Visit the Canada Health Infoway website
Visit the FHIR website

CA Core+

cibuild   Canada flag
  • Index
  • Home
  • Business Context
    • Business Context
    • Relationship to PCHDCF
    • Relationship to Other Specifications
    • CA Core+ to CACDI Mapping
  • Technical Context
    • Technical Context
    • Artifact Status Summary
    • Profiling Conventions & Approach
    • General Guidance
    • Mapping Logic
    • Security And Privacy
  • Modules
    • Modules
    • Common Data Exchange
    • Workflows
  • FHIR Artifacts
    • FHIR Artifacts
    • Profiles
    • Extensions
    • Data Types
    • Terminology
    • Actors
    • Examples
    • Download
  • Change Log
    • Change Log
    • Specification Guidance
    • Copyrights
    • Known Issues & Future Development
    • Specification Feedback
    1. Index
    2. FHIR Artifacts
    3. Profiles
    4. ServiceRequest (CA-Core)

1.2.0-DFT - The specification is version 1.2.0-DFT of CA Core+ For a full list of available versions, see the Directory of published versions

ServiceRequest (CA-Core)

Many ValueSet and CodeSystem bindings in this guide link to resources hosted on the Canada Health Infoway Terminology Service (Ontoserver). If you are redirected to a login page: This is expected and you are being directed to Infoway’s secure environment. To access these resources: You’ll need an InfoCentral Account.

Links

Profile

servicerequest-ca-core

Derived from

http://hl7.org/fhir/StructureDefinition/ServiceRequest

Examples

example-servicerequest-ca-core, example-servicerequest-pathology-ca-core-2

Description

This profile applies constraints to the ServiceRequest resource for CA Core+ to support orders and referrals for clinical services in the pan-Canadian context.

References to this resource

AppointmentCACore, DiagnosticReportCACore

CFMM: 2

Resource Content

  • Tree view
  • Overview
  • XML
  • JSON
ServiceRequestCACore (ServiceRequest)CServiceRequest
There are no (further) constraints on this element
Element id
ServiceRequest
Short description

A request for a service to be performed

Alternate names

diagnostic request, referral, referral request, transfer of care request

Definition

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

Data type

ServiceRequest

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • prr-1: orderDetail SHALL only be present if code is present
    orderDetail.empty() or code.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Request
  • v2: ORC
  • rim: Act[moodCode<=INT]
idΣ0..1id
There are no (further) constraints on this element
Element id
ServiceRequest.id
Short description

Logical id of this artifact

Definition

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

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.

Data type

id

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
metaΣ0..1Meta
There are no (further) constraints on this element
Element id
ServiceRequest.meta
Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
ServiceRequest.implicitRules
Short description

A set of rules under which this content was created

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.

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.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
language0..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

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).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
MaxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
text0..1Narrative
There are no (further) constraints on this element
Element id
ServiceRequest.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
ServiceRequest.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

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.

Data type

Resource

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
extensionC0..*ExtensionElement id
ServiceRequest.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
CopiedParticipantsC0..*Extension(Reference(PractitionerCACore))Element id
ServiceRequest.extension:CopiedParticipants
Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

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.

Data type

Extension(Reference(PractitionerCACore))

Extension URL

CopiedParticipants

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
PatientPresentLocationC0..*Extension(Reference(LocationCACore))Element id
ServiceRequest.extension:PatientPresentLocation
Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Used to communicate the present location of the patient if it is different than the patient's home address.

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.

Data type

Extension(Reference(LocationCACore))

Extension URL

PatientPresentLocation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
RoutingOptionsC0..*Extension(CodeableConcept)Element id
ServiceRequest.extension:RoutingOptions
Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

For Referral Source Type identification. Only one referral routing object is expected.

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.

Data type

Extension(CodeableConcept)

Extension URL

RoutingOptions

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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).

