FHIR Artifacts > Structure Definition: ServiceRequest Profile
Structure Definition: ServiceRequest Profile
Canonical URL:http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest
Simplifier project page: ServiceRequest
Derived from: ServiceRequest (R4)
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work
Differential View
ServiceRequest | I | ServiceRequest | There are no (further) constraints on this element Element IdServiceRequest A request for a service to be performed Alternate namesdiagnostic request, referral, referral request, transfer of care request DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
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meta | S Σ | 1..1 | Meta | There are no (further) constraints on this element Element IdServiceRequest.meta Metadata about the resource DefinitionThe 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.
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element IdServiceRequest.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element IdServiceRequest.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
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profile | S Σ | 1..* | canonical(StructureDefinition) | Element IdServiceRequest.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdServiceRequest.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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extension | I | 0..* | Extension | Element IdServiceRequest.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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PatientPresentLocation | S I | 0..1 | Extension(Reference(Location)) | Element IdServiceRequest.extension:PatientPresentLocation Optional Extensions Element Alternate namesextensions, user content DefinitionUsed to communicate the present location of the patient if it is different than the patient's home address. 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. Extension(Reference(Location)) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location
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value[x] | S | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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valueReference | Reference(Location) | There are no (further) constraints on this element Data Type | ||
RoutingOptions | S I | 0..* | Extension(CodeableConcept) | Element IdServiceRequest.extension:RoutingOptions Optional Extensions Element Alternate namesextensions, user content DefinitionFor Referral Source Type identification. Only one referral routing object is expected. 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. http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options
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value[x] | S | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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valueCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
coding | S Σ | 0..* | CodingBinding | Element IdServiceRequest.extension:RoutingOptions.value[x].coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ReferralSourceTypes (extensible) Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.value[x].text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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CopiedParticipants | S I | 0..1 | Extension(Reference(PractitionerRole)) | Element IdServiceRequest.extension:CopiedParticipants Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(Reference(PractitionerRole)) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-copied-participants Constraints
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DART | S I | 0..1 | Extension(Complex) | Element IdServiceRequest.extension:DART Optional Extensions Element Alternate namesextensions, user content DefinitionDART stands for 'Dates Affecting Readiness to Treat' and is defined as: Periods of time between the Decision To Treat (DTT) and the Procedure Date when the patient is unavailable for a procedure due to patient-related reasons. 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. Extension(Complex) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-dart Constraints
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DARC | S I | 0..1 | Extension(Complex) | Element IdServiceRequest.extension:DARC Optional Extensions Element Alternate namesextensions, user content DefinitionDARC stands for 'Dates Affecting Readiness to Consult' and is defines as: Periods of time between the referral and consult date when the patient is unavailable for a first consultation due to patient-related reasons. 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. Extension(Complex) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-darc Constraints
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identifier | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdServiceRequest.identifier Identifiers assigned to this order DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | S Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | There are no (further) constraints on this element Element IdServiceRequest.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Constraints
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element IdServiceRequest.instantiatesUri Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
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basedOn | Σ I | 0..1 | Reference(ServiceRequest) | Element IdServiceRequest.basedOn What request fulfills Alternate namesfulfills DefinitionPlan/proposal/order fulfilled by this request. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Allowed aggregation: referenced Constraints
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replaces | Σ I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdServiceRequest.replaces What request replaces Alternate namessupersedes, prior, renewed order DefinitionThe request takes the place of the referenced completed or terminated request(s). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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requisition | S Σ | 0..1 | Identifier | Element IdServiceRequest.requisition Composite Request ID Alternate namesgrouperId, groupIdentifier DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.requisition.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requisition.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requisition.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requisition.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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status | S Σ ?! | 1..1 | codeBinding | Element IdServiceRequest.status draft | active | on-hold | revoked | completed | entered-in-error | unknown DefinitionThe status of the order. The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. RequestStatus (required)Constraints
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intent | S Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.intent proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option DefinitionWhether the request is a proposal, plan, an original order or a reflex order. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. RequestIntent (required)Constraints
proposal
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category | S Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.category Classification of service DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. InterventionCodeSubsetCare (extensible)Constraints
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coding | S Σ | 0..* | Coding | Element IdServiceRequest.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. For details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311
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system | S Σ | 1..1 | uriFixed Value | Element IdServiceRequest.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | codeBinding | Element IdServiceRequest.category.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size InterventionCodeSubsetCare (extensible) Constraints
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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priority | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.priority routine | urgent | asap | stat DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. RequestPriority (required)Constraints
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doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.doNotPerform True if service/procedure should not be performed DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform"
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code | S Σ | 0..1 | CodeableConceptBinding | Element IdServiceRequest.code What is being requested/ordered Alternate namesservice requested DefinitionA code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. Note that the meaning of this field is to be used in conjunction with ServiceRequest.performer pointing to a HealthCareservice, and .code further specifies the service, for example code could be a specific procedure under the specificed HealthcareService (e.g., HealthcareService = Orthopaedic Surgeon, code=Knee Surgery)
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coding | S Σ | 0..* | Coding | Element IdServiceRequest.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. For details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311
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system | S Σ | 1..1 | uriFixed Value | Element IdServiceRequest.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | codeBinding | Element IdServiceRequest.code.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size InterventionCodeSubsetCare (extensible) Constraints
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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orderDetail | S Σ I | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.orderDetail Additional order information Alternate namesdetailed instructions DefinitionAdditional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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quantity[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.quantity[x] Service amount DefinitionAn 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). When ordering a service the number of service items may need to be specified separately from the the service item.
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quantityQuantity | Quantity | There are no (further) constraints on this element Data Type | ||
quantityRatio | Ratio | There are no (further) constraints on this element Data Type | ||
quantityRange | Range | There are no (further) constraints on this element Data Type | ||
subject | S Σ I | 1..1 | Reference(Patient) | Element IdServiceRequest.subject Individual or Entity the service is ordered for DefinitionOn whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Allowed aggregation: referenced Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdServiceRequest.encounter Encounter in which the request was created Alternate namescontext DefinitionAn encounter that provides additional information about the healthcare context in which this request is made. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.occurrence[x] When service should occur Alternate namesschedule DefinitionThe date/time at which the requested service should occur.
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occurrenceDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
occurrencePeriod | Period | There are no (further) constraints on this element Data Type | ||
occurrenceTiming | Timing | There are no (further) constraints on this element Data Type | ||
asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.asNeeded[x] Preconditions for service DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints
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asNeededBoolean | boolean | There are no (further) constraints on this element Data Type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
authoredOn | S Σ | 1..1 | dateTime | Element IdServiceRequest.authoredOn Date request signed Alternate namesorderedOn DefinitionWhen the request transitioned to being actionable. In case it's 'blank' the date time should fall back to the submission time/system time of the SENDING system.
