StructureDefinition NHSEngland-ServiceRequest-Genomics

Focal resource for test order messages. All additional information or resources SHOULD be linked back to the ServiceRequest or be referenced from the ServiceRequest directly.

ServiceRequests which have been updated post submission SHALL be accompanied by Provenance resources, referencing the ServiceRequest which detail when the resource was changed, who made the change and why.

Note on inheritance from prior requests

It is expected that the ServiceRequest.basedOn SHALL reference a parent request where this ServiceRequest is based a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or Germline Late tests in the Tumour First/Germline Late scenario (to link prior test which contain clinical context).

It is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.

Where multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available. Additionally, in most cases the data is required, rather than reprocessing of the sample itself, in which case referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHOULD be referenced from ServiceRequest.specimen as above. If multiple outputs, i.e. data from multiple samples, are associated with a previous request, a ServiceRequest MAY reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo.

An illustrative diagram of the links between ServiceRequests and other resources is provided below. Note: not all resource links are represented, to increase legibility of the diagram.

Profile url FHIR Module Normative Status
https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics NHS England Genomics trial-use

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomicsactive0.3.02026-04-16

This profile defines the Genomics constraints and extensions on the UK Core FHIR resource ServiceRequest.


Tree View

idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
sourceOfServiceRequestC0..1Extension(CodeableConcept)
additionalContactC0..*Extension(Reference(Organization | Practitioner | PractitionerRole))
coverageC1..1Extension(CodeableConcept)
genomicParticipantCountC0..1Extension(integer)
genomicPatientRoleC0..1Extension(CodeableConcept)Binding
modifierExtension?! C0..*Extension
id0..1string
extensionC0..*Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ C0..1Period
id0..1string
extensionC0..*Extension
referenceΣ C0..0string
typeΣ0..1uriBinding
identifierΣ1..1IdentifierFixed Value
displayΣ0..1string
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | PlanDefinition)
instantiatesUriΣ0..*uri
basedOnS Σ C0..*Reference(CarePlan | UKCoreMedicationRequest | NHSEngland_ServiceRequest_Genomics)
replacesΣ C0..1Reference(NHSEngland_ServiceRequest_Genomics)
requisitionΣ0..1Identifier
statusS Σ ?!1..1codeBinding
intentS Σ ?!1..1codeBinding
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
reasonForTestingS Σ1..*CodeableConceptBinding
id0..1string
priorityReasonC0..*Extension(CodeableConcept)
value0..1System.String
doNotPerformΣ ?!0..0boolean
id0..1string
extensionC0..*Extension
id0..1string
genomicTestCodeVersionC0..*Extension(decimal)
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionC0..*Extension
id0..1string
genomicTestCodeVersionC0..*Extension(decimal)
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
subjectS Σ C1..1Reference(NHSEngland_Patient_Genomics)
encounterΣ C0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrencePeriodPeriod
occurrenceTimingTiming
authoredOnS Σ1..1dateTime
requesterS Σ C1..1Reference(NHSEngland_PractitionerRole_Genomics)
performerTypeΣ0..0CodeableConcept
id0..1string
extensionC0..*Extension
referenceΣ C0..1string
typeΣ0..1uriBinding
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uriFixed Value
valueΣ0..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(Organization)
displayΣ0..1string
locationCodeΣ0..0CodeableConcept
locationReferenceΣ C0..0Reference(Location)
id0..1string
extensionC0..*Extension
id0..1string
genomicTestCodeVersionC0..*Extension(decimal)
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
reasonReferenceΣ C0..*Reference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics)
insuranceC0..0Reference(ClaimResponse | Coverage)
supportingInfoC0..*Reference(Resource)
specimenΣ C0..*Reference(Specimen)
bodySiteΣ0..0CodeableConceptBinding
id0..1string
annotationTypeC0..*Extension(CodeableConcept)
authorReferenceReference(Organization | Patient | Practitioner | RelatedPerson)
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown
patientInstructionΣ0..0string
relevantHistoryC0..0Reference(Provenance)

Detailed Descriptions

ServiceRequest
ShortA request for a service to be performed
Definition

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

Cardinality0..*
Aliasdiagnostic request, referral, referral request, transfer of care request
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • prr-1: orderDetail SHALL only be present if code is present
    orderDetail.empty() or code.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Request
  • v2: ORC
  • rim: Act[moodCode<=INT]
ServiceRequest.id
ShortLogical id of this artifact
Definition

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

Cardinality0..1
Typeid
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.meta
ShortMetadata about the resource
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.implicitRules
ShortA set of rules under which this content was created
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.text
ShortText summary of the resource, for human interpretation
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

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

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
ServiceRequest.contained
ShortContained, inline Resources
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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

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

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
ServiceRequest.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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.

Cardinality1..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:sourceOfServiceRequest
ShortThis represents the source of referral
Definition

This represents the source of referral.

Cardinality0..1
TypeExtension(CodeableConcept)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:additionalContact
ShortDetails of an additional contact
Definition

Extension used for recording additional personnel who should be contacted regarding questions related to a test order. This is separate from the requester or reporting address.

The additional contact SHOULD be a reference to a PractitionerRole resource wherever possible and SHALL contain contact details for the practitioner.

Additionally, where are there multiple practitioners involved in providing care who need to be listed as contacts, the contact details for each practitioner (or service) SHOULD be specified through additional additionalContact entries.

Cardinality0..*
TypeExtension(Reference(Organization | Practitioner | PractitionerRole))
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:coverage
ShortThe funding category for the Service Request
Definition

SHALL be present for Genomic Order Management test orders. Extension for recording how work against the test order is being funded. The ValueSet bound to this extension is currently under review by the NHS England Genomics Informatics Working Advisory Group and subject to change.