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
ServiceRequest.identifier
Short description

Identifiers assigned to this order

Definition

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

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.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • w5: FiveWs.identifier
  • v2: ORC.2, ORC.3, RF1-6 / RF1-11,
  • rim: .identifier
  • quick: ClinicalStatement.identifier
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | PlanDefinition)
There are no (further) constraints on this element
Element id
ServiceRequest.instantiatesCanonical
Short description

Instantiates FHIR protocol or definition

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.

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.

Data type

canonical(ActivityDefinition | PlanDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesCanonical
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUriΣ0..*uri
There are no (further) constraints on this element
Element id
ServiceRequest.instantiatesUri
Short description

Instantiates external protocol or definition

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.

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesUri
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
basedOnΣ C0..*Reference(CarePlan | MedicationRequest | ServiceRequest)
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn
Short description

What request fulfills

Alternate names

fulfills

Definition

Plan/proposal/order fulfilled by this request.

Comments

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

Data type

Reference(CarePlan | MedicationRequest | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.basedOn
  • v2: ORC.8 (plus others)
  • rim: .outboundRelationship[typeCode=FLFS].target
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
referenceΣ C0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

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

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

Comments

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

Data type

uri

Binding

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

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

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

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

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

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

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.type
Short description

Description of identifier

Definition

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

Requirements

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

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.

Data type

CodeableConcept

Binding

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

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
systemSO Σ0..1uriElement id
ServiceRequest.basedOn.identifier.system
Short description

The namespace for the identifier value

Definition

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

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.

Comments

Identifier.system is always case sensitive.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO Σ0..1stringElement id
ServiceRequest.basedOn.identifier.value
Short description

The value that is unique

Definition

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

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.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
periodΣ C0..1Period
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.period
Short description

Time period when id is/was valid for use

Definition

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

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ C0..1Reference(Organization)
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

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.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
displayΣ0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.display
Short description

Text alternative for the resource

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
replacesΣ C0..*Reference(ServiceRequest)
There are no (further) constraints on this element
Element id
ServiceRequest.replaces
Short description

What request replaces

Alternate names

supersedes, prior, renewed order

Definition

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

Comments

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

Data type

Reference(ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.replaces
  • v2: Handled by message location of ORC (ORC.1=RO or RU)
  • rim: .outboundRelationship[typeCode=RPLC].target
requisitionΣ0..1Identifier
There are no (further) constraints on this element
Element id
ServiceRequest.requisition
Short description

Composite Request ID

Alternate names

grouperId, groupIdentifier

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.

Requirements

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

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.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.groupIdentifier
  • v2: ORC.4
  • rim: .inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier
statusΣ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.status
Short description

draft | active | on-hold | revoked | completed | entered-in-error | unknown

Definition

The status of the order.

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.

Data type

code

Binding

The status of a service order.

RequestStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.status
  • w5: FiveWs.status
  • v2: ORC.5,RF1-1
  • rim: .status
  • quick: Action.currentStatus
intentΣ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.intent
Short description

proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option

Definition

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

Comments

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

Data type

code

Binding

The kind of service request.

RequestIntent (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.intent
  • w5: FiveWs.class
  • v2: N/A
  • rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
categoryΣ0..*CodeableConceptCACoreElement id
ServiceRequest.category
Short description

Concept - reference to a terminology or just text

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Requirements

Used for filtering what service request are retrieved and displayed.

Comments

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

Data type

CodeableConceptCACore

Binding

Classification of the requested service.

ServiceRequestCategoryCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: RF1-5
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
priorityΣ0..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.priority
Short description

routine | urgent | asap | stat

Definition

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If missing, this task should be performed with normal priority

Data type

code

Binding

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

RequestPriority (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.priority
  • w5: FiveWs.grade
  • v2: TQ1.9, RF1-2
  • rim: .priorityCode
doNotPerformΣ ?!0..1boolean
There are no (further) constraints on this element
Element id
ServiceRequest.doNotPerform
Short description

True if service/procedure should not be performed

Definition

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

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.

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.

