest.note.text
Must Supporttrue
38. ServiceRequest.patientInstruction
ShortUse Appointment.patientInstruction (referenced via ServiceRequest.extension) for patient-oriented instructions

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.

ShortCH ORF ServiceRequestA request for a service to be performed
Control0..*
Is Modifierfalse
Summaryfalse
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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

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
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
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional 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.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. ServiceRequest.extension:locationAndTime
Slice NamelocationAndTime
Definition

Location and Time of ServiceRequest Fulfillment.

ShortCH ORF Location and Time
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(CH ORF Location and Time) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
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:requestedEncounterDetails
Slice NamerequestedEncounterDetails
Definition

Requested Encounter Details for ServiceRequest Fulfillment.

ShortCH ORF Requested Encounter Details
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CH ORF Requested Encounter Details) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
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..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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())
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..*
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 are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
14. ServiceRequest.identifier:placerOrderIdentifier
Slice NameplacerOrderIdentifier
Definition

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

ShortPlacer Order IdentifierIdentifiers 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..1*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;PLAC&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ServiceRequest.identifier:placerOrderIdentifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ServiceRequest.identifier:placerOrderIdentifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ServiceRequest.identifier:placerOrderIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ServiceRequest.identifier:fillerOrderIdentifier
Slice NamefillerOrderIdentifier
Definition

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

ShortFiller Order IdentifierIdentifiers 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..1*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;FILL&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ServiceRequest.identifier:fillerOrderIdentifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ServiceRequest.identifier:fillerOrderIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. 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
BindingThe codes SHALL be taken from RequestStatushttp://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()))
32. 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
BindingThe codes SHALL be taken from RequestIntenthttp://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 &quot;the time the request is recommended to occur&quot; vs. &quot;the time the request is authorized to occur&quot; or &quot;who is recommended to perform the request&quot; vs. &quot;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()))
34. ServiceRequest.priority
Definition

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

ShortOrder priorityroutine | urgent | asap | stat
Control0..1
BindingThe codes SHALL be taken from RequestPriorityhttp://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()))
36. 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
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()))
38. ServiceRequest.subject
Definition

The principle target of a particular form content is one patient (for obstetrical and neonatal use cases see...).


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).

ShortPatientIndividual or Entity the service is ordered for
Control1..1
TypeReference(CH Core Patient, Patient, Group, Location, Device)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ServiceRequest.requester
Definition

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

ShortThe person/organization responsible for the form contentWho/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
TypeReference(CH Core PractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifierfalse
Must Supporttrue
Summarytrue
Alternate Namesauthor, orderer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. 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
Control0..*
TypeReference(CH ORF Coverage, Coverage, ClaimResponse)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ServiceRequest.note
Definition

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

ShortComments
Control0..*
TypeAnnotation
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. ServiceRequest.note.text
Definition

The text of the annotation in markdown format.

ShortThe annotation - text content (as markdown)
Control1..1
Typemarkdown
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()))
48. ServiceRequest.patientInstruction
Definition

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

ShortUse Appointment.patientInstruction (referenced via ServiceRequest.extension) for patient-oriented instructionsPatient or consumer-oriented instructions
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()))

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.

ShortCH ORF ServiceRequest
Control0..*
Is Modifierfalse
Summaryfalse
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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.id
Definition

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

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
Is Modifierfalse
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
TypeMeta
Is Modifierfalse
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
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
BindingThe codes SHOULD be taken from CommonLanguages

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
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
TypeNarrative
Is Modifierfalse
Summaryfalse
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
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. ServiceRequest.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
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 are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. ServiceRequest.extension:locationAndTime
Slice NamelocationAndTime
Definition

Location and Time of ServiceRequest Fulfillment.

ShortCH ORF Location and Time
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(CH ORF Location and Time) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
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:requestedEncounterDetails
Slice NamerequestedEncounterDetails
Definition

Requested Encounter Details for ServiceRequest Fulfillment.

ShortCH ORF Requested Encounter Details
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CH ORF Requested Encounter Details) (Extension Type: Reference)
Is Modifierfalse
Must Supporttrue
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.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..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
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())
22. 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..*
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 are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
24. ServiceRequest.identifier:placerOrderIdentifier
Slice NameplacerOrderIdentifier
Definition

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

ShortPlacer Order Identifier
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..1
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;PLAC&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ServiceRequest.identifier:placerOrderIdentifier.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
28. ServiceRequest.identifier:placerOrderIdentifier.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.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
30. ServiceRequest.identifier:placerOrderIdentifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ServiceRequest.identifier:placerOrderIdentifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ServiceRequest.identifier:placerOrderIdentifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. ServiceRequest.identifier:placerOrderIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ServiceRequest.identifier:placerOrderIdentifier.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ServiceRequest.identifier:placerOrderIdentifier.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. ServiceRequest.identifier:fillerOrderIdentifier
Slice NamefillerOrderIdentifier
Definition

