Profile: ServiceRequest

AB:eReC Simplifier Project Page: ServiceRequest (AB:eReC)

Derived from CA:eReC ServiceRequest

Views of Profile Content

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metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
PatientPresentLocationI0..*Extension(Reference(Location))
DARCI0..*Extension(Complex)
DARTI0..*Extension(Complex)
RoutingOptionsI0..*Extension(CodeableConcept)
CopiedParticipantsI0..*Extension(Reference(PractitionerRole))
ServiceProviderPreferenceI0..*Extension(Complex)
referralTimestampS I0..*Extension(Complex)
patientPreferenceS I0..*Extension(Complex)
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
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statusS Σ ?!1..1codeBinding
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categoryS Σ1..*CodeableConceptBinding
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orderDetailΣ I0..*CodeableConcept
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PerformerIdentifierI0..1Extension(Identifier)
referenceS Σ I0..1string
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PatientPresentLocationI0..*Extension(Reference(Location))
DARCI0..*Extension(Complex)
DARTI0..*Extension(Complex)
RoutingOptionsI0..*Extension(CodeableConcept)
CopiedParticipantsI0..*Extension(Reference(PractitionerRole))
ServiceProviderPreferenceI0..*Extension(Complex)
referralTimestampS I0..*Extension(Complex)
patientPreferenceS I0..*Extension(Complex)
modifierExtension?! I0..*Extension
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systemS Σ1..1uri
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systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
encounterΣ0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrencePeriodPeriod
occurrenceTimingTiming
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
authoredOnS Σ1..1dateTime
id0..1string
ServiceRequesterDelegateI0..1Extension(Complex)
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
performerTypeΣ0..1CodeableConcept
id0..1string
PerformerIdentifierI0..1Extension(Identifier)
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
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systemS Σ1..1uri
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periodΣ0..1Period
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displayΣ0..1string
locationCodeΣ0..*CodeableConcept
locationReferenceΣ0..*Reference(Location)
id0..1string
extensionI0..*Extension
codingΣ0..*Coding
textS Σ1..1string
reasonReferenceΣ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)
insurance0..*Reference(Coverage | ClaimResponse)
id0..1string
extensionI0..*Extension
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
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systemS Σ1..1uri
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assignerΣ0..1Reference(Organization)
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specimenΣ0..*Reference(Specimen)
bodySiteΣ0..*CodeableConcept
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extensionI0..*Extension
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extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
timeΣ0..1dateTime
textΣ1..1markdown
patientInstructionΣ0..1string
relevantHistory0..*Reference(Provenance)
idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
PatientPresentLocationI0..*Extension(Reference(Location))
DARCI0..*Extension(Complex)
DARTI0..*Extension(Complex)
RoutingOptionsI0..*Extension(CodeableConcept)
CopiedParticipantsI0..*Extension(Reference(PractitionerRole))
ServiceProviderPreferenceI0..*Extension(Complex)
referralTimestampS I0..*Extension(Complex)
patientPreferenceS I0..*Extension(Complex)
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | PlanDefinition)
instantiatesUriΣ0..*uri
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extensionI0..*Extension
referenceS Σ I0..1string
typeΣ0..1uriBinding
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systemS Σ1..1uri
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assignerΣ0..1Reference(Organization)
displayΣ0..1string
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extensionI0..*Extension
referenceS Σ I0..1string
typeΣ0..1uriBinding
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extensionI0..*Extension
useΣ ?!0..1codeBinding
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systemS Σ1..1uri
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periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
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extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
statusS Σ ?!1..1codeBinding
intentS Σ ?!1..1codeBindingFixed Value
categoryS Σ1..*CodeableConceptBinding
priorityΣ0..1codeBinding
doNotPerformΣ ?!0..1boolean
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ1..1uri
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
orderDetailΣ I0..*CodeableConcept
quantityQuantityQuantity
quantityRatioRatio
quantityRangeRange
id0..1string
extensionI0..*Extension
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
encounterΣ0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrencePeriodPeriod
occurrenceTimingTiming
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
authoredOnS Σ1..1dateTime
id0..1string
ServiceRequesterDelegateI0..1Extension(Complex)
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
performerTypeΣ0..1CodeableConcept
id0..1string
PerformerIdentifierI0..1Extension(Identifier)
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
locationCodeΣ0..*CodeableConcept
locationReferenceΣ0..*Reference(Location)
id0..1string
extensionI0..*Extension
codingΣ0..*Coding
textS Σ1..1string
reasonReferenceΣ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)
insurance0..*Reference(Coverage | ClaimResponse)
id0..1string
extensionI0..*Extension
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
specimenΣ0..*Reference(Specimen)
bodySiteΣ0..*CodeableConcept
id0..1string
extensionI0..*Extension
authorStringstring
id0..1string
extensionI0..*Extension
referenceS Σ I0..1string
typeΣ0..1uriBinding
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
timeΣ0..1dateTime
textΣ1..1markdown
patientInstructionΣ0..1string
relevantHistory0..*Reference(Provenance)