Cardinality1..1
TypeExtension(CodeableConcept)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:genomicParticipantCount
ShortOptional Extensions Element
Definition

Genomics specific extension used to record the total number of participants in a group test request.(e.g. family, duo / trio). SHALL be provided on the Proband test request which is part of a group. This will be copied to the RequestGroup to inform lab orchestration.

Cardinality0..1
TypeExtension(integer)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:genomicPatientRole
ShortOptional Extensions Element
Definition

Genomics specific extension to support family testing. SHALL be present on requests in Duo/Trio use cases where there is a need to differentiate a request for a Proband (which needs to be reported on), from the request for a consultand, which may not result in a report. It is expected that this will impact the Tasks spun up by the central service, though this is currently still under development.

Cardinality0..1
TypeExtension(CodeableConcept)
Binding

GenomicsPatientRole (required)

Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.modifierExtension
ShortExtensions that cannot be ignored
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier
ShortIdentifiers assigned to this order
Definition

Automatically assigned by the central service, though source systems MAY provide a local identifier for tracking within their own system, in which case the central order number is appended to the identifiers array.

Cardinality1..*
TypeIdentifier
SummaryTrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

Slicing

Unordered, Open, by system(Pattern)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • w5: FiveWs.identifier
  • v2: ORC.2, ORC.3, RF1-6 / RF1-11,
  • rim: .identifier
  • quick: ClinicalStatement.identifier
ServiceRequest.identifier:identifierGMSOrder
ShortIdentifiers assigned to this order
Definition

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

Cardinality0..1
TypeIdentifier
SummaryTrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • w5: FiveWs.identifier
  • v2: ORC.2, ORC.3, RF1-6 / RF1-11,
  • rim: .identifier
  • quick: ClinicalStatement.identifier
ServiceRequest.identifier:identifierGMSOrder.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.identifier:identifierGMSOrder.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier:identifierGMSOrder.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
ServiceRequest.identifier:identifierGMSOrder.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

Identifier Type Codes (extensible)

SummaryTrue
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
ServiceRequest.identifier:identifierGMSOrder.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.nhs.uk/Id/GMSOrder
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
ServiceRequest.identifier:identifierGMSOrder.value
ShortThe value that is unique
Definition

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

Cardinality1..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
ServiceRequest.identifier:identifierGMSOrder.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
Comments

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

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
ServiceRequest.identifier:identifierGMSOrder.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
ServiceRequest.identifier:localIdentifier
ShortIdentifiers assigned to this order
Definition

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

Cardinality0..*
TypeIdentifier
SummaryTrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • w5: FiveWs.identifier
  • v2: ORC.2, ORC.3, RF1-6 / RF1-11,
  • rim: .identifier
  • quick: ClinicalStatement.identifier
ServiceRequest.identifier:localIdentifier.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.identifier:localIdentifier.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier:localIdentifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
ServiceRequest.identifier:localIdentifier.type
ShortDescription of identifier
Definition

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

Cardinality0..1
TypeCodeableConcept
Binding

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

Identifier Type Codes (extensible)

SummaryTrue
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
ServiceRequest.identifier:localIdentifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.nhs.uk/local-identifier/servicerequest
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
ServiceRequest.identifier:localIdentifier.value
ShortThe value that is unique
Definition

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

Cardinality1..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
ServiceRequest.identifier:localIdentifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..1
TypePeriod
SummaryTrue
Comments

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

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
ServiceRequest.identifier:localIdentifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality1..1
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
ServiceRequest.identifier:localIdentifier.assigner.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.identifier:localIdentifier.assigner.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier:localIdentifier.assigner.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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

Cardinality0..0
Typestring
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier:localIdentifier.assigner.type
ShortType the reference refers to (e.g. "Patient")
Definition

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

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

Cardinality0..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier:localIdentifier.assigner.identifier
ShortLogical reference, when literal reference is not known
Definition

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

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

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

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

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

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
{
  "system": "https://fhir.nhs.uk/Id/ods-organization-code"
}
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
ServiceRequest.identifier:localIdentifier.assigner.display
ShortText alternative for the resource
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.instantiatesCanonical
ShortInstantiates FHIR protocol or definition
Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

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

Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesCanonical
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
ServiceRequest.instantiatesUri
ShortInstantiates external protocol or definition
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

Cardinality0..*
Typeuri
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesUri
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
ServiceRequest.basedOn
ShortWhat request fulfills
Definition

SHALL reference a parent request where this ServiceRequest is based on a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or Germline Late tests in the Tumour First/Germline Late scenario (to link tests where prior requests contain clinical context). It is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.

Where multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available, making the sample to be reprocessed unambiguous. In cases the data is required, rather than reprocessing of the sample itself, referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHALL be referenced from ServiceRequest.specimen as above. If multiple outputs are associated with a previous request, i.e. data from multiple samples, a ServiceRequest SHOULD reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo.

Cardinality0..*
TypeReference(CarePlan | UKCoreMedicationRequest | NHSEngland_ServiceRequest_Genomics)
Must SupportTrue
SummaryTrue
Aliasfulfills
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.basedOn
  • v2: ORC.8 (plus others)
  • rim: .outboundRelationship[typeCode=FLFS].target
ServiceRequest.replaces
ShortWhat request replaces
Definition

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

Cardinality0..1
TypeReference(NHSEngland_ServiceRequest_Genomics)
SummaryTrue
Aliassupersedes, prior, renewed order
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.replaces
  • v2: Handled by message location of ORC (ORC.1=RO or RU)
  • rim: .outboundRelationship[typeCode=RPLC].target
ServiceRequest.requisition
ShortComposite Request ID
Definition

SHALL be added for Duo/Trio (familial) requests in order to link tests together. Requisition Identifiers are used to generate RequestGroup resources that assist with management of linked requests. SHALL NOT be populated for other types of test (singleton) or other scenarios where requests/results need to be linked (see ServiceRequest.basedOn guidance). For cases where the requisition identifier is required, it is expected that this is provided by client systems, as there are no rules on the central service that would be able to determine whether the test request is part of a Duo/Trio. As there are no central naming systems for requisition identifiers, it is expected the identifiers will be local identifiers following guidance on Referencing and Identifiers. Other mechanisms for determining or setting the requisition identifier, e.g. by the central service, or deterministically using patient/request identifiers are being investigated by the NHS England Genomics Unit.

