Referral

idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
textC0..1Narrative
containedC0..*Resource
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
id0..0string
extensionC0..0Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ C1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
instantiatesCanonicalΣ0..0canonical(ActivityDefinition | PlanDefinition)
instantiatesUriΣ0..0uri
basedOnΣ C0..0Reference(CarePlan | MedicationRequest | ServiceRequest)
replacesΣ C0..0Reference(ServiceRequest)
requisitionΣ C0..0Identifier
statusΣ ?!1..1codeBindingPattern
intentΣ ?!1..1codeBindingPattern
categoryΣ1..1CodeableConceptBinding
priorityΣ0..1codeBindingPattern
doNotPerformΣ ?!0..0boolean
id0..0string
extensionC0..0Extension
referenceΣ C0..0string
typeΣ1..1uriBindingFixed Value
id0..0string
extensionC0..0Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ C1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
displayΣ C0..0string
focusΣ C0..0Reference(Resource)
encounterΣ C0..0Reference(Encounter)
authoredOnΣ0..1dateTime
id0..0string
extensionC0..0Extension
referenceΣ C0..1string
typeΣ0..1uriBindingFixed Value
id0..0string
extensionC0..0Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ C1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
displayΣ C0..0string
performerTypeΣ0..0CodeableConcept
id0..0string
extensionC0..0Extension
id0..1string
extensionC0..0Extension
codingΣ C0..0Coding
textΣ1..1string
referenceΣ C0..0Reference
id0..0string
extensionC0..0Extension
id0..1string
extensionC0..0Extension
codingΣ C0..0Coding
textΣ1..1string
referenceΣ C0..0Reference
insuranceC0..0Reference(ClaimResponse | Coverage)
supportingInfo0..0CodeableReference(Resource)
specimenΣ C0..0Reference(Specimen)
bodyStructureΣ C0..0Reference(BodyStructure)
note0..*Annotation
{
"resourceType": "StructureDefinition",
"url": "https://fhir.synapxe.sg/StructureDefinition/profile-referral",
"version": "1.2.0",
"name": "Referral",
"status": "active",
"description": "This resource stores a record of a request by a healthcare provider for a patient to be evaluated or treated by another healthcare professional or specialist. Referrals are made when a patient needs services, expertise, or procedures that are beyond the scope of the referring provider. The referral document typically includes patient information, reason for referral, relevant medical history, and specific questions or concerns to be addressed by the receiving provider.",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "ServiceRequest",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest",
"derivation": "constraint",
"element": [
{
"id": "ServiceRequest.identifier",
"path": "ServiceRequest.identifier",
"min": 1,
"max": "1",
"type": [
{
"code": "Identifier",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-identifier"
]
}
]
},
{
"id": "ServiceRequest.identifier.system",
"path": "ServiceRequest.identifier.system",
"fixedUri": "https://fhir.synapxe.sg/NamingSystem/referral-id"
},
{
"id": "ServiceRequest.instantiatesCanonical",
"path": "ServiceRequest.instantiatesCanonical",
"max": "0"
},
{
"id": "ServiceRequest.instantiatesUri",
"path": "ServiceRequest.instantiatesUri",
"max": "0"
},
{
"id": "ServiceRequest.basedOn",
"path": "ServiceRequest.basedOn",
"max": "0"
},
{
"id": "ServiceRequest.replaces",
"path": "ServiceRequest.replaces",
"max": "0"
},
{
"id": "ServiceRequest.requisition",
"path": "ServiceRequest.requisition",
"max": "0"
},
{
"id": "ServiceRequest.status",
"path": "ServiceRequest.status",
"patternCode": "completed"
},
{
"id": "ServiceRequest.intent",
"path": "ServiceRequest.intent",
"patternCode": "order"
},
{
"id": "ServiceRequest.category",
"path": "ServiceRequest.category",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-codeableconcept"
]
}
],
"binding": {
"strength": "required",
"valueSet": "https://fhir.synapxe.sg/ValueSet/referral-type"
}
},
{
"id": "ServiceRequest.priority",
"path": "ServiceRequest.priority",
"patternCode": "routine"
},
{
"id": "ServiceRequest.doNotPerform",
"path": "ServiceRequest.doNotPerform",
"max": "0"
},
{
"id": "ServiceRequest.code",
"path": "ServiceRequest.code",
"max": "0"
},
{
"id": "ServiceRequest.code.id",
"path": "ServiceRequest.code.id",
"max": "0"
},
{
"id": "ServiceRequest.code.extension",
"path": "ServiceRequest.code.extension",
"max": "0"
},
{
"id": "ServiceRequest.code.concept",
"path": "ServiceRequest.code.concept",
"type": [
{
"code": "CodeableConcept",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-codeableconcept"
]
}
],
"binding": {
"strength": "required",
"valueSet": "https://fhir.synapxe.sg/ValueSet/referral-type"
}
},
{
"id": "ServiceRequest.code.concept.extension",
