MII IG Molekulares Tumorboard DE v2025

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

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.

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.

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.

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.

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

Plan/proposal/order fulfilled by this request.

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

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.

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

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.

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

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

The kind of service request.

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

Used for filtering what service request are retrieved and displayed.

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

Classification of the requested service.

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

If missing, this task should be performed with normal priority

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

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

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.

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.

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

A reference to a code defined by a terminology system.

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

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

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

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

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

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.

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

Codified order entry details which are based on order context.

A reference from one resource to another.

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.

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

When the request transitioned to being actionable.

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

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.

Desired type of performer for doing the requested service.

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”.

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

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

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).

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.

A location type where services are delivered.

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

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

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.

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

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.

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

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

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

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.

Codes describing anatomical locations. May include laterality.

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

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

Key events in the history of the request.

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.