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requester | S Σ I | 1..1 | Reference(PractitionerRole | Patient) | Element IdServiceRequest.requester Who/what is requesting service Alternate namesauthor, orderer DefinitionThe individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference(PractitionerRole | Patient) Allowed aggregation: referenced Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.performerType Performer role Alternate namesspecialty DefinitionDesired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example)Constraints
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performer | S Σ I | 1..1 | Reference(PractitionerRole | HealthcareService) | Element IdServiceRequest.performer Requested performer Alternate namesrequest recipient DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Reference(PractitionerRole | HealthcareService) Allowed aggregation: referenced Constraints
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extension | I | 0..* | Extension | Element IdServiceRequest.performer.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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performerIdentifier | S I | 0..1 | Extension(Identifier) | Element IdServiceRequest.performer.extension:performerIdentifier Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. http://ehealthontario.ca/fhir/StructureDefinition/ext-performer-identifier Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.performer.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.performer.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..0 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.performer.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.performer.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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locationCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.locationCode Requested location DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. 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. A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example)Constraints
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locationReference | Σ I | 0..* | Reference(Location) | There are no (further) constraints on this element Element IdServiceRequest.locationReference Requested location DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | S Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.reasonCode Explanation/Justification for procedure or service DefinitionAn 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 This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes (preferred)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdServiceRequest.reasonReference Explanation/Justification for service or service DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference(Condition | Observation | DiagnosticReport | DocumentReference) Constraints
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insurance | I | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element IdServiceRequest.insurance Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Coverage | ClaimResponse) Constraints
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supportingInfo | S I | 0..* | Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) | Element IdServiceRequest.supportingInfo Additional clinical information Alternate namesAsk at order entry question, AOE DefinitionAdditional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdServiceRequest.specimen Procedure Samples DefinitionOne or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
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bodySite | Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.bodySite Location on Body Alternate nameslocation DefinitionAnatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (preferred)Constraints
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note | S | 0..* | Annotation | Element IdServiceRequest.note Comments DefinitionAny other notes and comments made about the service request. For example, internal billing notes.
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author[x] | Σ | 0..1 | Element IdServiceRequest.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation.
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authorString | string | Data Type | ||
authorReference | Reference(Practitioner | Organization | Patient) | Data Type | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdServiceRequest.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | S Σ | 1..1 | markdown | There are no (further) constraints on this element Element IdServiceRequest.note.text The annotation - text content (as markdown) DefinitionThe text of the annotation in markdown format. Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.patientInstruction Patient or consumer-oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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relevantHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdServiceRequest.relevantHistory Request provenance DefinitionKey events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Hybrid View
ServiceRequest | I | ServiceRequest | There are no (further) constraints on this element Element IdServiceRequest A request for a service to be performed Alternate namesdiagnostic request, referral, referral request, transfer of care request DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
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meta | S Σ | 1..1 | Meta | There are no (further) constraints on this element Element IdServiceRequest.meta Metadata about the resource DefinitionThe 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.
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element IdServiceRequest.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element IdServiceRequest.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
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profile | S Σ | 1..* | canonical(StructureDefinition) | Element IdServiceRequest.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdServiceRequest.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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extension | I | 0..* | Extension | Element IdServiceRequest.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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PatientPresentLocation | S I | 0..1 | Extension(Reference(Location)) | Element IdServiceRequest.extension:PatientPresentLocation Optional Extensions Element Alternate namesextensions, user content DefinitionUsed to communicate the present location of the patient if it is different than the patient's home address. 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. Extension(Reference(Location)) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location
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value[x] | S | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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valueReference | Reference(Location) | There are no (further) constraints on this element Data Type | ||
RoutingOptions | S I | 0..* | Extension(CodeableConcept) | Element IdServiceRequest.extension:RoutingOptions Optional Extensions Element Alternate namesextensions, user content DefinitionFor Referral Source Type identification. Only one referral routing object is expected. 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. http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options
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value[x] | S | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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valueCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
coding | S Σ | 0..* | CodingBinding | Element IdServiceRequest.extension:RoutingOptions.value[x].coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ReferralSourceTypes (extensible) Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.value[x].text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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CopiedParticipants | S I | 0..1 | Extension(Reference(PractitionerRole)) | Element IdServiceRequest.extension:CopiedParticipants Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(Reference(PractitionerRole)) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-copied-participants Constraints
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DART | S I | 0..1 | Extension(Complex) | Element IdServiceRequest.extension:DART Optional Extensions Element Alternate namesextensions, user content DefinitionDART stands for 'Dates Affecting Readiness to Treat' and is defined as: Periods of time between the Decision To Treat (DTT) and the Procedure Date when the patient is unavailable for a procedure due to patient-related reasons. 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. Extension(Complex) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-dart Constraints
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DARC | S I | 0..1 | Extension(Complex) | Element IdServiceRequest.extension:DARC Optional Extensions Element Alternate namesextensions, user content DefinitionDARC stands for 'Dates Affecting Readiness to Consult' and is defines as: Periods of time between the referral and consult date when the patient is unavailable for a first consultation due to patient-related reasons. 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. Extension(Complex) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-darc Constraints
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identifier | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdServiceRequest.identifier Identifiers assigned to this order DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | S Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | There are no (further) constraints on this element Element IdServiceRequest.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Constraints
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element IdServiceRequest.instantiatesUri Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
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basedOn | Σ I | 0..1 | Reference(ServiceRequest) | Element IdServiceRequest.basedOn What request fulfills Alternate namesfulfills DefinitionPlan/proposal/order fulfilled by this request. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Allowed aggregation: referenced Constraints
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replaces | Σ I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdServiceRequest.replaces What request replaces Alternate namessupersedes, prior, renewed order DefinitionThe request takes the place of the referenced completed or terminated request(s). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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requisition | S Σ | 0..1 | Identifier | Element IdServiceRequest.requisition Composite Request ID Alternate namesgrouperId, groupIdentifier DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.requisition.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requisition.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requisition.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requisition.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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status | S Σ ?! | 1..1 | codeBinding | Element IdServiceRequest.status draft | active | on-hold | revoked | completed | entered-in-error | unknown DefinitionThe status of the order. The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. RequestStatus (required)Constraints
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intent | S Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.intent proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option DefinitionWhether the request is a proposal, plan, an original order or a reflex order. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. RequestIntent (required)Constraints
proposal
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category | S Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.category Classification of service DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. InterventionCodeSubsetCare (extensible)Constraints
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coding | S Σ | 0..* | Coding | Element IdServiceRequest.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. For details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311
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system | S Σ | 1..1 | uriFixed Value | Element IdServiceRequest.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | codeBinding | Element IdServiceRequest.category.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size InterventionCodeSubsetCare (extensible) Constraints
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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priority | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.priority routine | urgent | asap | stat DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. RequestPriority (required)Constraints
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doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.doNotPerform True if service/procedure should not be performed DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform"
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code | S Σ | 0..1 | CodeableConceptBinding | Element IdServiceRequest.code What is being requested/ordered Alternate namesservice requested DefinitionA code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. Note that the meaning of this field is to be used in conjunction with ServiceRequest.performer pointing to a HealthCareservice, and .code further specifies the service, for example code could be a specific procedure under the specificed HealthcareService (e.g., HealthcareService = Orthopaedic Surgeon, code=Knee Surgery)
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coding | S Σ | 0..* | Coding | Element IdServiceRequest.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. For details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311
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system | S Σ | 1..1 | uriFixed Value | Element IdServiceRequest.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | codeBinding | Element IdServiceRequest.code.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size InterventionCodeSubsetCare (extensible) Constraints
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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orderDetail | S Σ I | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.orderDetail Additional order information Alternate namesdetailed instructions DefinitionAdditional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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quantity[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.quantity[x] Service amount DefinitionAn 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). When ordering a service the number of service items may need to be specified separately from the the service item.