"path": "ServiceRequest.code.concept.extension",
"max": "0"
},
{
"id": "ServiceRequest.code.concept.coding.system",
"path": "ServiceRequest.code.concept.coding.system",
"fixedUri": "https://fhir.synapxe.sg/CodeSystem/referral-type"
},
{
"id": "ServiceRequest.orderDetail",
"path": "ServiceRequest.orderDetail",
"max": "0"
},
{
"id": "ServiceRequest.quantity[x]",
"path": "ServiceRequest.quantity[x]",
"max": "0"
},
{
"id": "ServiceRequest.subject",
"path": "ServiceRequest.subject",
"type": [
{
"code": "Reference",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-reference-patient"
],
"https://fhir.synapxe.sg/StructureDefinition/profile-patient"
]
}
]
},
{
"id": "ServiceRequest.subject.display",
"path": "ServiceRequest.subject.display",
"max": "0"
},
{
"id": "ServiceRequest.focus",
"path": "ServiceRequest.focus",
"max": "0"
},
{
"id": "ServiceRequest.encounter",
"path": "ServiceRequest.encounter",
"max": "0",
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-encounter"
]
}
]
},
{
"id": "ServiceRequest.occurrence[x]",
"path": "ServiceRequest.occurrence[x]",
"max": "0",
"type": [
{
"code": "dateTime"
}
]
},
{
"id": "ServiceRequest.asNeeded[x]",
"path": "ServiceRequest.asNeeded[x]",
"max": "0"
},
{
"id": "ServiceRequest.requester",
"path": "ServiceRequest.requester",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-practitionerrole",
"https://fhir.synapxe.sg/StructureDefinition/profile-practitioner"
]
}
]
},
{
"id": "ServiceRequest.requester.id",
"path": "ServiceRequest.requester.id",
"max": "0"
},
{
"id": "ServiceRequest.requester.extension",
"path": "ServiceRequest.requester.extension",
"max": "0"
},
{
"id": "ServiceRequest.requester.type",
"path": "ServiceRequest.requester.type",
"fixedUri": "Practitioner"
},
{
"id": "ServiceRequest.requester.identifier.id",
"path": "ServiceRequest.requester.identifier.id",
"max": "0"
},
{
"id": "ServiceRequest.requester.identifier.extension",
"path": "ServiceRequest.requester.identifier.extension",
"max": "0"
},
{
"id": "ServiceRequest.requester.identifier.use",
"path": "ServiceRequest.requester.identifier.use",
"max": "0"
},
{
"id": "ServiceRequest.requester.identifier.type",
"path": "ServiceRequest.requester.identifier.type",
"max": "0"
},
{
"id": "ServiceRequest.requester.identifier.system",
"path": "ServiceRequest.requester.identifier.system",
"min": 1,
"fixedUri": "https://fhir.synapxe.sg/NamingSystem/mcr"
},
{
"id": "ServiceRequest.requester.identifier.value",
"path": "ServiceRequest.requester.identifier.value",
"min": 1
},
{
"id": "ServiceRequest.requester.identifier.period",
"path": "ServiceRequest.requester.identifier.period",
"max": "0"
},
{
"id": "ServiceRequest.requester.identifier.assigner",
"path": "ServiceRequest.requester.identifier.assigner",
"max": "0"
},
{
"id": "ServiceRequest.requester.display",
"path": "ServiceRequest.requester.display",
"max": "0"
},
{
"id": "ServiceRequest.performerType",
"path": "ServiceRequest.performerType",
"max": "0"
},
{
"id": "ServiceRequest.performer",
"path": "ServiceRequest.performer",
"max": "0",
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-practitioner"
]
}
]
},
{
"id": "ServiceRequest.performer.id",
"path": "ServiceRequest.performer.id",
"max": "0"
},
{
"id": "ServiceRequest.performer.extension",
"path": "ServiceRequest.performer.extension",
"max": "0"
},
{
"id": "ServiceRequest.performer.reference",
"path": "ServiceRequest.performer.reference",
"max": "0"
},
{
"id": "ServiceRequest.performer.type",
"path": "ServiceRequest.performer.type",
"min": 1,
"fixedUri": "Practitioner"
},
{
"id": "ServiceRequest.performer.identifier",
"path": "ServiceRequest.performer.identifier",
"min": 1
},
{
"id": "ServiceRequest.performer.identifier.id",
"path": "ServiceRequest.performer.identifier.id",
"max": "0"
},
{
"id": "ServiceRequest.performer.identifier.extension",
"path": "ServiceRequest.performer.identifier.extension",
"max": "0"
},
{
"id": "ServiceRequest.performer.identifier.use",
"path": "ServiceRequest.performer.identifier.use",
"max": "0"
},
{
"id": "ServiceRequest.performer.identifier.type",
"path": "ServiceRequest.performer.identifier.type",
"max": "0"
},
{
"id": "ServiceRequest.performer.identifier.system",
"path": "ServiceRequest.performer.identifier.system",
"min": 1,
"fixedUri": "https://fhir.synapxe.sg/NamingSystem/mcr"
},
{
"id": "ServiceRequest.performer.identifier.value",
"path": "ServiceRequest.performer.identifier.value",
"min": 1
},
{
"id": "ServiceRequest.performer.identifier.period",
"path": "ServiceRequest.performer.identifier.period",
"max": "0"
},
{
"id": "ServiceRequest.performer.identifier.assigner",
"path": "ServiceRequest.performer.identifier.assigner",