Meaning when missing

If missing, the request is a positive request e.g. "do perform"

Data type

boolean

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.doNotPerform
  • rim: .actionNegationInd
codeΣ0..1CodeableConceptCACoreBindingElement id
ServiceRequest.code
Short description

Concept - reference to a terminology or just text

Alternate names

service requested

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Comments

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

Data type

CodeableConceptCACore

Binding

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](valueset-diagnostic-requests.html).

ProcedureCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.code
  • w5: FiveWs.what[x]
  • v2: PR1-3 / OBR-4 (varies by domain)
  • rim: .code
  • quick: Procedure.procedureCode
orderDetailΣ C0..*CodeableConcept
There are no (further) constraints on this element
Element id
ServiceRequest.orderDetail
Short description

Additional order information

Alternate names

detailed instructions

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.

Comments

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

Data type

CodeableConcept

Binding

Codified order entry details which are based on order context.

ServiceRequestOrderDetailsCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, prr-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: NTE
  • rim: .code
  • quick: Procedure.procedureCode
quantity[x]Σ0..1
There are no (further) constraints on this element
Element id
ServiceRequest.quantity[x]
Short description

Service amount

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).

Requirements

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NTE
  • rim: .quantity
quantityQuantityQuantity
There are no (further) constraints on this element
Data type

Quantity

quantityRangeRange
There are no (further) constraints on this element
Data type

Range

quantityRatioRatio
There are no (further) constraints on this element
Data type

Ratio

subjectΣ C1..1Reference(LocationCACore | PatientCACore | Device | Group)Element id
ServiceRequest.subject
Short description

Individual or Entity the service is ordered for

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).

Comments

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

Data type

Reference(LocationCACore | PatientCACore | Device | Group)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • w5: FiveWs.subject[x]
  • v2: PID
  • rim: .participation[typeCode=SBJ].role
  • quick: ClinicalStatement.subject
  • w5: FiveWs.subject
encounterΣ C0..1Reference(EncounterCACore)Element id
ServiceRequest.encounter
Short description

Encounter in which the request was created

Alternate names

context

Definition

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

Comments

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

Data type

Reference(EncounterCACore)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.encounter
  • w5: FiveWs.context
  • v2: PV1
  • rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
  • quick: ClinicalStatement.encounter
occurrence[x]Σ0..1
There are no (further) constraints on this element
Element id
ServiceRequest.occurrence[x]
Short description

When service should occur

Alternate names

schedule

Definition

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.occurrence[x]
  • w5: FiveWs.planned
  • v2: TQ1/TQ2, OBR-7/OBR-8
  • rim: .effectiveTime
  • quick: Procedure.procedureSchedule
occurrenceDateTimedateTime
There are no (further) constraints on this element
Data type

dateTime

occurrencePeriodPeriod
There are no (further) constraints on this element
Data type

Period

occurrenceTimingTiming
There are no (further) constraints on this element
Data type

Timing

asNeeded[x]Σ0..1
There are no (further) constraints on this element
Element id
ServiceRequest.asNeeded[x]
Short description

Preconditions for service

Definition

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

Binding

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

SNOMEDCTMedicationAsNeededReasonCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value
  • quick: Proposal.prnReason.reason
asNeededBooleanboolean
There are no (further) constraints on this element
Data type

boolean

asNeededCodeableConceptCodeableConcept
There are no (further) constraints on this element
Data type

CodeableConcept

authoredOnΣ0..1dateTime
There are no (further) constraints on this element
Element id
ServiceRequest.authoredOn
Short description

Date request signed

Alternate names

orderedOn

Definition

When the request transitioned to being actionable.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • w5: FiveWs.recorded
  • v2: ORC.9, RF1-7 / RF1-9
  • rim: .participation[typeCode=AUT].time
  • quick: Proposal.proposedAtTime
requesterΣ C0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
ServiceRequest.requester
Short description

Who/what is requesting service

Alternate names

author, orderer

Definition

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

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.

Data type

Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.requester
  • w5: FiveWs.author
  • v2: ORC.12, PRT
  • rim: .participation[typeCode=AUT].role
  • quick: ClinicalStatement.statementAuthor
performerTypeΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
ServiceRequest.performerType
Short description

Performer role

Alternate names

specialty

Definition

Desired type of performer for doing the requested service.