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quantityQuantity | Quantity | There are no (further) constraints on this element Data Type | ||
quantityRatio | Ratio | There are no (further) constraints on this element Data Type | ||
quantityRange | Range | There are no (further) constraints on this element Data Type | ||
subject | S Σ I | 1..1 | Reference(Patient) | Element IdServiceRequest.subject Individual or Entity the service is ordered for DefinitionOn whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Allowed aggregation: referenced Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdServiceRequest.encounter Encounter in which the request was created Alternate namescontext DefinitionAn encounter that provides additional information about the healthcare context in which this request is made. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.occurrence[x] When service should occur Alternate namesschedule DefinitionThe date/time at which the requested service should occur.
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occurrenceDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
occurrencePeriod | Period | There are no (further) constraints on this element Data Type | ||
occurrenceTiming | Timing | There are no (further) constraints on this element Data Type | ||
asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.asNeeded[x] Preconditions for service DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints
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asNeededBoolean | boolean | There are no (further) constraints on this element Data Type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
authoredOn | S Σ | 1..1 | dateTime | Element IdServiceRequest.authoredOn Date request signed Alternate namesorderedOn DefinitionWhen the request transitioned to being actionable. In case it's 'blank' the date time should fall back to the submission time/system time of the SENDING system.
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requester | S Σ I | 1..1 | Reference(PractitionerRole | Patient) | Element IdServiceRequest.requester Who/what is requesting service Alternate namesauthor, orderer DefinitionThe individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference(PractitionerRole | Patient) Allowed aggregation: referenced Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.performerType Performer role Alternate namesspecialty DefinitionDesired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example)Constraints
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performer | S Σ I | 1..1 | Reference(PractitionerRole | HealthcareService) | Element IdServiceRequest.performer Requested performer Alternate namesrequest recipient DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Reference(PractitionerRole | HealthcareService) Allowed aggregation: referenced Constraints
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extension | I | 0..* | Extension | Element IdServiceRequest.performer.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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performerIdentifier | S I | 0..1 | Extension(Identifier) | Element IdServiceRequest.performer.extension:performerIdentifier Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. http://ehealthontario.ca/fhir/StructureDefinition/ext-performer-identifier Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.performer.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.performer.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..0 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.performer.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.performer.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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locationCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.locationCode Requested location DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. 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. A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example)Constraints
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locationReference | Σ I | 0..* | Reference(Location) | There are no (further) constraints on this element Element IdServiceRequest.locationReference Requested location DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | S Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.reasonCode Explanation/Justification for procedure or service DefinitionAn 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 This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes (preferred)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdServiceRequest.reasonReference Explanation/Justification for service or service DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference(Condition | Observation | DiagnosticReport | DocumentReference) Constraints
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insurance | I | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element IdServiceRequest.insurance Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Coverage | ClaimResponse) Constraints
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supportingInfo | S I | 0..* | Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) | Element IdServiceRequest.supportingInfo Additional clinical information Alternate namesAsk at order entry question, AOE DefinitionAdditional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdServiceRequest.specimen Procedure Samples DefinitionOne or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
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bodySite | Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.bodySite Location on Body Alternate nameslocation DefinitionAnatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (preferred)Constraints
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note | S | 0..* | Annotation | Element IdServiceRequest.note Comments DefinitionAny other notes and comments made about the service request. For example, internal billing notes.
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author[x] | Σ | 0..1 | Element IdServiceRequest.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation.
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authorString | string | Data Type | ||
authorReference | Reference(Practitioner | Organization | Patient) | Data Type | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdServiceRequest.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | S Σ | 1..1 | markdown | There are no (further) constraints on this element Element IdServiceRequest.note.text The annotation - text content (as markdown) DefinitionThe text of the annotation in markdown format. Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.patientInstruction Patient or consumer-oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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relevantHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdServiceRequest.relevantHistory Request provenance DefinitionKey events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Snapshot View
ServiceRequest | I | ServiceRequest | There are no (further) constraints on this element Element IdServiceRequest A request for a service to be performed Alternate namesdiagnostic request, referral, referral request, transfer of care request DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
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meta | S Σ | 1..1 | Meta | There are no (further) constraints on this element Element IdServiceRequest.meta Metadata about the resource DefinitionThe 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.