"max": "0"
},
{
"id": "ServiceRequest.performer.display",
"path": "ServiceRequest.performer.display",
"max": "0"
},
{
"id": "ServiceRequest.location",
"path": "ServiceRequest.location",
"max": "1"
},
{
"id": "ServiceRequest.location.id",
"path": "ServiceRequest.location.id",
"max": "0"
},
{
"id": "ServiceRequest.location.extension",
"path": "ServiceRequest.location.extension",
"max": "0"
},
{
"id": "ServiceRequest.location.concept",
"path": "ServiceRequest.location.concept",
"short": "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.",
"min": 1
},
{
"id": "ServiceRequest.location.concept.extension",
"path": "ServiceRequest.location.concept.extension",
"max": "0"
},
{
"id": "ServiceRequest.location.concept.coding",
"path": "ServiceRequest.location.concept.coding",
"max": "0"
},
{
"id": "ServiceRequest.location.concept.text",
"path": "ServiceRequest.location.concept.text",
"min": 1
},
{
"id": "ServiceRequest.location.reference",
"path": "ServiceRequest.location.reference",
"max": "0"
},
{
"id": "ServiceRequest.reason.id",
"path": "ServiceRequest.reason.id",
"max": "0"
},
{
"id": "ServiceRequest.reason.extension",
"path": "ServiceRequest.reason.extension",
"max": "0"
},
{
"id": "ServiceRequest.reason.concept",
"path": "ServiceRequest.reason.concept",
"short": "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."
},
{
"id": "ServiceRequest.reason.concept.extension",
"path": "ServiceRequest.reason.concept.extension",
"max": "0"
},
{
"id": "ServiceRequest.reason.concept.coding",
"path": "ServiceRequest.reason.concept.coding",
"max": "0"
},
{
"id": "ServiceRequest.reason.concept.text",
"path": "ServiceRequest.reason.concept.text",
"min": 1
},
{
"id": "ServiceRequest.reason.reference",
"path": "ServiceRequest.reason.reference",
"max": "0"
},
{
"id": "ServiceRequest.insurance",
"path": "ServiceRequest.insurance",
"max": "0"
},
{
"id": "ServiceRequest.supportingInfo",
"path": "ServiceRequest.supportingInfo",
"max": "0"
},
{
"id": "ServiceRequest.specimen",
"path": "ServiceRequest.specimen",
"max": "0"
},
{
"id": "ServiceRequest.bodySite",
"path": "ServiceRequest.bodySite",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.id",
"path": "ServiceRequest.bodySite.id",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.extension",
"path": "ServiceRequest.bodySite.extension",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.coding",
"path": "ServiceRequest.bodySite.coding",
"min": 1,
"max": "1"
},
{
"id": "ServiceRequest.bodySite.coding.id",
"path": "ServiceRequest.bodySite.coding.id",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.coding.extension",
"path": "ServiceRequest.bodySite.coding.extension",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.coding.system",
"path": "ServiceRequest.bodySite.coding.system",
"min": 1
},
{
"id": "ServiceRequest.bodySite.coding.version",
"path": "ServiceRequest.bodySite.coding.version",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.coding.code",
"path": "ServiceRequest.bodySite.coding.code",
"min": 1
},
{
"id": "ServiceRequest.bodySite.coding.display",
"path": "ServiceRequest.bodySite.coding.display",
"min": 1
},
{
"id": "ServiceRequest.bodySite.coding.userSelected",
"path": "ServiceRequest.bodySite.coding.userSelected",
"max": "0"
},
{
"id": "ServiceRequest.bodySite.text",
"path": "ServiceRequest.bodySite.text",
"max": "0"
},
{
"id": "ServiceRequest.bodyStructure",
"path": "ServiceRequest.bodyStructure",
"max": "0"
},
{
"id": "ServiceRequest.note",
"path": "ServiceRequest.note",
"type": [
{
"code": "Annotation",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-annotation"
]
}
]
},
{
"id": "ServiceRequest.patientInstruction",
"path": "ServiceRequest.patientInstruction",
"max": "0"
},
{
"id": "ServiceRequest.relevantHistory",
"path": "ServiceRequest.relevantHistory",
"max": "0",
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-provenance"
],
"contained"
]
}
]
},
{
"id": "ServiceRequest.relevantHistory.id",
"path": "ServiceRequest.relevantHistory.id",
"max": "0"
},
{
"id": "ServiceRequest.relevantHistory.extension",
"path": "ServiceRequest.relevantHistory.extension",
"max": "0"
},
{
"id": "ServiceRequest.relevantHistory.reference",
"path": "ServiceRequest.relevantHistory.reference",
"min": 1
},
{
"id": "ServiceRequest.relevantHistory.type",
"path": "ServiceRequest.relevantHistory.type",
"max": "0"
},
{
"id": "ServiceRequest.relevantHistory.identifier",
"path": "ServiceRequest.relevantHistory.identifier",
"max": "0"
},
{
"id": "ServiceRequest.relevantHistory.display",
"path": "ServiceRequest.relevantHistory.display",
"max": "0"
}
]
}
}
ServiceRequest
ShortA request for a service to be performed
Definition