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”.

Data type

CodeableConcept

Binding

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

ParticipantRoles (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.performerType
  • w5: FiveWs.actor
  • v2: PRT, RF!-3
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
performerΣ C0..*Reference(HealthcareServiceCACore | OrganizationCACore | PatientCACore | PractitionerCACore | PractitionerRoleCACore | CareTeam | Device | RelatedPerson)Element id
ServiceRequest.performer
Short description

Requested performer

Alternate names

request recipient

Definition

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

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).

Data type

Reference(HealthcareServiceCACore | OrganizationCACore | PatientCACore | PractitionerCACore | PractitionerRoleCACore | CareTeam | Device | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.performer
  • w5: FiveWs.actor
  • v2: PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.performer.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.performer.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
referenceΣ C0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.performer.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
ServiceRequest.performer.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

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

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

Comments

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

Data type

uri

Binding

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

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

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

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

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

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

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.type
Short description

Description of identifier

Definition

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

Requirements

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

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.

Data type

CodeableConcept

Binding

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

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
systemSO Σ0..1uriElement id
ServiceRequest.performer.identifier.system
Short description

The namespace for the identifier value

Definition

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

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.

Comments

Identifier.system is always case sensitive.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO Σ0..1stringElement id
ServiceRequest.performer.identifier.value
Short description

The value that is unique

Definition

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

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.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
periodΣ C0..1Period
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.period
Short description

Time period when id is/was valid for use

Definition

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

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ C0..1Reference(Organization)
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

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.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
displayΣ0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.performer.display
Short description

Text alternative for the resource

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
locationCodeΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
ServiceRequest.locationCode
Short description

Requested location

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.

Comments

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

Data type

CodeableConcept

Binding

A location type where services are delivered.

ServiceDeliveryLocationRoleType (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=KIND].code
locationReferenceΣ C0..*Reference(LocationCACore)Element id
ServiceRequest.locationReference
Short description

Requested location

Definition

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

Comments

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

Data type

Reference(LocationCACore)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=INSTANCE]
reasonCodeΣ0..*CodeableConceptBindingElement id
ServiceRequest.reasonCode
Short description

Explanation/Justification for procedure or service

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.

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.

Data type

CodeableConcept

Binding

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

HealthConditionCode (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.reasonCode
  • w5: FiveWs.why[x]
  • v2: ORC.16, RF1-10
  • rim: .reasonCode
reasonReferenceΣ C0..*Reference(Condition | DiagnosticReport | DocumentReference | Observation)
There are no (further) constraints on this element
Element id
ServiceRequest.reasonReference
Short description

Explanation/Justification for service or service

Definition

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

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.

Data type

Reference(Condition | DiagnosticReport | DocumentReference | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.reasonReference
  • w5: FiveWs.why[x]
  • v2: ORC.16
  • rim: .outboundRelationship[typeCode=RSON].target
insuranceC0..*Reference(ClaimResponse | Coverage)
There are no (further) constraints on this element
Element id
ServiceRequest.insurance
Short description

Associated insurance coverage

Definition

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

Comments

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

Data type

Reference(ClaimResponse | Coverage)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.insurance
  • v2: IN1/IN2
  • rim: .outboundRelationship[typeCode=COVBY].target
supportingInfoC0..*Reference(Resource)
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo
Short description

Additional clinical information

Alternate names

Ask at order entry question, AOE

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.

Comments

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

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
  • v2: Accompanying segments
  • rim: .outboundRelationship[typeCode=PERT].target
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
referenceΣ C0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

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

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

Comments

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

Data type

uri

Binding

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

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
identifierΣ0..1Identifier
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

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

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

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

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

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.type
Short description

Description of identifier

Definition

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

Requirements

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

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.

Data type

CodeableConcept

Binding

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

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
systemSO Σ0..1uriElement id
ServiceRequest.supportingInfo.identifier.system
Short description

The namespace for the identifier value

Definition

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

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.