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element IdServiceRequest.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 0..1 | instant | There are no (further) constraints on this element Element IdServiceRequest.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
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profile | S Σ | 1..* | canonical(StructureDefinition) | Element IdServiceRequest.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdServiceRequest.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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extension | I | 0..* | Extension | Element IdServiceRequest.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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PatientPresentLocation | S I | 0..1 | Extension(Reference(Location)) | Element IdServiceRequest.extension:PatientPresentLocation Optional Extensions Element Alternate namesextensions, user content DefinitionUsed to communicate the present location of the patient if it is different than the patient's home address. 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. Extension(Reference(Location)) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location
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value[x] | S | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:PatientPresentLocation.value[x].display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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valueReference | Reference(Location) | There are no (further) constraints on this element Data Type | ||
RoutingOptions | S I | 0..* | Extension(CodeableConcept) | Element IdServiceRequest.extension:RoutingOptions Optional Extensions Element Alternate namesextensions, user content DefinitionFor Referral Source Type identification. Only one referral routing object is expected. 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. http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options Constraints
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url | 1..1 | System.StringFixed Value | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. System.String Fixed Valuehttp://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options
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value[x] | S | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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valueCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
coding | S Σ | 0..* | CodingBinding | Element IdServiceRequest.extension:RoutingOptions.value[x].coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ReferralSourceTypes (extensible) Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.extension:RoutingOptions.value[x].text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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CopiedParticipants | S I | 0..1 | Extension(Reference(PractitionerRole)) | Element IdServiceRequest.extension:CopiedParticipants Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. Extension(Reference(PractitionerRole)) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-copied-participants Constraints
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DART | S I | 0..1 | Extension(Complex) | Element IdServiceRequest.extension:DART Optional Extensions Element Alternate namesextensions, user content DefinitionDART stands for 'Dates Affecting Readiness to Treat' and is defined as: Periods of time between the Decision To Treat (DTT) and the Procedure Date when the patient is unavailable for a procedure due to patient-related reasons. 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. Extension(Complex) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-dart Constraints
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DARC | S I | 0..1 | Extension(Complex) | Element IdServiceRequest.extension:DARC Optional Extensions Element Alternate namesextensions, user content DefinitionDARC stands for 'Dates Affecting Readiness to Consult' and is defines as: Periods of time between the referral and consult date when the patient is unavailable for a first consultation due to patient-related reasons. 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. Extension(Complex) Extension URLhttp://ehealthontario.ca/fhir/StructureDefinition/ext-darc Constraints
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identifier | S Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdServiceRequest.identifier Identifiers assigned to this order DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | S Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | There are no (further) constraints on this element Element IdServiceRequest.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Constraints
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element IdServiceRequest.instantiatesUri Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
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basedOn | Σ I | 0..1 | Reference(ServiceRequest) | Element IdServiceRequest.basedOn What request fulfills Alternate namesfulfills DefinitionPlan/proposal/order fulfilled by this request. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Allowed aggregation: referenced Constraints
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replaces | Σ I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdServiceRequest.replaces What request replaces Alternate namessupersedes, prior, renewed order DefinitionThe request takes the place of the referenced completed or terminated request(s). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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requisition | S Σ | 0..1 | Identifier | Element IdServiceRequest.requisition Composite Request ID Alternate namesgrouperId, groupIdentifier DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.requisition.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requisition.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requisition.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requisition.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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status | S Σ ?! | 1..1 | codeBinding | Element IdServiceRequest.status draft | active | on-hold | revoked | completed | entered-in-error | unknown DefinitionThe status of the order. The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. RequestStatus (required)Constraints
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intent | S Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.intent proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option DefinitionWhether the request is a proposal, plan, an original order or a reflex order. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. RequestIntent (required)Constraints
proposal
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category | S Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.category Classification of service DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. InterventionCodeSubsetCare (extensible)Constraints
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coding | S Σ | 0..* | Coding | Element IdServiceRequest.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. For details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311
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system | S Σ | 1..1 | uriFixed Value | Element IdServiceRequest.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | codeBinding | Element IdServiceRequest.category.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size InterventionCodeSubsetCare (extensible) Constraints
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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priority | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.priority routine | urgent | asap | stat DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. RequestPriority (required)Constraints
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doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.doNotPerform True if service/procedure should not be performed DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform"
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code | S Σ | 0..1 | CodeableConceptBinding | Element IdServiceRequest.code What is being requested/ordered Alternate namesservice requested DefinitionA code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. Note that the meaning of this field is to be used in conjunction with ServiceRequest.performer pointing to a HealthCareservice, and .code further specifies the service, for example code could be a specific procedure under the specificed HealthcareService (e.g., HealthcareService = Orthopaedic Surgeon, code=Knee Surgery)
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coding | S Σ | 0..* | Coding | Element IdServiceRequest.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. For details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311
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system | S Σ | 1..1 | uriFixed Value | Element IdServiceRequest.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | codeBinding | Element IdServiceRequest.code.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size InterventionCodeSubsetCare (extensible) Constraints
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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orderDetail | S Σ I | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.orderDetail Additional order information Alternate namesdetailed instructions DefinitionAdditional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.orderDetail.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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quantity[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.quantity[x] Service amount DefinitionAn 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). When ordering a service the number of service items may need to be specified separately from the the service item.
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quantityQuantity | Quantity | There are no (further) constraints on this element Data Type | ||
quantityRatio | Ratio | There are no (further) constraints on this element Data Type | ||
quantityRange | Range | There are no (further) constraints on this element Data Type | ||
subject | S Σ I | 1..1 | Reference(Patient) | Element IdServiceRequest.subject Individual or Entity the service is ordered for DefinitionOn whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Allowed aggregation: referenced Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.subject.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdServiceRequest.encounter Encounter in which the request was created Alternate namescontext DefinitionAn encounter that provides additional information about the healthcare context in which this request is made. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.occurrence[x] When service should occur Alternate namesschedule DefinitionThe date/time at which the requested service should occur.
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occurrenceDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
occurrencePeriod | Period | There are no (further) constraints on this element Data Type | ||
occurrenceTiming | Timing | There are no (further) constraints on this element Data Type | ||
asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.asNeeded[x] Preconditions for service DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints
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asNeededBoolean | boolean | There are no (further) constraints on this element Data Type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
authoredOn | S Σ | 1..1 | dateTime | Element IdServiceRequest.authoredOn Date request signed Alternate namesorderedOn DefinitionWhen the request transitioned to being actionable. In case it's 'blank' the date time should fall back to the submission time/system time of the SENDING system.
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requester | S Σ I | 1..1 | Reference(PractitionerRole | Patient) | Element IdServiceRequest.requester Who/what is requesting service Alternate namesauthor, orderer DefinitionThe individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference(PractitionerRole | Patient) Allowed aggregation: referenced Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requester.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.requester.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.performerType Performer role Alternate namesspecialty DefinitionDesired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example)Constraints
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performer | S Σ I | 1..1 | Reference(PractitionerRole | HealthcareService) | Element IdServiceRequest.performer Requested performer Alternate namesrequest recipient DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Reference(PractitionerRole | HealthcareService) Allowed aggregation: referenced Constraints
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extension | I | 0..* | Extension | Element IdServiceRequest.performer.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Unordered, Open, by url(Value) Constraints
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performerIdentifier | S I | 0..1 | Extension(Identifier) | Element IdServiceRequest.performer.extension:performerIdentifier Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. 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. http://ehealthontario.ca/fhir/StructureDefinition/ext-performer-identifier Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.performer.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.performer.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..0 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.performer.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.performer.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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locationCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.locationCode Requested location DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. 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. A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example)Constraints
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locationReference | Σ I | 0..* | Reference(Location) | There are no (further) constraints on this element Element IdServiceRequest.locationReference Requested location DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | S Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.reasonCode Explanation/Justification for procedure or service DefinitionAn 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 This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes (preferred)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.version Version of the system - if relevant DefinitionThe 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. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.reasonCode.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdServiceRequest.reasonReference Explanation/Justification for service or service DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference(Condition | Observation | DiagnosticReport | DocumentReference) Constraints
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insurance | I | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element IdServiceRequest.insurance Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Coverage | ClaimResponse) Constraints
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supportingInfo | S I | 0..* | Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) | Element IdServiceRequest.supportingInfo Additional clinical information Alternate namesAsk at order entry question, AOE DefinitionAdditional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.reference Literal reference, Relative, internal or absolute URL DefinitionA 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. 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.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.type Type the reference refers to (e.g. "Patient") DefinitionThe 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). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier Logical reference, when literal reference is not known DefinitionAn 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. 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).