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

Cardinality0..*
Aliasdiagnostic request, referral, referral request, transfer of care request
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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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()
  • bdystr-1: bodyStructure SHALL only be present if bodySite is not present
    bodySite.exists() implies bodyStructure.empty()
  • prr-1: orderDetail SHALL only be present if code is present
    orderDetail.empty() or code.exists()
Mappings
  • rim: n/a
  • rim: Entity. Role, or Act
  • rim: Entity, Role, or Act
  • workflow: Request
  • w5: clinical.general
  • v2: ORC
  • rim: Act[moodCode<=INT]
ServiceRequest.id
ShortLogical 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.

Cardinality0..1
Typeid
SummaryTrue
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.meta
ShortMetadata 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.

Cardinality0..1
TypeMeta
SummaryTrue
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
ServiceRequest.implicitRules
ShortA 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.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
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 its narrative along with other profiles, value sets, etc.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

IETF language tag for a human language

AllLanguages (required)

Additional bindings
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).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.text
ShortText summary of the resource, for human interpretation
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.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have a 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: dom-6
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?
ServiceRequest.contained
ShortContained, inline Resources
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

ConditionsThe cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5
Mappings
  • rim: n/a
  • rim: Entity. Role, or Act
  • rim: N/A
ServiceRequest.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.modifierExtension
ShortExtensions that cannot be ignored
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 managable, 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
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
ServiceRequest.identifier.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.identifier.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

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
ServiceRequest.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
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.

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
ServiceRequest.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/referral-id
ExamplesGeneral
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
ServiceRequest.identifier.value
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
ServiceRequest.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
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.

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 or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
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
ServiceRequest.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.instantiatesCanonical
ShortInstantiates 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.

Cardinality0..0
Typecanonical(ActivityDefinition | PlanDefinition)
SummaryTrue
Comments

The PlanDefinition resource is used to describe series, sequences, or groups of actions to be taken, while the ActivityDefinition resource is used to define each specific step or activity to be performed. More information can be found in the Boundaries and Relationships section for PlanDefinition.