Comments

Identifier.system is always case sensitive.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO Σ0..1stringElement id
ServiceRequest.supportingInfo.identifier.value
Short description

The value that is unique

Definition

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

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.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
periodΣ C0..1Period
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.period
Short description

Time period when id is/was valid for use

Definition

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

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ C0..1Reference(Organization)
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

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.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
displayΣ0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.display
Short description

Text alternative for the resource

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
specimenΣ C0..*Reference(Specimen)
There are no (further) constraints on this element
Element id
ServiceRequest.specimen
Short description

Procedure Samples

Definition

One or more specimens that the laboratory procedure will use.

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.

Data type

Reference(Specimen)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SPM
  • rim: .participation[typeCode=SPC].role
bodySiteΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
ServiceRequest.bodySite
Short description

Location on Body

Alternate names

location

Definition

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

Requirements

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

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.

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM
  • rim: targetSiteCode
  • quick: Procedure.targetBodySite
note0..*Annotation
There are no (further) constraints on this element
Element id
ServiceRequest.note
Short description

Comments

Definition

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

Comments

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

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • v2: NTE
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]
  • quick: ClinicalStatement.additionalText
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.note.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.note.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
author[x]Σ0..1Element id
ServiceRequest.note.author[x]
Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

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

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
authorStringstring
There are no (further) constraints on this element
Data type

string

authorReferenceΣ0..1Reference(Organization | Patient | Practitioner | RelatedPerson)Element id
ServiceRequest.note.author[x]:authorReference
Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

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

Data type

Reference(Organization | Patient | Practitioner | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
referenceSO Σ C0..1stringElement id
ServiceRequest.note.author[x]:authorReference.reference
Short description

Literal reference, Relative, internal or absolute URL

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, ref-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
typeΣ0..1uriBinding
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.type
Short description

Type the reference refers to (e.g. "Patient")

Definition

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

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

Comments

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

Data type

uri

Binding

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

ResourceType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
identifierSO Σ0..1IdentifierElement id
ServiceRequest.note.author[x]:authorReference.identifier
Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

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

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

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

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

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
id0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.id
Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings
  • rim: n/a
extensionC0..*Extension
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.extension
Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
useΣ ?!0..1codeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.use
Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

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

Comments

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

Data type

code

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
typeΣ0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.type
Short description

Description of identifier

Definition

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

Requirements

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

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.

Data type

CodeableConcept

Binding

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

Identifier Type Codes (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
systemSO Σ0..1uriElement id
ServiceRequest.note.author[x]:authorReference.identifier.system
Short description

The namespace for the identifier value

Definition

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

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.

Comments

Identifier.system is always case sensitive.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO Σ0..1stringElement id
ServiceRequest.note.author[x]:authorReference.identifier.value
Short description

The value that is unique

Definition

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

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.

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Examples
General
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
periodΣ C0..1Period
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.period
Short description

Time period when id is/was valid for use

Definition

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

Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
assignerΣ C0..1Reference(Organization)
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.assigner
Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

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.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
displayΣ0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.display
Short description

Text alternative for the resource

Definition

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

Comments

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

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
timeΣ0..1dateTime
There are no (further) constraints on this element
Element id
ServiceRequest.note.time
Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
textΣ1..1markdown
There are no (further) constraints on this element
Element id
ServiceRequest.note.text
Short description

The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

Data type

markdown

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
patientInstructionΣ0..1string
There are no (further) constraints on this element
Element id
ServiceRequest.patientInstruction
Short description

Patient or consumer-oriented instructions

Definition

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

string

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NTE
  • rim: .text
relevantHistoryC0..*Reference(Provenance)
There are no (further) constraints on this element
Element id
ServiceRequest.relevantHistory
Short description

Request provenance

Definition

Key events in the history of the request.

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.