For subsequent requests which are part of a group, it is expected the requisition identifier will be retrieved from the prior request, e.g. for the proband, either from the central broker or via some offline means, and will be recreated on the additional request exactly, including system and assigner, so the requests can be linked.

Cardinality0..1
TypeIdentifier
SummaryTrue
AliasgrouperId, groupIdentifier
Requirements

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

Comments

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.groupIdentifier
  • v2: ORC.4
  • rim: .inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier
ServiceRequest.status
Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
Definition

SHALL be provided. ServiceRequests SHOULD be marked as draft until ready to be acted upon, after which the user should mark the ServiceRequest as active. A ServiceRequest with the status of draft is assumed to be incomplete, i.e. missing information required for further processing. As such, a central order management broker SHOULD refrain from adding Tasks for the ServiceRequest until it is marked as active, at which time the necessary Tasks are spun up automatically by the broker (this is to be tested within the Genomic Order Management beta). Keeping a ServiceRequest in the draft state allows other parties to populate additional data required, such as phenotypic information from a dedicated service, or further information via a web portal. It is expected that draft ServiceRequests will be purged from the system after a period of inactivity with appropriate warnings (yet to be determined) to avoid stale orders from obscuring live tests/results.

A ServiceRequest may be marked as 'on-hold' if work against it cannot continue temporarily, e.g. due to certain prerequisite information not being provided. A ServiceRequest SHOULD be marked as 'revoked' if cancelled, either by the lab performing work against the order or at the request of the requesting clinician, though in each case a Provenance resource SHALL be provided to capture why the state change has occurred. The requesting clinician may also mark the ServiceRequest as entered-in-error, though implications for work already in progress needs to be investigated further.

A ServiceRequest SHOULD only be marked as completed by the requesting clinician upon receipt and review of the resulting DiagnosticReport.

Cardinality1..1
Typecode
Binding

The status of a service order.

RequestStatus (required)

Must SupportTrue
ModifierTrue
SummaryTrue
Comments

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Interactions for general discussion) or using the Task resource.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.status
  • w5: FiveWs.status
  • v2: ORC.5,RF1-1
  • rim: .status
  • quick: Action.currentStatus
ServiceRequest.intent
Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Definition

SHALL be provided. ServiceRequests SHOULD be marked as 'order' unless they have been raised by a lab in response to an existing ServiceRequest, in which case they SHOULD be marked as 'reflex-order'. For reflex orders, the ServiceRequest.basedOn field SHALL be populated with the original ServiceRequest, for traceability.

Cardinality1..1
Typecode
Binding

The kind of service request.

RequestIntent (required)

Must SupportTrue
ModifierTrue
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.intent
  • w5: FiveWs.class
  • v2: N/A
  • rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
ServiceRequest.category
ShortClassification of service
Definition

Category SHALL be populated with the reason for the request being ordered e.g. Diagnostic, Carrier, Predictive, Stored DNA etc. The final list of applicable codes which can be selected is still under review, the Genomic-ReasonforTesting ValueSet SHOULD be used for this categorisation.

Cardinality1..*
TypeCodeableConcept
Binding

Classification of the requested service.

ServiceRequestCategoryCodes (example)

Must SupportTrue
SummaryTrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

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.

Slicing

Unordered, Open, by coding.system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: RF1-5
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
ServiceRequest.category:genomicsWholeCaseSequencing
ShortClassification of Genomics service
Definition

A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases

Cardinality0..*
TypeCodeableConcept
Binding

Classification of the requested service.

UKCoreGenomeSequencingCategory (extensible)

SummaryTrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: RF1-5
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
ServiceRequest.category:genomicsWholeCaseSequencing.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.category:genomicsWholeCaseSequencing.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.category:genomicsWholeCaseSequencing.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.category:genomicsWholeCaseSequencing.coding.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.category:genomicsWholeCaseSequencing.coding.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.category:genomicsWholeCaseSequencing.coding.system
ShortIdentity of the terminology system
Definition

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

Cardinality0..1
Typeuri
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.category:genomicsWholeCaseSequencing.coding.version
ShortVersion of the system - if relevant
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

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

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

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.category:reasonForTesting
ShortClassification of service
Definition

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

Cardinality1..*
TypeCodeableConcept
Binding

Classification of the requested service.

GenomicsReasonforTesting (required)

Must SupportTrue
SummaryTrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: RF1-5
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
ServiceRequest.priority
Shortroutine | urgent | asap | stat
Definition

ServiceRequests marked as urgent (i.e. not routine) SHOULD populate the extension:priorityReason with why an urgent test is being requested. This SHOULD ideally be coded using SNOMED CT concepts. Multiple priorityReason extensions are allowed within a single ServiceRequest in order to aid post-coordination.

Cardinality0..1
Typecode
Binding

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

RequestPriority (required)

Must SupportTrue
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Meaning when missing

If missing, this task should be performed with normal priority

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.priority
  • w5: FiveWs.grade
  • v2: TQ1.9, RF1-2
  • rim: .priorityCode
ServiceRequest.priority.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.priority.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.priority.extension:priorityReason
ShortA SNOMED CT concept representing the reason a Service Request is urgent.
Definition

A SNOMED CT concept representing the reason a Service Request is urgent

Cardinality0..*
TypeExtension(CodeableConcept)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.priority.value
ShortPrimitive value for code
Definition

Primitive value for code

Cardinality0..1
TypeSystem.String
Maximum string length1048576
ServiceRequest.doNotPerform
ShortTrue if service/procedure should not be performed
Definition

For the purposes of Genomic Test Ordering, the doNotPerform field SHALL NOT be used. All ServiceRequests requests received by the system will be assumed to be orders for services/testing.