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
ServiceRequest.instantiatesUri
ShortInstantiates 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.

Cardinality0..0
Typeuri
SummaryTrue
Comments

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

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
ServiceRequest.basedOn
ShortWhat request fulfills
Definition

Plan/proposal/order fulfilled by this request.

Cardinality0..0
TypeReference(CarePlan | MedicationRequest | ServiceRequest)
SummaryTrue
Aliasfulfills
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.replaces
ShortWhat request replaces
Definition

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

Cardinality0..0
TypeReference(ServiceRequest)
SummaryTrue
Aliassupersedes, prior, renewed order
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.requisition
ShortComposite Request ID
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.

Cardinality0..0
TypeIdentifier
SummaryTrue
AliasgrouperId, groupIdentifier
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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
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
ServiceRequest.status
Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
Definition

The status of the order.

Cardinality1..1
Typecode
Binding

The status of a service order.

RequestStatus (required)

ModifierTrue
SummaryTrue
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, revoked or placed on-hold. 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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
completed
Mappings
  • rim: n/a
  • workflow: Request.status
  • w5: FiveWs.status
  • v2: ORC-5,RF1-1
  • rim: .status
  • quick: Action.currentStatus
ServiceRequest.intent
Shortproposal | plan | directive | order +
Definition

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

Cardinality1..1
Typecode
Binding

The kind of service request.

RequestIntent (required)

ModifierTrue
SummaryTrue
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
order
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)
ServiceRequest.category
ShortConcept - 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.

Cardinality1..1
TypeCodeableConcept
Binding

Classification of the requested service.

ReferralTypeValueSet (required)

SummaryTrue
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.

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
ServiceRequest.priority
Shortroutine | urgent | asap | stat
Definition

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

Cardinality0..1
Typecode
Binding

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

RequestPriority (required)

SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

Meaning when missing

If missing, this task should be performed with normal priority

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Pattern
routine
Mappings
  • rim: n/a
  • workflow: Request.priority
  • w5: FiveWs.grade
  • v2: TQ1.9, RF1-2
  • rim: .priorityCode
ServiceRequest.doNotPerform
ShortTrue 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.

Cardinality0..0
Typeboolean
ModifierTrue
SummaryTrue
Requirements

Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

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"

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
ServiceRequest.code
ShortWhat is being requested/ordered
Definition

A code or reference that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

Cardinality0..0
TypeCodeableReference(ActivityDefinition | PlanDefinition)
Binding

Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.

ProcedureCodesSNOMEDCT (example)

SummaryTrue
Aliasservice requested
Comments

Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

ConditionsThe cardinality or value of this element may be affected by these constraints: prr-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.code
  • w5: FiveWs.what[x]
  • v2: PR1-3 / OBR-4 (varies by domain)
  • rim: .code
  • quick: Procedure.procedureCode
ServiceRequest.code.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.code.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.code.concept
ShortConcept - 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.

Cardinality0..1
TypeCodeableConcept
Binding

ReferralTypeValueSet (required)

SummaryTrue
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.

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
  • rim: N/A
ServiceRequest.code.concept.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.code.concept.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.code.concept.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality1..*
TypeCoding
SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.code.concept.coding.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.code.concept.coding.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.code.concept.coding.system
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/CodeSystem/referral-type
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.code.concept.coding.version
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
ServiceRequest.code.concept.coding.code
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

ConditionsThe cardinality or value of this element may be affected by these constraints: cod-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
ServiceRequest.code.concept.coding.display
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality1..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

ConditionsThe cardinality or value of this element may be affected by these constraints: cod-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
ServiceRequest.code.concept.coding.userSelected
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
ServiceRequest.code.concept.text
ShortPlain text representation of the concept
Definition

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.

Cardinality0..0
Typestring
SummaryTrue
Requirements

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.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.code.reference
ShortReference to a resource (by instance)
Definition

A reference to a resource the provides exact details about the information being referenced.

Cardinality0..1
TypeReference
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: N/A
ServiceRequest.orderDetail
ShortAdditional order information
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.

Cardinality0..0
TypeBackboneElement
SummaryTrue
Aliasdetailed instructions
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: 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: NTE
ServiceRequest.orderDetail.id
ShortUnique 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.

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.orderDetail.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.orderDetail.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 managable, 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. 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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
ServiceRequest.orderDetail.parameterFocus
ShortThe context of the order details by reference
Definition

Indicates the context of the order details by reference.