Data type

Reference(Provenance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.relevantHistory
  • v2: N/A
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
ServiceRequestCACore (ServiceRequest)ServiceRequest
There are no (further) constraints on this element
Data type

ServiceRequest

extension
There are no (further) constraints on this element
Element id
ServiceRequest.extension
Slicing

Unordered, Open, by url(Value)

CopiedParticipants0..*Extension(Reference(PractitionerCACore))
There are no (further) constraints on this element
Element id
ServiceRequest.extension:CopiedParticipants
Data type

Extension(Reference(PractitionerCACore))

Extension URL

CopiedParticipants

PatientPresentLocation0..*Extension(Reference(LocationCACore))
There are no (further) constraints on this element
Element id
ServiceRequest.extension:PatientPresentLocation
Data type

Extension(Reference(LocationCACore))

Extension URL

PatientPresentLocation

RoutingOptions0..*Extension(CodeableConcept)
There are no (further) constraints on this element
Element id
ServiceRequest.extension:RoutingOptions
Data type

Extension(CodeableConcept)

Extension URL

RoutingOptions

basedOn
There are no (further) constraints on this element
identifier
There are no (further) constraints on this element
systemSO
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.system
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO
There are no (further) constraints on this element
Element id
ServiceRequest.basedOn.identifier.value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
categoryCodeableConceptCACore
There are no (further) constraints on this element
Element id
ServiceRequest.category
Data type

CodeableConceptCACore

codeCodeableConceptCACoreBinding
There are no (further) constraints on this element
Element id
ServiceRequest.code
Data type

CodeableConceptCACore

Binding

ProcedureCode (extensible)

subjectReference(LocationCACore | PatientCACore | Device | Group)
There are no (further) constraints on this element
Element id
ServiceRequest.subject
Data type

Reference(LocationCACore | PatientCACore | Device | Group)

encounterReference(EncounterCACore)
There are no (further) constraints on this element
Element id
ServiceRequest.encounter
Data type

Reference(EncounterCACore)

performerReference(HealthcareServiceCACore | OrganizationCACore | PatientCACore | PractitionerCACore | PractitionerRoleCACore | CareTeam | Device | RelatedPerson)
There are no (further) constraints on this element
Element id
ServiceRequest.performer
Data type

Reference(HealthcareServiceCACore | OrganizationCACore | PatientCACore | PractitionerCACore | PractitionerRoleCACore | CareTeam | Device | RelatedPerson)

identifier
There are no (further) constraints on this element
systemSO
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.system
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO
There are no (further) constraints on this element
Element id
ServiceRequest.performer.identifier.value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
locationReferenceReference(LocationCACore)
There are no (further) constraints on this element
Element id
ServiceRequest.locationReference
Data type

Reference(LocationCACore)

reasonCodeBinding
There are no (further) constraints on this element
Element id
ServiceRequest.reasonCode
Binding

HealthConditionCode (preferred)

supportingInfo
There are no (further) constraints on this element
identifier
There are no (further) constraints on this element
systemSO
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.system
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO
There are no (further) constraints on this element
Element id
ServiceRequest.supportingInfo.identifier.value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
note
There are no (further) constraints on this element
author[x]
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]
Slicing

Unordered, Open, by $this(Type)

authorReference0..1Reference(Organization | Patient | Practitioner | RelatedPerson)
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference
Data type

Reference(Organization | Patient | Practitioner | RelatedPerson)