Cardinality0..0
Typeboolean
ModifierTrue
SummaryTrue
Requirements

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

Comments

In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

Meaning when missing

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.doNotPerform
  • rim: .actionNegationInd
ServiceRequest.code
ShortWhat is being requested/ordered
Definition

SHOULD be provided if known. If populated, Code SHOULD contain an appropriate test code, preferrably a DGTS Genomic Test code, though NGTD codes MAY be used during the transition period, currently available at https://www.england.nhs.uk/publication/national-genomic-test-directories/. There is currently a prototype DGTS FHIR API in development to support querying/retrieving codes. Codes from the Genomic Test Directory SHOULD also specify the version number of the test at the time the test is being ordered, to ensure the test methods used are consistent with that version.

Cardinality1..1
TypeCodeableConcept
Binding

A set of codes that define a procedure or a procedure with explicit context. Selected from the SNOMED CT UK coding system.

UKCoreProcedureCode (preferred)

Must SupportTrue
SummaryTrue
Aliasservice requested
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.code
  • w5: FiveWs.what[x]
  • v2: PR1-3 / OBR-4 (varies by domain)
  • rim: .code
  • quick: Procedure.procedureCode
ServiceRequest.code.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.code.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.code.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

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

Comments

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

Slicing

Unordered, Open, by system(Pattern)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.code.coding:DGTSCode
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..1
TypeCoding
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.code.coding:DGTSCode.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.code.coding:DGTSCode.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.code.coding:DGTSCode.extension:genomicTestCodeVersion
ShortOptional Extensions Element
Definition

Optional Extension Element - found in all resources.

Cardinality0..*
TypeExtension(decimal)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.code.coding:DGTSCode.system
ShortIdentity of the terminology system
Definition

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

Cardinality0..1
Typeuri
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.code.coding:DGTSCode.version
ShortVersion of the system - if relevant
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

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

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

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.orderDetail
ShortAdditional order information
Definition

If additional coded details need to captured as part of a test order, e.g. Panels or targeted genes, these SHOULD be represented using the 'orderDetail' field, with the main indication captured using the 'reasonCode' field. If completely separate pathways/samples etc. are required for processing against the codes, it is expected these would be requested via multiple ServiceRequests instead of a single ServiceRequest with multiple orderDetail codes. The exact cut-off for when orderDetail vs. multiple ServiceRequest should be used is still being investigated. An appropriate code(Panel codes) SHOULD come from the following NamingSystem: England-GenomicTestPanelCode For Cancer WGS, where no panel or test-level details are relevant, orderDetail SHOULD be omitted.

Cardinality0..*
TypeCodeableConcept
Binding

Codified order entry details which are based on order context.

UKCoreProcedureCode (preferred)

SummaryTrue
Aliasdetailed instructions
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, prr-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: NTE
  • rim: .code
  • quick: Procedure.procedureCode
ServiceRequest.orderDetail.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.orderDetail.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.orderDetail.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

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

Comments

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

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.orderDetail.coding:genomicsTestPanelCode
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension:genomicTestCodeVersion
ShortOptional Extensions Element
Definition

Optional Extension Element - found in all resources.

Cardinality0..*
TypeExtension(decimal)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.system
ShortGenomics Test Panel Code
Definition

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

Cardinality0..1
Typeuri
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.nhs.uk/CodeSystem/England-GenomicTestPanelCode
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.version
ShortVersion of the system - if relevant
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

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

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

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.quantity[x]
ShortService amount
Definition

An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

Cardinality0..0
TypeQuantity | Range | Ratio
SummaryTrue
Requirements

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NTE
  • rim: .quantity
ServiceRequest.subject
ShortIndividual or Entity the service is ordered for
Definition

SHALL be provided. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS

Cardinality1..1
TypeReference(NHSEngland_Patient_Genomics)
Must SupportTrue
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • w5: FiveWs.subject[x]
  • v2: PID
  • rim: .participation[typeCode=SBJ].role
  • quick: ClinicalStatement.subject
  • w5: FiveWs.subject
ServiceRequest.encounter
ShortEncounter in which the request was created
Definition

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

Cardinality0..1
TypeReference(Encounter)
SummaryTrue
Aliascontext
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.encounter
  • w5: FiveWs.context
  • v2: PV1
  • rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
  • quick: ClinicalStatement.encounter
ServiceRequest.occurrence[x]
ShortWhen service should occur
Definition

If a result is required by a specific date, this MAY be indicated though occurrenceDateTime, though there is no guarantee from the GMS that the ServiceRequest will be processed in the time frame specified.

Cardinality0..1
TypedateTime | Period | Timing
SummaryTrue
Aliasschedule
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.occurrence[x]
  • w5: FiveWs.planned
  • v2: TQ1/TQ2, OBR-7/OBR-8
  • rim: .effectiveTime
  • quick: Procedure.procedureSchedule
ServiceRequest.asNeeded[x]
ShortPreconditions for service
Definition

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

Cardinality0..0
Typeboolean | CodeableConcept
Binding

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

SNOMEDCTMedicationAsNeededReasonCodes (example)

SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value
  • quick: Proposal.prnReason.reason
ServiceRequest.authoredOn
ShortDate request signed
Definition

SHALL be populated by the client upon submission, either manually by the user or automatically by the system integrating with the central GMS.

Cardinality1..1
TypedateTime
Must SupportTrue
SummaryTrue
AliasorderedOn
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • w5: FiveWs.recorded
  • v2: ORC.9, RF1-7 / RF1-9
  • rim: .participation[typeCode=AUT].time
  • quick: Proposal.proposedAtTime
ServiceRequest.requester
ShortWho/what is requesting service
Definition

SHALL be populated on all ServiceRequests submitted to the central GMS. This SHALL reference a PractitionerRole resource also submitted to the system (either within a single transaction or previously POSTed).