Cardinality0..1
TypeCodeableReference(BiologicallyDerivedProduct | Device | DeviceDefinition | DeviceRequest | Medication | MedicationRequest | Substance | SupplyRequest)
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.orderDetail.parameter
ShortThe parameter details for the service being requested
Definition

The parameter details for the service being requested.

Cardinality1..*
TypeBackboneElement
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.orderDetail.parameter.id
ShortUnique 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.

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.orderDetail.parameter.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.orderDetail.parameter.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 managable, 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. 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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
ServiceRequest.orderDetail.parameter.code
ShortThe detail of the order being requested
Definition

A value representing the additional detail or instructions for the order (e.g., catheter insertion, body elevation, descriptive device configuration and/or setting instructions).

Cardinality1..1
TypeCodeableConcept
Binding

Codes for order detail parameters.

ServiceRequestOrderDetailParameterCode (example)

SummaryTrue
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.

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
ServiceRequest.orderDetail.parameter.value[x]
ShortThe value for the order detail
Definition

Indicates a value for the order detail.

Cardinality1..1
Typeboolean | CodeableConcept | Period | Quantity | Range | Ratio | string
SummaryTrue
Comments

CodeableConcept values are indented to express concepts that would normally be coded - when a code is not available for a concept, CodeableConcept.text can be used. When the data is a text or not a single identifiable concept, string should be used.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.quantity[x]
ShortService 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).

Cardinality0..0
TypeQuantity | Range | Ratio
SummaryTrue
Requirements

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

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
ServiceRequest.subject
ShortA reference from one resource to another
Definition

A reference from one resource to another.

Cardinality1..1
TypeReference(Patient)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.subject.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.subject.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.subject.reference
ShortLiteral 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.

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, 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
ServiceRequest.subject.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
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).

Cardinality1..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
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 known RESTful URL) or by resolving the target of the reference.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
Patient
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.subject.identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
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
ServiceRequest.subject.identifier.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.subject.identifier.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.subject.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

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
ServiceRequest.subject.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
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.

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
ServiceRequest.subject.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/nric
ExamplesGeneral
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
ServiceRequest.subject.identifier.value
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
ServiceRequest.subject.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
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.

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 or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
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
ServiceRequest.subject.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.subject.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
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
ServiceRequest.focus
ShortWhat the service request is about, when it is not about the subject of record
Definition

The actual focus of a service request when it is not the subject of record representing something or someone associated with the subject such as a spouse, parent, fetus, or donor. The focus of a service request could also be an existing condition, an intervention, the subject's diet, another service request on the subject, or a body structure such as tumor or implanted device.

Cardinality0..0
TypeReference(Resource)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.subject[x]
  • rim: participation[typeCode=SBJ]
ServiceRequest.encounter
ShortEncounter in which the request was created
Definition

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

Cardinality0..0
TypeReference(Encounter)
SummaryTrue
Aliascontext
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.occurrence[x]
ShortWhen service should occur
Definition

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

Cardinality0..0
TypedateTime
SummaryTrue
Aliasschedule
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
ServiceRequest.asNeeded[x]
ShortPreconditions for service
Definition

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

Cardinality0..0
Typeboolean | CodeableConcept
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)

SummaryTrue
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
ServiceRequest.authoredOn
ShortDate request signed
Definition

When the request transitioned to being actionable.

Cardinality0..1
TypedateTime
SummaryTrue
AliasorderedOn
Comments

UTC offset is allowed for dates and partial dates

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
ServiceRequest.requester
ShortWho/what is requesting service
Definition

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

Cardinality1..1
TypeReference(Practitioner | PractitionerRole)
SummaryTrue
Aliasauthor, orderer
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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.requester.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.requester.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.requester.reference
ShortLiteral 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.

Cardinality0..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, 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
ServiceRequest.requester.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
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).

Cardinality0..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
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 known RESTful URL) or by resolving the target of the reference.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
Practitioner
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.requester.identifier
ShortLogical 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.

Cardinality0..1
TypeIdentifier
SummaryTrue
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).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
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
ServiceRequest.requester.identifier.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.requester.identifier.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.requester.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

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
ServiceRequest.requester.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
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.

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
ServiceRequest.requester.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/mcr
ExamplesGeneral
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
ServiceRequest.requester.identifier.value
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
ServiceRequest.requester.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
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.

