## eRef /ServiceRequest Resource Profile **Completeness: 60% - Pilot Ready** [view discussion space](https://3.basecamp.com/3573371/buckets/7959278/documents/1124502897) The /ServiceRequest is the main resource of this specification, all other resources flow from the /ServiceRequest. It is used to send all eReferral related information to the target destination. ### LEGEND * ~~strikethrough~~ indicates the the element is not included in this profile * `red` indicates that the field is likely useful in a future iteration of the specification **Canonical URl for this profile:** http://fhir.infoway-inforoute.ca/StructureDefinition/ca-eReferral-ServiceRequest | Name | Card | Type | Comments |Terminology Binding| |---|---|---|---| | identifier | 0..* | Identifier | Any number of identifiers can be included in the ServiceRequest. When ServiceRequest updates are send back to the sender, all submitted Identifiers should be included, even if not used by the receiving system (e.g., an Identifier generated by the sending system). | ~~instantiates~~ | ~~0..*~~ | ~~uri~~ | | basedOn | 0..1 | Reference(ServiceRequest) | is used for when a referral is "forwarded" to another destination, such as in a central access process, to reference the original ServiceRequest. *basedOn is not used in a new (non-forwarded) eReferral. | ~~replaces~~ | ~~0..*~~ | ~~Reference(ServiceRequest)~~ | | `requisition` | 0..1 | Identifier | `for future use` is intended for when more than one eReferral is generated at the same time, and are connected to each other (e.g., lab requests for multiple tests). | status | 1..1 | code | should always be submitted as "active". The eReferral server is responsible for updating the status as the eReferral progresses. The /Task resource is used for more detailed status tracking. | intent | 1..1 | code | always set to = "proposal" | priority | 0..1 | code | Submit = routine \ urgent \ asap \ stat (routine default & most common value) | ~~doNotPerform~~ | ~~0..*~~ | ~~boolean~~ | | ~~category~~ | ~~0..*~~ | ~~CodeableConcept~~ | Handled by the "performer" field | `code` | 0..1 | CodeableConcept | `for future use if enabling referrals down very specific and detailed pathways. Currently, this is sufficiently handled by the performer>HealthcareService / performer.PractitionerRole and the reasonCode element` | ~~orderDetail~~ | ~~0..*~~ | ~~CodeableConcept~~ | n/a | subject | 1..1 | Reference (Patient) | always represents the patient | ~~context~~ | ~~0..*~~ | ~~Reference (Encounter \ EpisodeOfCare)~~ | | ~~occurence~~ | ~~0..1~~ | (x) | Is intended for specifying the timeframe in which the requested service should be provided. This is more applicable for orders than for referrals. | ~~asNeededBoolean~~ | | ~~boolean~~ | | authoredOn | 0..1 | dateTime | This is the date the request was "signed". If submitted blank, the eReferral server will assign this as the time of submission. A different (earlier) time can be submitted if the request was "signed" at a time before the online submission. To track the time that the eReferral was submitted, see Task.authoredOn. | requester | `1`..1 | Reference (PractitionerRole\ Patient) | who or what is requesting service. "Patient" is used for self referrals. (note that ~~~device, practitioner and organization~~ are NOT included here as requester options) `for future use - "RelatedPerson is used for referring family members.` | ~~performerType~~ | ~~0..*~~ | ~~CodeableConcept~~ | unnecessary detail | performer | `1`..1 | Reference(HealthcareService \PractitionerRole ) | **IMPORTANT:** This field will alyways be included as an externally referenced resource, likely hosted by the same entity that hosts the eReferral target endpoint. The reference is restricted to HealthcareService for services, and PractitionerRole for clinicians (not ~~Practitioner, Organization, Patient, Device, RelatedPerson, Caredove~~). | reasonCode.text | 0..* | CodeableConcept | used to communicate the "Reason for Referral" as a narrative. | ~~reasonReference~~ | ~~0..*~~ | ~~Reference(Condition\ Observation\ DiagnosticReport\ DocumentReference)~~ | unnecessary detail | ~~insurance~~ | ~~0..*~~ | ~~Reference(Coverage\ ClaimResponse)~~ | n/a | `supportingInfo` | 0..* | Reference | `Will be used to connecto to Consent, DocumentReference, Provenance of the ServiceRequest, plus eventually any relevant clinical resources such as Medications, Allergies, etc.` | ~~specimen~~ | ~~0..*~~ | ~~Reference(Specimen)~~ | | bodySite | 0..* | CodeableConcept | `Valueset to be specified by EHO` Example-[SNOMED CT Body Structures](http://hl7.org/fhir/2018May/valueset-body-site.html) | note | 0..* | Annotation | used to include additional information in the referral that is not captured by an existing resource or in a DocumentReference. This is often used when the sending application has a custom data capture form with fields are not mapped to a resource (e.g., Food preference, home visit risk factors, etc...). On submission of the ServiceRequest, if .authorx and .time are not included, they are assumed to be the requester and received time of the ServiceRequest respectively (this is expected to be the normal use case). | patientInstruction | 0..1 | string | is used to provide patient instructions. Note that this should NOT BEe SUBMITTED with a new referral, it is updated by the eReferral server and provided in the response. | ~~relevantHistory~~ | ~~0..*~~ | ~~Reference(Provenance)~~ | Use Task.relevantHistory to track provenance instead of here.