Te Whatu Ora Shared Care FHIR API
0.3.9 - release New Zealand flag

Te Whatu Ora Shared Care FHIR API, published by Te Whatu Ora. This guide is not an authorized publication; it is the continuous build for version 0.3.9 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/cinc-fhir-ig/ and changes regularly. See the Directory of published versions

Resource Profile: ManaakiNgaTahiServiceRequest - Detailed Descriptions

Active as of 2024-05-02

Definitions for the ManaakiNgaTahiServiceRequest resource profile.

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

0. ServiceRequest
2. ServiceRequest.implicitRules
Control0..0
4. ServiceRequest.language
Control0..0
6. ServiceRequest.modifierExtension
Control0..0
8. ServiceRequest.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0
10. ServiceRequest.instantiatesCanonical
Typecanonical(ActivityDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. ServiceRequest.instantiatesUri
Control0..0
14. ServiceRequest.basedOn
TypeReference(CarePlan)
16. ServiceRequest.replaces
Control0..0
18. ServiceRequest.requisition
Control0..0
20. ServiceRequest.category
Control0..0
22. ServiceRequest.orderDetail
Control0..0
24. ServiceRequest.quantity[x]
Control0..0
26. ServiceRequest.subject
TypeReference(Patient)
28. ServiceRequest.encounter
Control0..0
30. ServiceRequest.occurrence[x]
Control1..?
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on ServiceRequest.occurrence[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 32. ServiceRequest.occurrence[x]:occurrenceDateTime
    Slice NameoccurrenceDateTime
    Control0..1
    TypedateTime
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Invariantsfhir-hnz-dateTime-utc-1: Value of dateTime must be UTC Coordinated Universal Time (not New Zealand time) (true)
    34. ServiceRequest.occurrence[x]:occurrencePeriod
    Slice NameoccurrencePeriod
    Control0..1
    TypePeriod
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Invariantsfhir-hnz-period-utc-1: period start and end must be dateTime values in UTC Coordinated Universal Time (not New Zealand time) (true)
    36. ServiceRequest.asNeeded[x]
    Control0..0
    38. ServiceRequest.performerType
    BindingThe codes SHALL be taken from ParticipantRoles
    (required to http://hl7.org/fhir/ValueSet/participant-role)
    40. ServiceRequest.performer
    Control0..1
    42. ServiceRequest.locationCode
    Control0..0
    44. ServiceRequest.locationReference
    Control0..0
    46. ServiceRequest.reasonCode
    Control0..0
    48. ServiceRequest.reasonReference
    Control0..0
    50. ServiceRequest.insurance
    Control0..0
    52. ServiceRequest.supportingInfo
    Control0..0
    54. ServiceRequest.specimen
    Control0..0
    56. ServiceRequest.bodySite
    Control0..0
    58. ServiceRequest.note
    Control0..0
    60. ServiceRequest.patientInstruction
    Control0..0
    62. ServiceRequest.relevantHistory
    Control0..0

    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
    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..01
    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.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..01
    BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
    (preferred to http://hl7.org/fhir/ValueSet/languages)

    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()))
    6. ServiceRequest.modifierExtension
    Definition

    An Extension


    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).

    ShortExtensionExtensions 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..0*
    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())
    8. 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)
    Control0..0*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. 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()))
    12. 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..0*
    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()))
    14. 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()))
    16. ServiceRequest.replaces
    Definition

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

    ShortWhat request replaces
    Control0..0*
    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()))
    18. 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..01
    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()))
    20. 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
    (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
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. ServiceRequest.intent
    Definition

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

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

    A code that classifies the service for searching, sorting and display purposes (e.g. "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..0*
    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
    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.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()))
    28. 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..0*
    This element is affected by the following invariants: prr-1
    BindingFor example codes, see ServiceRequestOrderDetailsCodeshttp://hl7.org/fhir/ValueSet/servicerequest-orderdetail
    (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

    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()))
    30. 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..01
    TypeChoice of: Quantity, Ratio, Range
    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()))
    32. 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
    Control1..1
    TypeReference(Patient, Group, Location, Device)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. 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..01
    TypeReference(Encounter)
    Is Modifierfalse
    Summarytrue
    Alternate Namescontext
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. ServiceRequest.occurrence[x]
    Definition

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

    ShortWhen service should occur
    Control10..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()))
    SlicingThis element introduces a set of slices on ServiceRequest.occurrence[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 38. ServiceRequest.occurrence[x]:occurrenceDateTime
      Slice NameoccurrenceDateTime
      Definition

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

      ShortWhen service should occur
      Control0..1
      TypedateTime, 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()))
      fhir-hnz-dateTime-utc-1: Value of dateTime must be UTC Coordinated Universal Time (not New Zealand time) (true)
      40. ServiceRequest.occurrence[x]:occurrencePeriod
      Slice NameoccurrencePeriod
      Definition