Cardinality1..1
TypeReference(NHSEngland_PractitionerRole_Genomics)
Must SupportTrue
SummaryTrue
Aliasauthor, orderer
Comments

This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.requester
  • w5: FiveWs.author
  • v2: ORC.12, PRT
  • rim: .participation[typeCode=AUT].role
  • quick: ClinicalStatement.statementAuthor
ServiceRequest.performerType
ShortPerformer role
Definition

Desired type of performer for doing the requested service.

Cardinality0..0
TypeCodeableConcept
Binding

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

ParticipantRoles (example)

SummaryTrue
Aliasspecialty
Comments

This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.performerType
  • w5: FiveWs.actor
  • v2: PRT, RF!-3
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
ServiceRequest.performer
ShortRequested performer
Definition

Allows a requester to assign processing of the ServiceRequest to a particular organization (e.g. a remote GLH). The performer field SHOULD be populated with the ODS code for the managing organization/GLH. In the future state, ServiceRequests may be kept open, by not specifying a performer, allowing them to be picked up by the local GLH or otherwise routed based on by test routing (TBC).

Cardinality0..1
TypeReference(UKCoreOrganization)
SummaryTrue
Aliasrequest recipient
Comments

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.performer
  • w5: FiveWs.actor
  • v2: PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
ServiceRequest.performer.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.performer.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.performer.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.performer.type
ShortType the reference refers to (e.g. "Patient")
Definition

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

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

Cardinality0..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.performer.identifier
ShortLogical reference, when literal reference is not known
Definition

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

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

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

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

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

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
ServiceRequest.performer.identifier.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.performer.identifier.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.performer.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
ServiceRequest.performer.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..1
TypeCodeableConcept
Binding

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

Identifier Type Codes (extensible)

SummaryTrue
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
ServiceRequest.performer.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality0..1
Typeuri
SummaryTrue
Requirements

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

Comments

Identifier.system is always case sensitive.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.nhs.uk/Id/ods-organization-code
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
ServiceRequest.performer.identifier.value
ShortThe value that is unique
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the 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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
ServiceRequest.performer.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..1
TypePeriod
SummaryTrue
Comments

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

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
ServiceRequest.performer.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
ServiceRequest.performer.display
ShortText alternative for the resource
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.locationCode
ShortRequested location
Definition

The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

Cardinality0..0
TypeCodeableConcept
Binding

A location type where services are delivered.

v3.ServiceDeliveryLocationRoleType (example)

SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=KIND].code
ServiceRequest.locationReference
ShortRequested location
Definition

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

Cardinality0..0
TypeReference(Location)
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=INSTANCE]
ServiceRequest.reasonCode
ShortExplanation/Justification for procedure or service
Definition

An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

Cardinality0..*
TypeCodeableConcept
Binding

A set of codes that define a reason for a service request.

UKCoreServiceRequestReasonCode (preferred)

SummaryTrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

Slicing

Unordered, Open, by coding.system(Pattern)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.reasonCode
  • w5: FiveWs.why[x]
  • v2: ORC.16, RF1-10
  • rim: .reasonCode
ServiceRequest.reasonCode:DGTSTestPackage
ShortExplanation/Justification for procedure or service
Definition

reasonCode SHALL be populated with the Test Package code for the order.

Cardinality1..1
TypeCodeableConcept
Binding

A set of codes that define a reason for a service request.

UKCoreServiceRequestReasonCode (preferred)

SummaryTrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.reasonCode
  • w5: FiveWs.why[x]
  • v2: ORC.16, RF1-10
  • rim: .reasonCode
ServiceRequest.reasonCode:DGTSTestPackage.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.reasonCode:DGTSTestPackage.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.reasonCode:DGTSTestPackage.coding
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.reasonCode:DGTSTestPackage.coding.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.reasonCode:DGTSTestPackage.coding.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.reasonCode:DGTSTestPackage.coding.extension:genomicTestCodeVersion
ShortOptional Extensions Element
Definition

Optional Extension Element - found in all resources.

Cardinality0..*
TypeExtension(decimal)
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.reasonCode:DGTSTestPackage.coding.system
ShortIdentity of the terminology system
Definition

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

Cardinality0..1
Typeuri
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.reasonCode:DGTSTestPackage.coding.version
ShortVersion of the system - if relevant
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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

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

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

Cardinality0..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

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

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

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

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

Comments

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

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

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

Cardinality0..1
Typestring
SummaryTrue
Requirements

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

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.reasonReference
ShortExplanation/Justification for service or service
Definition

Reference SHOULD be associated to the primary condition being tested for. Required if additional information related to the condition, such as onsetAge, needs to be captured for interpretation.

Cardinality0..*
TypeReference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics)
SummaryTrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.reasonReference
  • w5: FiveWs.why[x]
  • v2: ORC.16
  • rim: .outboundRelationship[typeCode=RSON].target
ServiceRequest.insurance
ShortAssociated insurance coverage
Definition

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

Cardinality0..0
TypeReference(ClaimResponse | Coverage)
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.insurance
  • v2: IN1/IN2
  • rim: .outboundRelationship[typeCode=COVBY].target
ServiceRequest.supportingInfo
ShortAdditional clinical information
Definition

Any clinical information provided about the patient for whom the testing is being requested SHALL be referenced though the supportingInfo field, to ensure all the information relevant to the ServiceRequest can be easily retrieved. This includes Observations, Conditions, Procedures, FamilyMemberHistories etc. This also includes resources related to family members included as part of testing (consultands), e.g. in Duo/Trio scenarios. In this instance, RelatedPerson and Patient resource references for the consultands SHALL be added to the supportingInfo array, as well as any clinical resources related to these individuals. This is to ensure the number of participants for a given test can be calculated correctly, e.g. through counting the number of RelatedPerson resources referenced from ServiceRequest.supportingInfo plus the subject of the ServiceRequest itself (the proband).