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. 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.
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdServiceRequest.specimen Procedure Samples DefinitionOne or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
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bodySite | Σ | 0..* | CodeableConceptBinding | Element IdServiceRequest.bodySite Location on Body Alternate nameslocation DefinitionAnatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (preferred)Constraints
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note | S | 0..* | Annotation | Element IdServiceRequest.note Comments DefinitionAny other notes and comments made about the service request. For example, internal billing notes.
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author[x] | Σ | 0..1 | Element IdServiceRequest.note.author[x] Individual responsible for the annotation DefinitionThe individual responsible for making the annotation.
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authorString | string | Data Type | ||
authorReference | Reference(Practitioner | Organization | Patient) | Data Type | ||
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdServiceRequest.note.time When the annotation was made DefinitionIndicates when this particular annotation was made.
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text | S Σ | 1..1 | markdown | There are no (further) constraints on this element Element IdServiceRequest.note.text The annotation - text content (as markdown) DefinitionThe text of the annotation in markdown format. Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.patientInstruction Patient or consumer-oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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relevantHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdServiceRequest.relevantHistory Request provenance DefinitionKey events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Table View
ServiceRequest | .. | |
ServiceRequest.meta | 1.. | |
ServiceRequest.meta.profile | 1.. | |
ServiceRequest.extension | 0.. | |
ServiceRequest.extension | Extension | 0..1 |
ServiceRequest.extension.url | .. | |
ServiceRequest.extension.value[x] | .. | |
ServiceRequest.extension.value[x].reference | .. | |
ServiceRequest.extension.value[x].identifier | .. | |
ServiceRequest.extension | Extension | 0.. |
ServiceRequest.extension.url | .. | |
ServiceRequest.extension.value[x] | .. | |
ServiceRequest.extension.value[x].coding | .. | |
ServiceRequest.extension | Extension | 0..1 |
ServiceRequest.extension | Extension | 0..1 |
ServiceRequest.extension | Extension | 0..1 |
ServiceRequest.identifier | .. | |
ServiceRequest.identifier.type | .. | |
ServiceRequest.identifier.type.coding | .. | |
ServiceRequest.identifier.type.coding.system | .. | |
ServiceRequest.identifier.type.coding.code | .. | |
ServiceRequest.identifier.type.coding.display | .. | |
ServiceRequest.identifier.system | .. | |
ServiceRequest.identifier.value | .. | |
ServiceRequest.basedOn | Reference(ServiceRequest) | ..1 |
ServiceRequest.requisition | .. | |
ServiceRequest.requisition.system | .. | |
ServiceRequest.requisition.value | .. | |
ServiceRequest.status | .. | |
ServiceRequest.intent | .. | |
ServiceRequest.category | .. | |
ServiceRequest.category.coding | .. | |
ServiceRequest.category.coding.system | 1.. | |
ServiceRequest.category.coding.code | 1.. | |
ServiceRequest.category.coding.display | 1.. | |
ServiceRequest.priority | .. | |
ServiceRequest.code | .. | |
ServiceRequest.code.coding | .. | |
ServiceRequest.code.coding.system | 1.. | |
ServiceRequest.code.coding.code | 1.. | |
ServiceRequest.code.coding.display | 1.. | |
ServiceRequest.orderDetail | .. | |
ServiceRequest.orderDetail.coding | .. | |
ServiceRequest.orderDetail.coding.system | 1.. | |
ServiceRequest.orderDetail.coding.code | 1.. | |
ServiceRequest.orderDetail.coding.display | 1.. | |
ServiceRequest.subject | Reference(Patient) | .. |
ServiceRequest.subject.reference | .. | |
ServiceRequest.subject.identifier | .. | |
ServiceRequest.subject.identifier.system | .. | |
ServiceRequest.subject.identifier.value | .. | |
ServiceRequest.authoredOn | 1.. | |
ServiceRequest.requester | Reference(PractitionerRole | Patient) | 1.. |
ServiceRequest.requester.reference | .. | |
ServiceRequest.requester.identifier | .. | |
ServiceRequest.requester.identifier.system | .. | |
ServiceRequest.requester.identifier.value | .. | |
ServiceRequest.performer | Reference(PractitionerRole | HealthcareService) | 1..1 |
ServiceRequest.performer.extension | 0.. | |
ServiceRequest.performer.extension | Extension | 0..1 |
ServiceRequest.performer.reference | .. | |
ServiceRequest.performer.identifier | ..0 | |
ServiceRequest.performer.identifier.system | .. | |
ServiceRequest.performer.identifier.value | .. | |
ServiceRequest.reasonCode | .. | |
ServiceRequest.reasonCode.coding | .. | |
ServiceRequest.reasonCode.coding.system | 1.. | |
ServiceRequest.reasonCode.coding.code | 1.. | |
ServiceRequest.reasonCode.coding.display | 1.. | |
ServiceRequest.reasonCode.text | .. | |
ServiceRequest.supportingInfo | Reference(Resource | QuestionnaireResponse | DocumentReference | Consent | AllergyIntolerance | Condition | Communication) | .. |
ServiceRequest.supportingInfo.reference | .. | |
ServiceRequest.supportingInfo.identifier | .. | |
ServiceRequest.supportingInfo.identifier.system | .. | |
ServiceRequest.supportingInfo.identifier.value | .. | |
ServiceRequest.bodySite | .. | |
ServiceRequest.note | .. | |
ServiceRequest.note.author[x] | Reference(Practitioner | Organization | Patient), string | .. |
ServiceRequest.note.text | .. |
JSON View
{ "resourceType": "StructureDefinition", "id": "ca-on-eReferral-profile-ServiceRequest", "url": "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest", "version": "1.0.1", "name": "EReferralServiceRequest", "title": "ServiceRequest", "status": "draft", "description": "ServiceRequest is the main resource use to send all referral related information to the destination system.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "ServiceRequest", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest", "derivation": "constraint", "differential": { "element": [ { "id": "ServiceRequest.meta", "path": "ServiceRequest.meta", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.meta.profile", "path": "ServiceRequest.meta.profile", "comment": "#### **_` FOR eREFERRAL USAGE: The meta.profile = http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest|1.0.1 `_**\n\nIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.extension", "path": "ServiceRequest.