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 or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
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
ServiceRequest.requester.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.requester.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
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
ServiceRequest.performerType
ShortPerformer role
Definition

Desired type of performer for doing the requested service.

Cardinality0..0
TypeCodeableConcept
Binding

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

ParticipantRoles (example)

SummaryTrue
Aliasspecialty
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”.

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, RF1-3
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
ServiceRequest.performer
ShortRequested performer
Definition

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

Cardinality0..0
TypeReference(Practitioner)
SummaryTrue
Aliasrequest recipient
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 http://hl7.org/fhir/StructureDefinition/request-performerOrder. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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]
ServiceRequest.performer.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.performer.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.performer.reference
ShortLiteral 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.

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, 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
ServiceRequest.performer.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
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).

Cardinality1..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
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 known RESTful URL) or by resolving the target of the reference.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
Practitioner
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.performer.identifier
ShortLogical 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.

Cardinality1..1
TypeIdentifier
SummaryTrue
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).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
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
ServiceRequest.performer.identifier.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.performer.identifier.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.performer.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
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.

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
ServiceRequest.performer.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
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.

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
ServiceRequest.performer.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/mcr
ExamplesGeneral
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
ServiceRequest.performer.identifier.value
ShortThe 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.

Cardinality1..1
Typestring
SummaryTrue
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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
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
ServiceRequest.performer.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
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.

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 or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
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
ServiceRequest.performer.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.performer.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
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
ServiceRequest.location
ShortRequested 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.

Cardinality0..1
TypeCodeableReference(Location)
Binding

A location type where services are delivered.

http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType (example)

SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=KIND].code
ServiceRequest.location.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.location.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.location.concept
ShortConcept - 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.

Cardinality1..1
TypeCodeableConcept
SummaryTrue
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.

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
  • rim: N/A
ServiceRequest.location.concept.id
ShortUnique 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.

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.location.concept.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.location.concept.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..0
TypeCoding
SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.location.concept.text
ShortPlain text representation of the concept
Definition

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.

Cardinality1..1
Typestring
SummaryTrue
Requirements

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.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.location.reference
ShortReference to a resource (by instance)
Definition

A reference to a resource the provides exact details about the information being referenced.

Cardinality0..0
TypeReference
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: N/A
ServiceRequest.reason
ShortExplanation/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.

Cardinality0..*
TypeCodeableReference(Condition | DetectedIssue | DiagnosticReport | DocumentReference | Observation)
Binding

SNOMED CT Condition/Problem/Diagnosis Codes

ProcedureReasonCodes (example)

SummaryTrue
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, use concept.text element if the data is free (uncoded) text as shown in the CT Scan example.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.reason
  • w5: FiveWs.why[x]
  • v2: ORC-16, RF1-10
  • rim: .reasonCode
ServiceRequest.reason.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.reason.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.reason.concept
ShortConcept - 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.

Cardinality0..1
TypeCodeableConcept
SummaryTrue
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.

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
  • rim: N/A
ServiceRequest.reason.concept.id
ShortUnique 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.

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.reason.concept.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.reason.concept.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..0
TypeCoding
SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.reason.concept.text
ShortPlain text representation of the concept
Definition

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.

Cardinality1..1
Typestring
SummaryTrue
Requirements

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.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.reason.reference
ShortReference to a resource (by instance)
Definition

A reference to a resource the provides exact details about the information being referenced.

Cardinality0..0
TypeReference
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: N/A
ServiceRequest.insurance
ShortAssociated insurance coverage
Definition

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

Cardinality0..0
TypeReference(ClaimResponse | Coverage)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.supportingInfo
ShortAdditional clinical information
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.

Cardinality0..0
TypeCodeableReference(Resource)
AliasAsk at order entry question, AOE
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.supportingInfo
  • v2: Accompanying segments
  • rim: .outboundRelationship[typeCode=PERT].target
ServiceRequest.specimen
ShortProcedure Samples
Definition

One or more specimens that the laboratory procedure will use.

Cardinality0..0
TypeReference(Specimen)
SummaryTrue
Comments

The purpose of the ServiceRequest.specimen is to reflect the actual specimen that the requested test/procedure is asked to be performed on, whether the lab already has it or not. References to specimens for purposes other than to perform a test/procedure on should be made using the ServiceRequest.supportingInfo or the Specimen.parent where the Specimen.parent would enable descendency and ServiceRequest.supportingInfo a general reference for context.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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
ServiceRequest.bodySite
ShortCoded location on Body
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

SNOMED CT Body site concepts

SNOMEDCTBodyStructures (example)

SummaryTrue
Aliaslocation
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 http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure.