Restrictions

Alberta eReferral and eConsult (AB:eReC) employs a set of constraints on the Bundle (AB:eReC) Profile that prevents referrals and consults created in Alberta to include certain elements from ServiceRequest.

ServiceRequest records sent in an AB:eReC Bundle SHALL NOT contain any of the following ServiceRequest details:

  • .contained
  • .replaces
  • .encounter
  • .reasonReference
  • .insurance
  • .specimen
  • .relevantHistory

These elements are restricted based on current privacy requirements that require data that is collected, used or disclosed be limited to only the amount of health information that is essential to enable the custodian or the recipient of the information to carry out the intended purpose.

Usage

Information about a healthcare provider's request for a service to be performed for a patient.

The ServiceRequest resource contains the key information about a service being requested (such as eReferral or eConsult), who requested it, which patient it's for, who is assigned to perform, and the nature of the service being requested.

Notes

.id

  • TESTED element
  • an identifier for the ServiceRequest resource, unique within the submitted bundle
  • if a persistent identity for the resource is not available to use when constructing a Bundle for transmission, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)

.meta

  • TESTED element
  • metadata about the ServiceRequest resource, relevant to the submission or data exchange.
  • .lastUpdated
    • TESTED element
    • the date and time when the service request` was last updated, spanning all contained resources and data elements
    • contains the create-date for a new request, or the date when it was most recently updated by the referring provider or by any workflow participant authorized to create or change the request

.identifier

  • TESTED element
  • one or more version-independent identifiers for the ServiceRequest resource
  • different participants may each assign their own identifier (e.g., referring provider or service provider)
  • SHALL always be populated
  • EMR
    • the submitting EMR SHALL assign its own identifier prior to submission to facilitate matching the provincially-assigned identifier to its own records
    • SHALL use UUID for .value and SHALL use "urn:ietf:rfc:3986" for .system
  • Central Access & Triage (CAT)
    • when CAT receives a submitted referral, it will assign the eReferral provincial identifier that will be sent back to the submitting EMR (along with the initially submitted identifier)
    • EMRs SHOULD just use the eReferral provincial identifier from that point forward - as that ensures traceability to/from the specialist EMR as well
    • SHALL use URI from Service Identifier Naming System for .system
  • .use
    • TESTED element
    • the purpose of the identifier
    • SHALL always be populated with "official" for CAT assigned/eReferral provincial identifier
  • .system
    • TESTED element
    • the namespace / naming system used for this service request identifier
    • SHALL always be populated
  • .value
    • TESTED element
    • the value of the assigned service request identifier
    • SHALL always be populated

.basedOn

  • CONDITIONALLY TESTED element
  • links this particular ServiceRequest to another existing ServiceRequest, when both are explicitly linked
  • if an identifier is previously known to both systems, .identifier SHALL be populated and used for reference to minimize the amount of detail required from submitting systems
  • otherwise .reference SHALL be used
    • the referenced resource SHALL be included in the Bundle.entry
    • SHALL be the UUID in the Bundle.entry.fullURL of the referenced resource