referenceSO
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.reference
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
identifierSO
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
systemSO
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.system
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
valueSO
There are no (further) constraints on this element
Element id
ServiceRequest.note.author[x]:authorReference.identifier.value
Obligations
CodeActor
SHALL:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
{{ren
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="servicerequest-ca-core" />
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="2" />
</extension>
<url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/servicerequest-ca-core" />
<version value="1.1.0" />
<name value="ServiceRequestCACore" />
<title value="ServiceRequest (CA-Core)" />
<status value="active" />
<experimental value="false" />
<date value="2025-03-06" />
<publisher value="Canada Health Infoway" />
<contact>
<name value="National Standards Release Centre" />
<telecom>
<system value="url" />
<value value="http://www.infoway-inforoute.ca" />
</telecom>
<telecom>
<system value="email" />
<value value="standards@infoway-inforoute.ca" />
</telecom>
</contact>
<description value="This profile applies constraints to the ServiceRequest resource for CA Core+ to support orders and referrals for clinical services in the pan-Canadian context." />
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166" />
<code value="CA" />
</coding>
</jurisdiction>
<copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="ServiceRequest" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
<derivation value="constraint" />
<differential>
<element id="ServiceRequest.extension">
<path value="ServiceRequest.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="ServiceRequest.extension:CopiedParticipants">
<path value="ServiceRequest.extension" />
<sliceName value="CopiedParticipants" />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/servicerequest-copied-participants" />
</type>
</element>
<element id="ServiceRequest.extension:PatientPresentLocation">
<path value="ServiceRequest.extension" />
<sliceName value="PatientPresentLocation" />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/servicerequest-patientPresentLocation" />
</type>
</element>
<element id="ServiceRequest.extension:RoutingOptions">
<path value="ServiceRequest.extension" />
<sliceName value="RoutingOptions" />
<min value="0" />
<max value="*" />
<type>
<code value="Extension" />
<profile value="http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/routingOptions" />
</type>
</element>
<element id="ServiceRequest.basedOn.identifier.system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.basedOn.identifier.system" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.basedOn.identifier.value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.basedOn.identifier.value" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.category">
<path value="ServiceRequest.category" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
</element>
<element id="ServiceRequest.code">
<path value="ServiceRequest.code" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<binding>
<strength value="extensible" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/procedurecode" />
</binding>
</element>
<element id="ServiceRequest.subject">
<path value="ServiceRequest.subject" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
</type>
</element>
<element id="ServiceRequest.encounter">
<path value="ServiceRequest.encounter" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/encounter-ca-core" />
</type>
</element>
<element id="ServiceRequest.performer">
<path value="ServiceRequest.performer" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/healthcareservice-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
</element>
<element id="ServiceRequest.performer.identifier.system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.performer.identifier.system" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.performer.identifier.value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.performer.identifier.value" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.locationReference">
<path value="ServiceRequest.locationReference" />
<type>
<code value="Reference" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
</type>
</element>
<element id="ServiceRequest.reasonCode">
<path value="ServiceRequest.reasonCode" />
<binding>
<strength value="preferred" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode" />
</binding>
</element>
<element id="ServiceRequest.supportingInfo.identifier.system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.supportingInfo.identifier.system" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.supportingInfo.identifier.value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.supportingInfo.identifier.value" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.note.author[x]">
<path value="ServiceRequest.note.author[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="ServiceRequest.note.author[x]:authorReference">
<path value="ServiceRequest.note.author[x]" />
<sliceName value="authorReference" />
<min value="0" />
<max value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
</element>
<element id="ServiceRequest.note.author[x]:authorReference.reference">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.note.author[x].reference" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.note.author[x]:authorReference.identifier">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.note.author[x].identifier" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.note.author[x]:authorReference.identifier.system">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.note.author[x].identifier.system" />
<mustSupport value="true" />
</element>