ConditionsThe cardinality or value of this element may be affected by these constraints: bdystr-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
ServiceRequest.bodySite.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.bodySite.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.bodySite.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality1..1
TypeCoding
SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cod-1: A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text
    code.exists().not() implies display.exists().not()
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.bodySite.coding.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.bodySite.coding.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.bodySite.coding.system
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.bodySite.coding.version
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
ServiceRequest.bodySite.coding.code
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

ConditionsThe cardinality or value of this element may be affected by these constraints: cod-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
ServiceRequest.bodySite.coding.display
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality1..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

ConditionsThe cardinality or value of this element may be affected by these constraints: cod-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
ServiceRequest.bodySite.coding.userSelected
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
ServiceRequest.bodySite.text
ShortPlain text representation of the concept
Definition

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.

Cardinality0..0
Typestring
SummaryTrue
Requirements

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.

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.bodyStructure
ShortBodyStructure-based location on the body
Definition

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

Cardinality0..0
TypeReference(BodyStructure)
SummaryTrue
AliaslocationStructure
Requirements

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

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

ConditionsThe cardinality or value of this element may be affected by these constraints: bdystr-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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SPM
  • rim: targetSiteCode
  • quick: Procedure.targetBodyStructure
ServiceRequest.note
ShortText node with attribution
Definition

A text note which also contains information about who made the statement and when.

Cardinality0..*
TypeAnnotation
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).

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
ServiceRequest.patientInstruction
ShortPatient or consumer-oriented instructions
Definition

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

Cardinality0..0
TypeBackboneElement
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
ServiceRequest.patientInstruction.id
ShortUnique 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.

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.patientInstruction.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.patientInstruction.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 managable, 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. 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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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
ServiceRequest.patientInstruction.instruction[x]
ShortPatient or consumer-oriented instructions
Definition

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

Cardinality0..1
Typemarkdown | Reference(DocumentReference)
SummaryTrue
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
ServiceRequest.relevantHistory
ShortRequest provenance
Definition

Key events in the history of the request.

Cardinality0..0
TypeReference(Provenance)
Comments

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

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))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
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]
ServiceRequest.relevantHistory.id
ShortUnique 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.

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
ServiceRequest.relevantHistory.extension
ShortAdditional content defined by implementations
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 managable, 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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

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
ServiceRequest.relevantHistory.reference
ShortLiteral 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.

Cardinality1..1
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, 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
ServiceRequest.relevantHistory.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
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).

Cardinality0..0
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
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 known RESTful URL) or by resolving the target of the reference.

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
ServiceRequest.relevantHistory.identifier
ShortLogical 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.

Cardinality0..0
TypeIdentifier
SummaryTrue
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).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
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
ServiceRequest.relevantHistory.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
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

Terminology Bindings

PathBinding StrengthValue Set (Code System)Description
ServiceRequest.languagerequiredhttp://hl7.org/fhir/ValueSet/all-languages|5.0.0

IETF language tag for a human language

ServiceRequest.statusrequiredhttp://hl7.org/fhir/ValueSet/request-status|5.0.0

The status of a service order.

ServiceRequest.intentrequiredhttp://hl7.org/fhir/ValueSet/request-intent|5.0.0

The kind of service request.

ServiceRequest.categoryrequiredhttps://fhir.synapxe.sg/ValueSet/referral-type

Classification of the requested service.

ServiceRequest.priorityrequiredhttp://hl7.org/fhir/ValueSet/request-priority|5.0.0

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

ServiceRequest.code.conceptrequiredhttps://fhir.synapxe.sg/ValueSet/referral-type
ServiceRequest.orderDetail.parameter.codeexamplehttp://hl7.org/fhir/ValueSet/servicerequest-orderdetail-parameter-code

Codes for order detail parameters.

ServiceRequest.subject.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

ServiceRequest.requester.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

ServiceRequest.performer.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

ServiceRequest.locationexamplehttp://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType

A location type where services are delivered.

ServiceRequest.reasonexamplehttp://hl7.org/fhir/ValueSet/procedure-reason

SNOMED CT Condition/Problem/Diagnosis Codes

Constraints