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" }, "min": 0 }, { "id": "ServiceRequest.extension:PatientPresentLocation", "path": "ServiceRequest.extension", "sliceName": "PatientPresentLocation", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location" ] } ], "mustSupport": true }, { "id": "ServiceRequest.extension:PatientPresentLocation.url", "path": "ServiceRequest.extension.url", "fixedUri": "http://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location" }, { "id": "ServiceRequest.extension:PatientPresentLocation.value[x]", "path": "ServiceRequest.extension.value[x]", "mustSupport": true }, { "id": "ServiceRequest.extension:PatientPresentLocation.value[x].reference", "path": "ServiceRequest.extension.value[x].reference", "mustSupport": true }, { "id": "ServiceRequest.extension:PatientPresentLocation.value[x].identifier", "path": "ServiceRequest.extension.value[x].identifier", "mustSupport": true }, { "id": "ServiceRequest.extension:RoutingOptions", "path": "ServiceRequest.extension", "sliceName": "RoutingOptions", "min": 0, "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options" ] } ], "mustSupport": true }, { "id": "ServiceRequest.extension:RoutingOptions.url", "path": "ServiceRequest.extension.url", "fixedUri": "http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options" }, { "id": "ServiceRequest.extension:RoutingOptions.value[x]", "path": "ServiceRequest.extension.value[x]", "mustSupport": true }, { "id": "ServiceRequest.extension:RoutingOptions.value[x].coding", "path": "ServiceRequest.extension.value[x].coding", "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "http://ehealthontario.ca/fhir/ValueSet/ereferral-source-types" } }, { "id": "ServiceRequest.extension:CopiedParticipants", "path": "ServiceRequest.extension", "sliceName": "CopiedParticipants", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ext-copied-participants" ] } ], "mustSupport": true, "isModifier": false }, { "id": "ServiceRequest.exentsion:DART", "path": "ServiceRequest.extension", "sliceName": "DART", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ext-dart" ] } ] }, { "id": "ServiceRequest.exentsion:DARC", "path": "ServiceRequest.extension", "sliceName": "DARC", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ext-darc" ] } ] }, { "id": "ServiceRequest.identifier", "path": "ServiceRequest.identifier", "mustSupport": true }, { "id": "ServiceRequest.identifier.type", "path": "ServiceRequest.identifier.type", "mustSupport": true }, { "id": "ServiceRequest.identifier.type.coding", "path": "ServiceRequest.identifier.type.coding", "mustSupport": true }, { "id": "ServiceRequest.identifier.type.coding.system", "path": "ServiceRequest.identifier.type.coding.system", "mustSupport": true }, { "id": "ServiceRequest.identifier.type.coding.code", "path": "ServiceRequest.identifier.type.coding.code", "mustSupport": true }, { "id": "ServiceRequest.identifier.type.coding.display", "path": "ServiceRequest.identifier.type.coding.display", "mustSupport": true }, { "id": "ServiceRequest.identifier.system", "path": "ServiceRequest.identifier.system", "mustSupport": true }, { "id": "ServiceRequest.identifier.value", "path": "ServiceRequest.identifier.value", "mustSupport": true }, { "id": "ServiceRequest.basedOn", "path": "ServiceRequest.basedOn", "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest" ], "aggregation": [ "referenced" ] } ] }, { "id": "ServiceRequest.requisition", "path": "ServiceRequest.requisition", "comment": "#### **_` FOR EREFERRAL USAGE: It is highly recommended that the common elements should match between multiple ServiceRequests (e.g., patient, requester, etc...) 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. `_**", "mustSupport": true }, { "id": "ServiceRequest.requisition.system", "path": "ServiceRequest.requisition.system", "mustSupport": true }, { "id": "ServiceRequest.requisition.value", "path": "ServiceRequest.requisition.value", "mustSupport": true }, { "id": "ServiceRequest.status", "path": "ServiceRequest.status", "mustSupport": true, "binding": { "strength": "required", "valueSet": "http://hl7.org/fhir/ValueSet/request-status" } }, { "id": "ServiceRequest.intent", "path": "ServiceRequest.intent", "fixedCode": "proposal", "mustSupport": true }, { "id": "ServiceRequest.category", "path": "ServiceRequest.category", "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/interventioncodesubsetcare" } }, { "id": "ServiceRequest.category.coding", "path": "ServiceRequest.category.coding", "comment": "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.\n\nFor details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311", "mustSupport": true }, { "id": "ServiceRequest.category.coding.system", "path": "ServiceRequest.category.coding.system", "min": 1, "fixedUri": "http://snomed.info/sct", "mustSupport": true }, { "id": "ServiceRequest.category.coding.code", "path": "ServiceRequest.category.coding.code", "min": 1, "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/interventioncodesubsetcare" } }, { "id": "ServiceRequest.category.coding.display", "path": "ServiceRequest.category.coding.display", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.priority", "path": "ServiceRequest.priority", "mustSupport": true }, { "id": "ServiceRequest.code", "path": "ServiceRequest.code", "definition": "A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.\nNote that the meaning of this field is to be used in conjunction with ServiceRequest.performer pointing to a HealthCareservice, and .code further specifies the service, for example code could be a specific procedure under the specificed HealthcareService (e.g., HealthcareService = Orthopaedic Surgeon, code=Knee Surgery)", "comment": "#### **_`FOR EREFERRAL USAGE: The meaning of this field is to be used in conjunction with ServiceRequest.performing pointing to a HealthCareservice, and .code further specifies the service, for example code could be a specific procedure under the specificed HealthcareService (e.g., HealthcareService = Orthopaedic Surgeon, code=Knee Surgery). `_**\n\nMany 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.", "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/interventioncodesubsetcare" } }, { "id": "ServiceRequest.code.coding", "path": "ServiceRequest.code.coding", "comment": "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.\n\nFor details of the value set, please visit https://tgateway.infoway-inforoute.ca/mtw.html?id=2.16.840.1.113883.2.20.3.97&versionid=20160311", "mustSupport": true }, { "id": "ServiceRequest.code.coding.system", "path": "ServiceRequest.code.coding.system", "min": 1, "fixedUri": "http://snomed.info/sct", "mustSupport": true }, { "id": "ServiceRequest.code.coding.code", "path": "ServiceRequest.code.coding.code", "min": 1, "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/interventioncodesubsetcare" } }, { "id": "ServiceRequest.code.coding.display", "path": "ServiceRequest.code.coding.display", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.orderDetail", "path": "ServiceRequest.orderDetail", "mustSupport": true }, { "id": "ServiceRequest.orderDetail.coding", "path": "ServiceRequest.orderDetail.coding", "mustSupport": true }, { "id": "ServiceRequest.orderDetail.coding.system", "path": "ServiceRequest.orderDetail.coding.system", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.orderDetail.coding.code", "path": "ServiceRequest.orderDetail.coding.code", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.orderDetail.coding.display", "path": "ServiceRequest.orderDetail.coding.display", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.subject", "path": "ServiceRequest.subject", "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient" ], "aggregation": [ "referenced" ] } ], "mustSupport": true }, { "id": "ServiceRequest.subject.reference", "path": "ServiceRequest.subject.reference", "mustSupport": true }, { "id": "ServiceRequest.subject.identifier", "path": "ServiceRequest.subject.identifier", "mustSupport": true }, { "id": "ServiceRequest.subject.identifier.system", "path": "ServiceRequest.subject.identifier.system", "mustSupport": true }, { "id": "ServiceRequest.subject.identifier.value", "path": "ServiceRequest.subject.identifier.value", "mustSupport": true }, { "id": "ServiceRequest.authoredOn", "path": "ServiceRequest.authoredOn", "definition": "When the request transitioned to being actionable. In case it's 'blank' the date time should fall back to the submission time/system time of the SENDING system.", "comment": "#### **_`FOR EREFERRAL USAGE: authoredOn is the submission time of the sending system `_**", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.requester", "path": "ServiceRequest.requester", "min": 1, "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-PractitionerRole", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient" ], "aggregation": [ "referenced" ] } ], "mustSupport": true }, { "id": "ServiceRequest.requester.reference", "path": "ServiceRequest.requester.reference", "mustSupport": true }, { "id": "ServiceRequest.requester.identifier", "path": "ServiceRequest.requester.identifier", "mustSupport": true }, { "id": "ServiceRequest.requester.identifier.system", "path": "ServiceRequest.requester.identifier.system", "mustSupport": true }, { "id": "ServiceRequest.requester.identifier.value", "path": "ServiceRequest.requester.identifier.value", "mustSupport": true }, { "id": "ServiceRequest.performer", "path": "ServiceRequest.performer", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-PractitionerRole", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-HealthcareService" ], "aggregation": [ "referenced" ] } ], "mustSupport": true }, { "id": "ServiceRequest.performer.extension", "path": "ServiceRequest.performer.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" }, "min": 0 }, { "id": "ServiceRequest.performer.extension:performerIdentifier", "path": "ServiceRequest.performer.extension", "sliceName": "performerIdentifier", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ext-performer-identifier" ] } ], "mustSupport": true, "isModifier": false }, { "id": "ServiceRequest.performer.reference", "path": "ServiceRequest.performer.reference", "mustSupport": true }, { "id": "ServiceRequest.performer.identifier", "path": "ServiceRequest.performer.identifier", "max": "0", "mustSupport": true }, { "id": "ServiceRequest.performer.identifier.system", "path": "ServiceRequest.performer.identifier.system", "mustSupport": true }, { "id": "ServiceRequest.performer.identifier.value", "path": "ServiceRequest.performer.identifier.value", "mustSupport": true }, { "id": "ServiceRequest.reasonCode", "path": "ServiceRequest.reasonCode", "mustSupport": true, "binding": { "strength": "preferred" } }, { "id": "ServiceRequest.reasonCode.coding", "path": "ServiceRequest.reasonCode.coding", "mustSupport": true }, { "id": "ServiceRequest.reasonCode.coding.system", "path": "ServiceRequest.reasonCode.coding.system", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.reasonCode.coding.code", "path": "ServiceRequest.reasonCode.coding.code", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.reasonCode.coding.display", "path": "ServiceRequest.reasonCode.coding.display", "min": 1, "mustSupport": true }, { "id": "ServiceRequest.reasonCode.text", "path": "ServiceRequest.reasonCode.text", "mustSupport": true }, { "id": "ServiceRequest.supportingInfo", "path": "ServiceRequest.supportingInfo", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-QuestionnaireResponse", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-DocumentReference", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Consent", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-AllergyIntolerance", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Condition", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Communication" ] } ], "mustSupport": true }, { "id": "ServiceRequest.supportingInfo.reference", "path": "ServiceRequest.supportingInfo.reference", "mustSupport": true }, { "id": "ServiceRequest.supportingInfo.identifier", "path": "ServiceRequest.supportingInfo.identifier", "mustSupport": true }, { "id": "ServiceRequest.supportingInfo.identifier.system", "path": "ServiceRequest.supportingInfo.identifier.system", "mustSupport": true }, { "id": "ServiceRequest.supportingInfo.identifier.value", "path": "ServiceRequest.supportingInfo.identifier.value", "mustSupport": true }, { "id": "ServiceRequest.bodySite", "path": "ServiceRequest.bodySite", "binding": { "strength": "preferred" } }, { "id": "ServiceRequest.note", "path": "ServiceRequest.note", "comment": "#### **_`FOR EREFERRAL USAGE: 'note' is used to include additional information in the referral that is not captured by an existing resource or in a DocumentReference. This is often used when the sending application has a custom data capture form with fields are not mapped to a resource (e.g., Food preference, home visit risk factors, etc...). `_**\n\nFor 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).", "mustSupport": true }, { "id": "ServiceRequest.note.author[x]", "path": "ServiceRequest.note.author[x]", "comment": "#### **_`FOR EREFERRAL USAGE: On submission of the ServiceRequest, if .author[x] and .time are not included, they are assumed to be the requester and received time of the ServiceRequest respectively (this is expected to be the normal use case). `_**\nOrganization is used when there's no need for specific attribution as to who made the comment.", "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Practitioner", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Organization", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient" ] }, { "code": "string" } ] }, { "id": "ServiceRequest.note.text", "path": "ServiceRequest.note.text", "mustSupport": true } ] } }
Usage
The ServiceRequest resource is the primary resource used to represent a referral request in this IG. References to other resources are used to convey the details of the request including the Patient (ServiceRequest.subject
), Referrer (ServiceRequest.requester
) and supporting information (ServiceRequest.supportingInfo
).
Notes
.id
- used to uniquely identify the resource
- if a persistent identity for the resource is not available to use when constructing a message Bundle for transmission via Direct Messaging, a UUID SHOULD be used in this element (with a corresponding value in
Bundle.entry.fullUrl
)
.meta.profile
- used to declare conformance to this profile
- populate with a fixed value:
http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest|1.0.1
.extension:PatientPresentLocation
- used to communicate the present location of the patient if it is different than the patient's home address
- see business rules for more information
.extension:RoutingOptions
- used to communicate referral source type information to support referral processes with automated referral processing rules
- see business rules for more information
.extension:CopiedParticipant
- used to communicate updates to the ServiceRequest in cases of forwarding referrals
.extension:DARC
- used to communicate dates affecting reason to consult
.extension:DART
- used to communicate dates affecting reason to treat
.identifier
- business identifers associate the information exchanged between systems with the real world entity
- any number of business identifiers MAY be included in the resource (e.g., Ontario HCN, Band #, CHRIS #, Caredove #, Hubly ID, etc...).