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

ShortFiller Order Identifier
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..1
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;FILL&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ServiceRequest.identifier:fillerOrderIdentifier.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
46. ServiceRequest.identifier:fillerOrderIdentifier.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.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
48. ServiceRequest.identifier:fillerOrderIdentifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. ServiceRequest.identifier:fillerOrderIdentifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

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

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. ServiceRequest.identifier:fillerOrderIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. ServiceRequest.identifier:fillerOrderIdentifier.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. ServiceRequest.identifier:fillerOrderIdentifier.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. 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..*
Typecanonical(ActivityDefinition, PlanDefinition)
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()))
62. 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..*
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()))
64. ServiceRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

ShortWhat request fulfills
Control0..*
TypeReference(CarePlan, ServiceRequest, MedicationRequest)
Is Modifierfalse
Summarytrue
Alternate Namesfulfills
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. ServiceRequest.replaces
Definition

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

ShortWhat request replaces
Control0..*
TypeReference(ServiceRequest)
Is Modifierfalse
Summarytrue
Alternate Namessupersedes, prior, renewed order
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. 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
TypeIdentifier
Is Modifierfalse
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()))
70. 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
BindingThe codes SHALL be taken from RequestStatus

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()))
72. 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
BindingThe codes SHALL be taken from RequestIntent

The kind of service request.

Typecode
Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example &quot;the time the request is recommended to occur&quot; vs. &quot;the time the request is authorized to occur&quot; or &quot;who is recommended to perform the request&quot; vs. &quot;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()))
74. 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..*
BindingFor example codes, see ServiceRequestCategoryCodes

Classification of the requested service.

TypeCodeableConcept
Is Modifierfalse
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()))
76. ServiceRequest.priority
Definition

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

ShortOrder priority
Control0..1
BindingThe codes SHALL be taken from RequestPriority

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()))
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
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
BindingFor example codes, see ProcedureCodes(SNOMEDCT)

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
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: prr-1
BindingFor example codes, see ServiceRequestOrderDetailsCodes

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()))
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
TypeChoice of: Quantity, Ratio, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
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

The principle target of a particular form content is one patient (for obstetrical and neonatal use cases see...).

ShortPatient
Control1..1
TypeReference(CH Core Patient)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. 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
Control0..1
TypeReference(Encounter)
Is Modifierfalse
Summarytrue
Alternate Namescontext
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. ServiceRequest.occurrence[x]
Definition

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

ShortWhen service should occur
Control0..1
TypeChoice of: dateTime, Period, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
Is Modifierfalse
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()))
92. 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
BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes

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] NoteSee Choice of Data Types for further information about how to use [x]
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()))
94. ServiceRequest.authoredOn
Definition

When the request transitioned to being actionable.

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

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

ShortThe person/organization responsible for the form content
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
TypeReference(CH Core PractitionerRole)
Is Modifierfalse
Must Supporttrue
Summarytrue
Alternate Namesauthor, orderer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. 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
BindingFor example codes, see ParticipantRoles

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

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Alternate Namesspecialty
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. 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..*
TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
Is Modifierfalse
Summarytrue
Alternate Namesrequest recipient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. 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
Control0..*
BindingFor example codes, see ServiceDeliveryLocationRoleType

A location type where services are delivered.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. 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
Control0..*
TypeReference(Location)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. 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..*
BindingFor example codes, see ProcedureReasonCodes

Diagnosis or problem codes justifying the reason for requesting the service investigation.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. 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..*
TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. 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
Control0..*
TypeReference(CH ORF Coverage)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. 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..*
TypeReference(Resource)
Is Modifierfalse
Summaryfalse
Alternate NamesAsk at order entry question, AOE
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. 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..*
TypeReference(Specimen)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. 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..*
BindingFor example codes, see SNOMEDCTBodyStructures

Codes describing anatomical locations. May include laterality.

TypeCodeableConcept
Is Modifierfalse
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()))
118. ServiceRequest.note
Definition

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

ShortComments
Control0..*
TypeAnnotation
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. ServiceRequest.note.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
122. ServiceRequest.note.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.note.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
124. ServiceRequest.note.author[x]
Definition

The individual responsible for making the annotation.

ShortIndividual responsible for the annotation
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Control0..1
TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
[x] NoteSee Choice of Data Types for further information about how to use [x]
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()))
126. ServiceRequest.note.time
Definition

Indicates when this particular annotation was made.

ShortWhen the annotation was made
Control0..1
TypedateTime
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()))
128. ServiceRequest.note.text
Definition

The text of the annotation in markdown format.

ShortThe annotation - text content (as markdown)
Control1..1
Typemarkdown
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()))
130. ServiceRequest.patientInstruction
Definition

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

ShortUse Appointment.patientInstruction (referenced via ServiceRequest.extension) for patient-oriented instructions
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()))
132. 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..*
TypeReference(Provenance)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))