.status

  • TESTED element
  • the workflow state of the service request
  • SHALL always be populated
  • a nationally-defined set of standard workflow status values cannot be modified or extended with additonal values. More granular workflow states are captured in Task.businessStatus
  • is used primarily to indicate whether the request is active or not
  • for referrals and eConsult requests, will be set to "active" when submitted and will remain in that state until "completed" or 'revoked'

.intent

  • TESTED element
  • the intention and authorization underlying the service request, indicating how it should be received and acted upon
  • SHALL always be populated with fixed value of "proposal"
  • a nationally-defined set of standard values cannot be modified or extended. The value of "proposal" is standard for referral and eConsult requests

.category

  • TESTED element
  • A coded value that represents the specialty being requested for the referral or eConsult
  • same value as the HealthcareService.specialty
  • SHALL always be populated
  • value SHALL match a code in the associated value set, otherwise, the service request will be rejected

.priority

  • TESTED element
  • the priority with which the service request should be addressed with respect to other requests
  • SHOULD default to "routine" in source / submitting systems
  • "urgent" is accepted if the source system has some mechanism to prompt or instruct parallel use of urgent referral pathways (e.g. RAAPID, etc.).
  • "asap" and "stat" are not supported for electronic referrals or eConsults

.code

  • TESTED element
  • a code or text description identifying the type of service being requested
  • expected to be populated from the provincially published list of "Reason for Referral" (RFRs) codes, that are eligible for electronic submissions
  • NOTE the codes provided in the bound value set do not constitute the full list, only a few examples
  • SHALL always be populated
    • .coding
      • TESTED element
      • .code
        • TESTED element
        • a codified value that represents the type of service being requested
        • SHALL always be populated
      • .system
        • TESTED element
        • the terminology system used by the code
        • SHALL always be populated
    • .text
      • TESTED element
      • the name or textual description of the type of service being requested
      • SHOULD be populated with the published text from Alberta Health to EMRs, accompanying the allowed codes

.orderDetail

  • CONDITIONALLY TESTED element
  • for eConsults, contains the question(s) explaining the advice being sought
  • if populated, only .text SHALL be used

.subject

  • TESTED element
  • a reference to the Patient resource of the submitted service request, specifying that the patient is the subject of the requested service
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated subject (patient) resource within the submission bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the subject's information
  • .identifier
    • TESTED element
    • .system
      • TESTED element
      • if .identifier is populated, this SHALL always be populated
    • .value
      • TESTED element
      • if .identifier is populated, this SHALL always be populated
  • the Patient resource SHALL be included on any new ServiceRequest, but can be referenced through the patient's provicial identifier (without needing to include the Patient resource in the Bundle) on subsequent updates to the ServiceRequest or when the ServiceRequest is otherwise included in the Bundle
  • if an identifier is previously known to both systems, .identifier SHALL be populated and used for reference to minimize the amount of detail required from submitting systems
  • otherwise .reference SHALL be used
    • the referenced resource SHALL be included in the Bundle.entry
    • SHALL be the UUID in the Bundle.entry.fullURL of the referenced resource

.authoredOn

  • TESTED element
  • the date and time when the service request was created from the source system's information and submitted for action

.requester

  • TESTED element
  • a reference to the PractitionerRole resource for the provider requesting the service, specifying the requesting healthcare provider's role, services, and location for the purpose of this service request
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated healthcare provider role resource within the submission Bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the requester's information

.performer

  • TESTED element
  • a reference to the resource of the performer requested to fulfill the service
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated resource within the submission bundle
  • type
    • TESTED element
    • identifies the type of FHIR resource used to convey the requested performer's information
  • .identifier
    • TESTED element
    • .system
      • TESTED element
      • the namespace / naming system used for this service request identifier
      • if .identifier is populated, this SHALL always be populated
    • .value
      • TESTED element
      • the value of the assigned service request identifier
      • if .identifier is populated, this SHALL always be populated
  • when performer is CAT (HealthcareService), if an identifier is previously known to both systems, .identifier SHALL be populated and used for reference to minimize the amount of detail required from submitting systems
  • otherwise .reference SHALL be used
    • the referenced resource SHALL be included in the Bundle.entry
    • SHALL be the UUID in the Bundle.entry.fullURL of the referenced resource
  • when performer is CAT, a valid HealthcareService.identifier SHALL be provided, otherwise the service request will be rejected