- when a resource is send back to the sender in a message, all business identifiers received SHOULD be included with the resource to help the sending system to associate the information received with the resource sent
- for Health Information System assigned and similar Identifier values record the organization that issued the identifier in identifier.assigner.display.
.basedOn
- used when the recipient of a ServiceRequest, creates ServiceRequests for other service providers (e.g.: a coordinator in a central intake or assessment centre may create requests for other service providers
basedOn
the ServiceRequest being peformed) basedOn
SHALL NOT be populated when a new ServiceRequest is created to initiate a referral- when a service provider performing a ServiceRequest creates another,
basedOn
SHALL be populated on the new ServiceRequest with a reference to the ServiceRequest being performed - if the ServiceRequest is being transmitted via messaging, the referenced ServiceRequest resource SHALL be included in the message as a
Bundle.entry
.requisition
used in cases where multiple connected referrals are made simultaneously (i.e. a requisition
in these cases:
- multiple ServiceRequests SHALL be referenced in
MessageHeader.focus
- each of the ServiceRequests in
MessageHeader.focus
SHALL have the same identifier inServiceRequest.requisition
- the identifier used in
ServiceRequest.requisition
SHALL also be used inMessageHeader.extension:ReferralIdentifier
- multiple ServiceRequests SHALL be referenced in
Note that additional business rules apply to requisitions
FOR EREFERRAL USAGE: It is highly recommended that the common elements should match between multiple ServiceRequests (e.g., patient, requester, etc...) 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.
.status
- used to communicate the current status of the ServiceRequest on the requester's system
- see Direct Messaging for a discussion of ServiceRequest.status and the state machine
.intent
- populate with the fixed value: "proposal"
.category
- see note on terminology binding in profile
.code
- eREFERRAL USAGE:
- the meaning of this field is to be used in conjunction with
ServiceRequest.performer
which points to a HealthCareservice, .code
further specifies the service, for example code could be a specific procedure under the specificed HealthcareService (e.g., HealthcareService = Orthopaedic Surgeon, code=Knee Surgery).- 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.
- the meaning of this field is to be used in conjunction with
.subject
- identifies the patient being referred to the service provider
- SHALL be populated with a reference to a Patient resource
- if the ServiceRequest is being transmitted via messaging, the referenced Patient resource SHALL be included in the message as a
Bundle.entry
.authoredOn
- FOR EREFERRAL AND ECONSULT USAGE:
.authoredOn
is the submission time of the sending system - note: if this element corresponds to the dateTime the author "signed" the request, it could be populated with a time before the message was actually submitted
- recommentation: to track the time that a ServiceRequest message was submitted to the performer,
Task.authoredOn
will contain the time the ServiceRequest was received and the Task (perform-request) was created
.requester
- identifies the person who requested the service
- SHALL be populated with a reference to a PractitionerRole resource or, for self-referrals, a Patient resource
- if the ServiceRequest is being transmitted via messaging, the referenced resource SHALL be included in the message as a
Bundle.entry
.performer
- identifies the requested service or service provider
- populate with a reference to a HealthcareService for services, or a PractitionerRole for clinicians
- IMPORTANT if the ServiceRequest is being transmitted via messaging, this element SHALL always reference a resource known to the recipient of the message, therefore this resource is not expected to be included as a
Bundle.entry
when transmitting a ServiceRequest to a service provider - see business rules for more information
.reasonCode
- FOR ECONSULT USAGE:
- .text - will contain a description of the eConsult "question"
.supportingInfo
- used to associate supporting information in the patient's record with a ServiceRequest
- MAY be populated with references to AllergyIntolerance, Condition, Consent, QuestionnaireResponse, or other FHIR resources in the future to associate structured information with a ServiceRequest
- MAY be populated with references to DocumentReference to associate binary attachments with a ServiceRequest
- if the ServiceRequest is being transmitted via messaging, any resource referenced here SHALL be included in messages from the requester to the performer as a
Bundle.entry
.note
used to communicate information that cannot be referenced in
supportingInfo
with a ServiceRequestMAY be used when the referral source system has a custom data capture form with fields are not mapped to a resource (e.g., Food preference, home visit risk factors, etc...).
if
note.author
andnote.time
are not populated, these SHOULD be assumed to be therequester
andauthoredOn
respectively (this is expected to be the normal use case)an Organization MAY be referenced as the
note.author
when there's no need for specific attribution as to who made the comment.FOR EREFERRAL USAGE:
note
is used to include additional information in the referral that is not captured by an existing resource or in a DocumentReference. This is often used when the sending application has a custom data capture form with fields are not mapped to a resource (e.g., Food preference, home visit risk factors, etc...).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).
Search Parameters
Name | Parameter | Description | Sample Expression | |
---|---|---|---|---|
authored | ServiceRequest.authoredOn | Date request signed | GET [BASE]/ServiceRequest?authored=2022-07-01 | |
status | ServiceRequest.status | Status of the ServiceRequest | GET [BASE]/ServiceRequest?status=completed | |
category | ServiceRequest.category | Classification of service | GET [BASE]/ServiceRequest?category=424008009 | |
code | ServiceRequest.code | What is being requested/ordered | GET [BASE]/ServiceRequest?code=105385000 | |
identifier | ServiceRequest.identifier | Identifiers assigned to this order | GET [BASE]/ServiceRequest?identifier=123 | |
patient | ServiceRequest.subject.where(resolve() is Patient) | Search by subject - a patient | GET [BASE]/ServiceRequest?patient=3640897 | |
performer | ServiceRequest.performer | Performer role | GET [BASE]/ServiceRequest?performer=6478147 | |
requester | ServiceRequest.requester | Who/what is requesting service | GET [BASE]/ServiceRequest?requester=6840735 | |
_id | The logical ID of the resource. | GET [BASE]/ServiceRequest?_id=123 | ||
_lastUpdated | This parameter can be used to select resources based on the last time they were changed. | GET [BASE]/ServiceRequest?_lastUpdated=gt2020-01-01&_lastUpdated=lt2021-03-31 | ||
_include | This parameter retrieves the primary resource and resources that are referenced by the primary resource. For HealthcareService, the _include parameter is used to return addtional resources such as Organization. | GET [BASE]/ServiceRequest?id=23414_include=* GET [BASE]/ServiceRequest?patient=3640897&_include=ServiceRequest:patient&_include=ServiceRequest:performer&_include=ServiceRequest:requester |
||
_revinclude | This parameter retrieves resources that reference the primary resource. | GET [base]/ServiceRequest?_revinclude=ServiceRequest:identifier GET [base]/ServiceRequest?_revinclude=* |