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

      ShortWhen service should occur
      Control0..1
      TypePeriod, dateTime, Timing
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Alternate Namesschedule
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      fhir-hnz-period-utc-1: period start and end must be dateTime values in UTC Coordinated Universal Time (not New Zealand time) (true)
      42. 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..01
      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
      (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
      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()))
      44. 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
      BindingThe codes SHALL be taken from For example codes, see ParticipantRoleshttp://hl7.org/fhir/ValueSet/participant-role
      (required to http://hl7.org/fhir/ValueSet/participant-role)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Alternate Namesspecialty
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. 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..1*
      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()))
      48. 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..0*
      BindingFor example codes, see ServiceDeliveryLocationRoleTypehttp://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
      (example to http://terminology.hl7.org/ValueSet/v3-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()))
      50. 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..0*
      TypeReference(Location)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. ServiceRequest.reasonCode
      Definition

      An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

      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..0*
      BindingFor example codes, see ProcedureReasonCodeshttp://hl7.org/fhir/ValueSet/procedure-reason
      (example to http://hl7.org/fhir/ValueSet/procedure-reason)

      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()))
      54. ServiceRequest.reasonReference
      Definition

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

      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..0*
      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()))
      56. 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..0*
      TypeReference(Coverage, ClaimResponse)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. ServiceRequest.supportingInfo
      Definition

      Additional clinical information about the patient 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..0*
      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()))
      60. 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..0*
      TypeReference(Specimen)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. 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..0*
      BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site
      (example to http://hl7.org/fhir/ValueSet/body-site)

      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()))
      64. ServiceRequest.note
      Definition

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

      ShortComments
      Control0..0*
      TypeAnnotation
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. ServiceRequest.patientInstruction
      Definition

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

      ShortPatient or consumer-oriented instructions
      Control0..01
      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()))
      68. 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..0*
      TypeReference(Provenance)
      Is Modifierfalse
      Summaryfalse
      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.

      ShortA 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())
      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..0
      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..0
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      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

      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..*
      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())
      16. ServiceRequest.modifierExtension
      Definition

      An Extension

      ShortExtension
      Control0..0
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      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())
      18. 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)
      Control0..0
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. 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)
      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()))
      22. 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..0
      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()))
      24. ServiceRequest.basedOn
      Definition

      Plan/proposal/order fulfilled by this request.

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

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

      ShortWhat request replaces
      Control0..0
      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()))
      28. 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..0
      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()))
      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 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
      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 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
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. 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..0
      BindingFor example codes, see ServiceRequestCategoryCodes
      (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

      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()))
      36. ServiceRequest.priority
      Definition

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

      Shortroutine | urgent | asap | stat
      Control0..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
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      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()))
      38. 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()))
      40. 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)
      (example to http://hl7.org/fhir/ValueSet/procedure-code)

      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()))
      42. 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..0
      This element is affected by the following invariants: prr-1
      BindingFor example codes, see ServiceRequestOrderDetailsCodes
      (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

      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()))
      44. 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..0
      TypeChoice of: Quantity, Ratio, Range
      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()))
      46. 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
      Control1..1
      TypeReference(Patient)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. 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..0
      TypeReference(Encounter)
      Is Modifierfalse
      Summarytrue
      Alternate Namescontext
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. ServiceRequest.occurrence[x]
      Definition

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

      ShortWhen service should occur
      Control1..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()))
      SlicingThis element introduces a set of slices on ServiceRequest.occurrence[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 52. ServiceRequest.occurrence[x]:occurrenceDateTime
        Slice NameoccurrenceDateTime
        Definition

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

        ShortWhen service should occur
        Control0..1
        TypedateTime
        [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()))
        fhir-hnz-dateTime-utc-1: Value of dateTime must be UTC Coordinated Universal Time (not New Zealand time) (true)
        54. ServiceRequest.occurrence[x]:occurrencePeriod
        Slice NameoccurrencePeriod
        Definition

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

        ShortWhen service should occur
        Control0..1
        TypePeriod
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Alternate Namesschedule
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        fhir-hnz-period-utc-1: period start and end must be dateTime values in UTC Coordinated Universal Time (not New Zealand time) (true)
        56. 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..0
        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
        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()))
        58. 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()))
        60. 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
        TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
        Is Modifierfalse
        Summarytrue
        Alternate Namesauthor, orderer
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. 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
        BindingThe codes SHALL be taken from ParticipantRoles
        (required to http://hl7.org/fhir/ValueSet/participant-role)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Alternate Namesspecialty
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. 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..1
        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()))
        66. 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..0
        BindingFor example codes, see ServiceDeliveryLocationRoleType
        (example to http://terminology.hl7.org/ValueSet/v3-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()))
        68. 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..0
        TypeReference(Location)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. 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..0
        BindingFor example codes, see ProcedureReasonCodes
        (example to http://hl7.org/fhir/ValueSet/procedure-reason)

        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()))
        72. 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..0
        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()))
        74. 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..0
        TypeReference(Coverage, ClaimResponse)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. 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..0
        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()))
        78. 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..0
        TypeReference(Specimen)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. 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..0
        BindingFor example codes, see SNOMEDCTBodyStructures
        (example to http://hl7.org/fhir/ValueSet/body-site)

        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()))
        82. ServiceRequest.note
        Definition

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

        ShortComments
        Control0..0
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. ServiceRequest.patientInstruction
        Definition

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

        ShortPatient or consumer-oriented instructions
        Control0..0
        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()))
        86. 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..0
        TypeReference(Provenance)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))