.reasonCode

  • TESTED element
  • the requesting provider's rationale for requesting the service
  • SHALL always be populated
  • .text
    • TESTED element
    • a text description of the requesting provider's rationale for requesting the service; or additional information about why advice is being sought for an eConsult
    • SHALL always be populated

.supportingInfo

  • TESTED element
  • one or more attached files ("Documents") containing the referral letter and any supporting investigations (e.g. lab/DI results) that supports the service request
  • depending on source system capabilities, all information MAY be bundled into a single attached file vs separate attachments for each (letter, test result, etc.)
  • every referral SHOULD have at least one attached document for the referral letter - as not all required information can be captured through discrete elements in electronic referrals
  • a Communication resource SHALL be used when the information is captured only as "notes" content rather than a file attachment in which case DocumentReference SHALL be used
  • .reference
    • TESTED element
    • a reference to the associated document or other allowed resource within the submission bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the supporting information
  • .identifier
    • TESTED element
    • .system
      • TESTED element
      • the namespace / naming system used for supporting information identifier
      • if .identifier is populated, this SHALL always be populated
    • .value
      • TESTED element
      • the value of the assigned supporting information identifier
      • if .identifier is populated, this SHALL always be populated
  • when supporting information is DocumentReference, if an identifier is previously known to both systems, .identifier SHALL be populated and used for reference to minimize the amount of detail required from submitting systems
  • otherwise .reference SHALL be used
    • the referenced resource SHALL be included in the Bundle.entry
    • SHALL be the UUID in the Bundle.entry.fullURL of the referenced resource

.bodySite

  • TESTED element
  • a code or text description identifying the target anatomic location for the requested service
  • captured if available in the source system, and if relevant for the requested service (e.g. joint or body location for an orthopedic procedure)
  • if valued, only .text SHALL be used

.note

  • TESTED element
  • notes and comments about the service request
  • used for special considerations relevant to the referral (e.g., patient's physical, psychological, social and/or economic situation)
  • this information will appear in Netcare as part of the referral record
  • .text
    • TESTED element
    • additional information about the service request that the requesting provider chooses to include

Extensions

.referralTimestamp

  • CONDITIONALLY TESTED element
  • zero or more timestamps of interest during the referral workflow
  • approppriate timestamp SHALL be populated when the corresponding event has taken place (e.g. when CAT has received the referral)
  • if populated,
    • timestamp
      • CONDITIONALLY TESTED element
      • the date and time of the referral activity
      • SHALL always be populated
    • timestampType
      • CONDITIONALLY TESTED element
      • identifies the type of referral activity associated with the date and time (e.g., referral received)
      • SHALL always be populated

.patientPreference

  • CONDITIONALLY TESTED element
  • zero or more patient preferences
  • SHALL only be populated if patient prefers a provider or location other than "next available"
  • if populated,
    • preferenceType
      • CONDITIONALLY TESTED element
      • identifies the type of preference being expressed (e.g., preferred, excluded, etc.)
      • SHALL always be populated
    • preferenceValueType
      • CONDITIONALLY TESTED element
      • Identifies what is being preferred (e.g., provider, location, etc.)
      • SHALL always be populated
    • preferenceValue
      • CONDITIONALLY TESTED element
      • the patient's expressed preference
      • SHALL always be populated
    • rationale
      • CONDITIONALLY TESTED element
      • the patient's expressed reason for the preference
      • SHOULD be provided

Unused if submitted

  • .requisition
  • .doNotPerform
  • .quantity
  • .subject.display
  • .occurence
  • .asNeeded
  • .performerType
  • .locationCode
  • .locationReference