For WGS testing, where Records of Discussion are required in order to process the test, Consent resources SHOULD also be added to the supportingInfo array once available.

Cardinality0..*
TypeReference(Resource)
AliasAsk at order entry question, AOE
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
  • v2: Accompanying segments
  • rim: .outboundRelationship[typeCode=PERT].target
ServiceRequest.specimen
ShortProcedure Samples
Definition

ServiceRequests where the required samples already exist, e.g. in the case where a specimen already in storage needs to be processed, SHOULD reference these samples through the ServiceRequest.specimen field. Where samples need to be collected to support testing, these SHOULD instead reference the ServiceRequest, through Specimen.request (i.e. the service request has prompted collection of the sample), and these Specimen resources do not need to be referenced from within ServiceRequest.supportingInfo. The referenced Specimen resources SHOULD either be contained within the test order transaction bundle or already exist on the central GMS. In the case of Reanalysis or Reinterpretation tests, Specimens related to previous ServiceRequest are not required to be added to the new test request. The links from the previous ServiceRequest can be followed to identify the Specimens that resulted in the data being reanalysed, e.g. (reanalysis) ServiceRequest.basedOn -> (prior) ServiceRequest, (prior) ServiceRequest <- (original) Specimen.request

For requests based on prior requests where multiple samples 'active' are associated with the prior request. The specific sample to be reprocessed SHALL be referenced from ServiceRequest.specimen.

Cardinality0..*
TypeReference(Specimen)
SummaryTrue
Comments

Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SPM
  • rim: .participation[typeCode=SPC].role
ServiceRequest.bodySite
ShortLocation on Body
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (preferred)

SummaryTrue
Aliaslocation
Requirements

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

Comments

Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM
  • rim: targetSiteCode
  • quick: Procedure.targetBodySite
ServiceRequest.note
ShortComments
Definition

Any information which cannot be readily be structured SHOULD be entered into the note field, though prolific use of the field to capture clinical information which better fits in level 3/4 FHIR resources is discouraged. To support disambiguation of notes originating from different fields in a client system, the AnnotationType extension MAY be used, specifying the UI element name in text (coded elements for the full list of free text UI elements expected within Test Order forms is pending finalisation and addition to the Genomic Order Management MDS). The author element MAY also be used to reference a Practitioner, by identifier or name (string), indicating the person who created the note.

Cardinality0..*
TypeAnnotation
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • v2: NTE
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]
  • quick: ClinicalStatement.additionalText
ServiceRequest.note.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
ServiceRequest.note.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.note.extension:annotationType
ShortThe type of annotation
Definition

The type of annotation. This extension can be used to map the v2 NTE-4 comment type field.

Cardinality0..*
TypeExtension(CodeableConcept)
Aliasextensions, user content
Comments

This is used to identify the type of annotation.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.note.author[x]
ShortIndividual responsible for the annotation
Definition

The individual responsible for making the annotation.

Cardinality0..1
TypeReference(Organization | Patient | Practitioner | RelatedPerson) | string
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
ServiceRequest.note.time
ShortWhen the annotation was made
Definition

Indicates when this particular annotation was made.

Cardinality0..1
TypedateTime
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
ServiceRequest.note.text
ShortThe annotation - text content (as markdown)
Definition

The text of the annotation in markdown format.

Cardinality1..1
Typemarkdown
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
ServiceRequest.patientInstruction
ShortPatient or consumer-oriented instructions
Definition

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

Cardinality0..0
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NTE
  • rim: .text
ServiceRequest.relevantHistory
ShortRequest provenance
Definition

Key events in the history of the request.

Cardinality0..0
TypeReference(Provenance)
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.relevantHistory
  • v2: N/A
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Table View