<element id="ServiceRequest.note.author[x]:authorReference.identifier.value">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="ServiceRequest.note.author[x].identifier.value" />
<mustSupport value="true" />
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"id": "servicerequest-ca-core",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
}
],
"url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/servicerequest-ca-core",
"version": "1.1.0",
"name": "ServiceRequestCACore",
"title": "ServiceRequest (CA-Core)",
"status": "active",
"experimental": false,
"date": "2025-03-06",
"publisher": "Canada Health Infoway",
"contact": [
{
"name": "National Standards Release Centre",
"telecom": [
{
"system": "url",
"value": "http://www.infoway-inforoute.ca"
},
{
"system": "email",
"value": "standards@infoway-inforoute.ca"
}
]
}
],
"description": "This profile applies constraints to the ServiceRequest resource for CA Core+ to support orders and referrals for clinical services in the pan-Canadian context.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "CA"
}
]
}
],
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "ServiceRequest",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "ServiceRequest.extension",
"path": "ServiceRequest.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "ServiceRequest.extension:CopiedParticipants",
"path": "ServiceRequest.extension",
"sliceName": "CopiedParticipants",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/servicerequest-copied-participants"
]
}
]
},
{
"id": "ServiceRequest.extension:PatientPresentLocation",
"path": "ServiceRequest.extension",
"sliceName": "PatientPresentLocation",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/servicerequest-patientPresentLocation"
]
}
]
},
{
"id": "ServiceRequest.extension:RoutingOptions",
"path": "ServiceRequest.extension",
"sliceName": "RoutingOptions",
"min": 0,
"max": "*",
"type": [
{
"code": "Extension",
"profile": [
"http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/routingOptions"
]
}
]
},
{
"id": "ServiceRequest.basedOn.identifier.system",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.basedOn.identifier.system",
"mustSupport": true
},
{
"id": "ServiceRequest.basedOn.identifier.value",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.basedOn.identifier.value",
"mustSupport": true
},
{
"id": "ServiceRequest.category",
"path": "ServiceRequest.category",
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
]
},
{
"id": "ServiceRequest.code",
"path": "ServiceRequest.code",
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"binding": {
"strength": "extensible",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode"
}
},
{
"id": "ServiceRequest.subject",
"path": "ServiceRequest.subject",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core",
"http://hl7.org/fhir/StructureDefinition/Device"
]
}
]
},
{
"id": "ServiceRequest.encounter",
"path": "ServiceRequest.encounter",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/encounter-ca-core"
]
}
]
},
{
"id": "ServiceRequest.performer",
"path": "ServiceRequest.performer",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core",
"http://hl7.org/fhir/StructureDefinition/CareTeam",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/healthcareservice-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
]
},
{
"id": "ServiceRequest.performer.identifier.system",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.performer.identifier.system",
"mustSupport": true
},
{
"id": "ServiceRequest.performer.identifier.value",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.performer.identifier.value",
"mustSupport": true
},
{
"id": "ServiceRequest.locationReference",
"path": "ServiceRequest.locationReference",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core"
]
}
]
},
{
"id": "ServiceRequest.reasonCode",
"path": "ServiceRequest.reasonCode",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode"
}
},
{
"id": "ServiceRequest.supportingInfo.identifier.system",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.supportingInfo.identifier.system",
"mustSupport": true
},
{
"id": "ServiceRequest.supportingInfo.identifier.value",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.supportingInfo.identifier.value",
"mustSupport": true
},
{
"id": "ServiceRequest.note.author[x]",
"path": "ServiceRequest.note.author[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "ServiceRequest.note.author[x]:authorReference",
"path": "ServiceRequest.note.author[x]",
"sliceName": "authorReference",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
]
},
{
"id": "ServiceRequest.note.author[x]:authorReference.reference",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.note.author[x].reference",
"mustSupport": true
},
{
"id": "ServiceRequest.note.author[x]:authorReference.identifier",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.note.author[x].identifier",
"mustSupport": true
},
{
"id": "ServiceRequest.note.author[x]:authorReference.identifier.system",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.note.author[x].identifier.system",
"mustSupport": true
},
{
"id": "ServiceRequest.note.author[x]:authorReference.identifier.value",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "ServiceRequest.note.author[x].identifier.value",
"mustSupport": true
}
]
}
}

Terminology bindings

PathConformanceValueSet
ServiceRequest.codeextensiblehttps://fhir.infoway-inforoute.ca/ValueSet/procedurecode
ServiceRequest.reasonCodepreferredhttps://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode

Additional Terminology Bindings

These bindings may be used in lieu of the primary bindings in the table above.

Mappings to CACDI

The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.

Constraints

The following table lists constraints (from differential).

IG © based on FHIR R4 | Package project:CA-Core
Copyright © 2026 Canada Health Infoway. All rights reserved. Terms of Use & License Agreements. Privacy Policy.
HL7® and FHIR® are the registered trademarks of Health Level Seven International