ServiceRequest0..*
ServiceRequest.idid0..1
ServiceRequest.metaMeta0..1
ServiceRequest.implicitRulesuri0..1
ServiceRequest.languagecode0..1
ServiceRequest.textNarrative0..1
ServiceRequest.containedResource0..*
ServiceRequest.extensionExtension1..*
ServiceRequest.extension:sourceOfServiceRequestExtension0..1
ServiceRequest.extension:additionalContactExtension0..*
ServiceRequest.extension:coverageExtension1..1
ServiceRequest.extension:genomicParticipantCountExtension0..1
ServiceRequest.extension:genomicPatientRoleExtension0..1
ServiceRequest.modifierExtensionExtension0..*
ServiceRequest.identifierIdentifier1..*
ServiceRequest.identifier:identifierGMSOrderIdentifier0..1
ServiceRequest.identifier:identifierGMSOrder.idstring0..1
ServiceRequest.identifier:identifierGMSOrder.extensionExtension0..*
ServiceRequest.identifier:identifierGMSOrder.usecode0..0
ServiceRequest.identifier:identifierGMSOrder.typeCodeableConcept0..0
ServiceRequest.identifier:identifierGMSOrder.systemuri1..1
ServiceRequest.identifier:identifierGMSOrder.valuestring1..1
ServiceRequest.identifier:identifierGMSOrder.periodPeriod0..0
ServiceRequest.identifier:identifierGMSOrder.assignerReference(Organization)0..0
ServiceRequest.identifier:localIdentifierIdentifier0..*
ServiceRequest.identifier:localIdentifier.idstring0..1
ServiceRequest.identifier:localIdentifier.extensionExtension0..*
ServiceRequest.identifier:localIdentifier.usecode0..1
ServiceRequest.identifier:localIdentifier.typeCodeableConcept0..1
ServiceRequest.identifier:localIdentifier.systemuri1..1
ServiceRequest.identifier:localIdentifier.valuestring1..1
ServiceRequest.identifier:localIdentifier.periodPeriod0..1
ServiceRequest.identifier:localIdentifier.assignerReference(Organization)1..1
ServiceRequest.identifier:localIdentifier.assigner.idstring0..1
ServiceRequest.identifier:localIdentifier.assigner.extensionExtension0..*
ServiceRequest.identifier:localIdentifier.assigner.referencestring0..0
ServiceRequest.identifier:localIdentifier.assigner.typeuri0..1
ServiceRequest.identifier:localIdentifier.assigner.identifierIdentifier1..1
ServiceRequest.identifier:localIdentifier.assigner.displaystring0..1
ServiceRequest.instantiatesCanonicalcanonical(ActivityDefinition | PlanDefinition)0..*
ServiceRequest.instantiatesUriuri0..*
ServiceRequest.basedOnReference(CarePlan | UKCoreMedicationRequest | NHSEngland_ServiceRequest_Genomics)0..*
ServiceRequest.replacesReference(NHSEngland_ServiceRequest_Genomics)0..1
ServiceRequest.requisitionIdentifier0..1
ServiceRequest.statuscode1..1
ServiceRequest.intentcode1..1
ServiceRequest.categoryCodeableConcept1..*
ServiceRequest.category:genomicsWholeCaseSequencingCodeableConcept0..*
ServiceRequest.category:genomicsWholeCaseSequencing.idstring0..1
ServiceRequest.category:genomicsWholeCaseSequencing.extensionExtension0..*
ServiceRequest.category:genomicsWholeCaseSequencing.codingCoding0..*
ServiceRequest.category:genomicsWholeCaseSequencing.coding.idstring0..1
ServiceRequest.category:genomicsWholeCaseSequencing.coding.extensionExtension0..*
ServiceRequest.category:genomicsWholeCaseSequencing.coding.systemuri0..1
ServiceRequest.category:genomicsWholeCaseSequencing.coding.versionstring0..1
ServiceRequest.category:genomicsWholeCaseSequencing.coding.codecode0..1
ServiceRequest.category:genomicsWholeCaseSequencing.coding.displaystring0..1
ServiceRequest.category:genomicsWholeCaseSequencing.coding.userSelectedboolean0..1
ServiceRequest.category:genomicsWholeCaseSequencing.textstring0..1
ServiceRequest.category:reasonForTestingCodeableConcept1..*
ServiceRequest.prioritycode0..1
ServiceRequest.priority.idstring0..1
ServiceRequest.priority.extensionExtension0..*
ServiceRequest.priority.extension:priorityReasonExtension0..*
ServiceRequest.priority.valueSystem.String0..1
ServiceRequest.doNotPerformboolean0..0
ServiceRequest.codeCodeableConcept1..1
ServiceRequest.code.idstring0..1
ServiceRequest.code.extensionExtension0..*
ServiceRequest.code.codingCoding0..*
ServiceRequest.code.coding:DGTSCodeCoding0..1
ServiceRequest.code.coding:DGTSCode.idstring0..1
ServiceRequest.code.coding:DGTSCode.extensionExtension0..*
ServiceRequest.code.coding:DGTSCode.extension:genomicTestCodeVersionExtension0..*
ServiceRequest.code.coding:DGTSCode.systemuri0..1
ServiceRequest.code.coding:DGTSCode.versionstring0..1
ServiceRequest.code.coding:DGTSCode.codecode0..1
ServiceRequest.code.coding:DGTSCode.displaystring0..1
ServiceRequest.code.coding:DGTSCode.userSelectedboolean0..1
ServiceRequest.code.textstring0..1
ServiceRequest.orderDetailCodeableConcept0..*
ServiceRequest.orderDetail.idstring0..1
ServiceRequest.orderDetail.extensionExtension0..*
ServiceRequest.orderDetail.codingCoding0..*
ServiceRequest.orderDetail.coding:genomicsTestPanelCodeCoding0..*
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.idstring0..1
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extensionExtension0..*
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension:genomicTestCodeVersionExtension0..*
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.systemuri0..1
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.versionstring0..1
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.codecode0..1
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.displaystring0..1
ServiceRequest.orderDetail.coding:genomicsTestPanelCode.userSelectedboolean0..1
ServiceRequest.orderDetail.textstring0..1
ServiceRequest.quantity[x]Quantity | Range | Ratio0..0
ServiceRequest.subjectReference(NHSEngland_Patient_Genomics)1..1
ServiceRequest.encounterReference(Encounter)0..1
ServiceRequest.occurrence[x]dateTime | Period | Timing0..1
ServiceRequest.asNeeded[x]boolean | CodeableConcept0..0
ServiceRequest.authoredOndateTime1..1
ServiceRequest.requesterReference(NHSEngland_PractitionerRole_Genomics)1..1
ServiceRequest.performerTypeCodeableConcept0..0
ServiceRequest.performerReference(UKCoreOrganization)0..1
ServiceRequest.performer.idstring0..1
ServiceRequest.performer.extensionExtension0..*
ServiceRequest.performer.referencestring0..1
ServiceRequest.performer.typeuri0..1
ServiceRequest.performer.identifierIdentifier1..1
ServiceRequest.performer.identifier.idstring0..1
ServiceRequest.performer.identifier.extensionExtension0..*
ServiceRequest.performer.identifier.usecode0..1
ServiceRequest.performer.identifier.typeCodeableConcept0..1
ServiceRequest.performer.identifier.systemuri0..1
ServiceRequest.performer.identifier.valuestring0..1
ServiceRequest.performer.identifier.periodPeriod0..1
ServiceRequest.performer.identifier.assignerReference(Organization)0..1
ServiceRequest.performer.displaystring0..1
ServiceRequest.locationCodeCodeableConcept0..0
ServiceRequest.locationReferenceReference(Location)0..0
ServiceRequest.reasonCodeCodeableConcept0..*
ServiceRequest.reasonCode:DGTSTestPackageCodeableConcept1..1
ServiceRequest.reasonCode:DGTSTestPackage.idstring0..1
ServiceRequest.reasonCode:DGTSTestPackage.extensionExtension0..*
ServiceRequest.reasonCode:DGTSTestPackage.codingCoding0..*
ServiceRequest.reasonCode:DGTSTestPackage.coding.idstring0..1
ServiceRequest.reasonCode:DGTSTestPackage.coding.extensionExtension0..*
ServiceRequest.reasonCode:DGTSTestPackage.coding.extension:genomicTestCodeVersionExtension0..*
ServiceRequest.reasonCode:DGTSTestPackage.coding.systemuri0..1
ServiceRequest.reasonCode:DGTSTestPackage.coding.versionstring0..1
ServiceRequest.reasonCode:DGTSTestPackage.coding.codecode0..1
ServiceRequest.reasonCode:DGTSTestPackage.coding.displaystring0..1
ServiceRequest.reasonCode:DGTSTestPackage.coding.userSelectedboolean0..1
ServiceRequest.reasonCode:DGTSTestPackage.textstring0..1
ServiceRequest.reasonReferenceReference(https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics)0..*
ServiceRequest.insuranceReference(ClaimResponse | Coverage)0..0
ServiceRequest.supportingInfoReference(Resource)0..*
ServiceRequest.specimenReference(Specimen)0..*
ServiceRequest.bodySiteCodeableConcept0..0
ServiceRequest.noteAnnotation0..*
ServiceRequest.note.idstring0..1
ServiceRequest.note.extensionExtension0..*
ServiceRequest.note.extension:annotationTypeExtension0..*
ServiceRequest.note.author[x]Reference(Organization | Patient | Practitioner | RelatedPerson) | string0..1
ServiceRequest.note.timedateTime0..1
ServiceRequest.note.textmarkdown1..1
ServiceRequest.patientInstructionstring0..0
ServiceRequest.relevantHistoryReference(Provenance)0..0

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="NHSEngland-ServiceRequest-Genomics" />
<url value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<version value="0.3.0" />
<name value="NHSEngland_ServiceRequest_Genomics" />
<title value="NHSEngland ServiceRequest Genomics" />
<status value="active" />
<date value="2026-04-16" />
<publisher value="NHS England" />
<name value="NHS England" />
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="This profile defines the Genomics constraints and extensions on the UK Core FHIR resource [ServiceRequest](https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest)." />
<purpose value="Focal resource for test order messages. All additional information or resources SHOULD be linked back to the ServiceRequest or be referenced from the ServiceRequest directly.\n\nServiceRequests which have been updated post submission SHALL be accompanied by Provenance resources, referencing the ServiceRequest which detail when the resource was changed, who made the change and why.\n\nNote on inheritance from prior requests\nIt is expected that the ServiceRequest.basedOn SHALL reference a parent request where this ServiceRequest is based a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or Germline Late tests in the Tumour First/Germline Late scenario (to link prior test which contain clinical context).\n\nIt is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.\n\nWhere multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available. Additionally, in most cases the data is required, rather than reprocessing of the sample itself, in which case referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHOULD be referenced from ServiceRequest.specimen as above. If multiple outputs, i.e. data from multiple samples, are associated with a previous request, a ServiceRequest MAY reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo." />
<copyright value="Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="ServiceRequest" />
<baseDefinition value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest" />
<derivation value="constraint" />
<element id="ServiceRequest">
<path value="ServiceRequest" />
<short value="A request for a service to be performed" />
<definition value="A record of a request for service such as diagnostic investigations, treatments, or operations to be performed." />
<alias value="diagnostic request" />
<alias value="referral" />
<alias value="referral request" />
<alias value="transfer of care request" />
<min value="0" />
<max value="*" />
<path value="ServiceRequest" />
<min value="0" />
<max value="*" />
</base>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-3" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" />
<expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="prr-1" />
<severity value="error" />
<human value="orderDetail SHALL only be present if code is present" />
<expression value="orderDetail.empty() or code.exists()" />
<xpath value="exists(f:code) or not(exists(f:orderDetail))" />
<source value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
</constraint>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<identity value="workflow" />
<map value="Request" />
</mapping>
<identity value="v2" />
<map value="ORC" />
</mapping>
<identity value="rim" />
<map value="Act[moodCode<=INT]" />
</mapping>
</element>
<element id="ServiceRequest.id">
<path value="ServiceRequest.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id" />
</extension>
<code value="id" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.meta">
<path value="ServiceRequest.meta" />
<short value="Metadata about the resource" />
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
<min value="0" />
<max value="1" />
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<code value="Meta" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.implicitRules">
<path value="ServiceRequest.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
<min value="0" />
<max value="1" />
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.language">
<path value="ServiceRequest.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
<min value="0" />
<max value="1" />
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.text">
<path value="ServiceRequest.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<code value="Narrative" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="ServiceRequest.contained">
<path value="ServiceRequest.contained" />
<short value="Contained, inline Resources" />
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<code value="Resource" />
</type>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.extension">
<path value="ServiceRequest.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="1" />
<max value="*" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.extension:sourceOfServiceRequest">
<path value="ServiceRequest.extension" />
<sliceName value="sourceOfServiceRequest" />
<short value="This represents the source of referral" />
<definition value="This represents the source of referral." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SourceOfServiceRequest" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.extension:additionalContact">
<path value="ServiceRequest.extension" />
<sliceName value="additionalContact" />
<short value="Details of an additional contact" />
<definition value="Extension used for recording additional personnel who should be contacted regarding questions related to a test order. This is separate from the requester or reporting address.\n\nThe additional contact SHOULD be a reference to a PractitionerRole resource wherever possible and SHALL contain contact details for the practitioner.\n\nAdditionally, where are there multiple practitioners involved in providing care who need to be listed as contacts, the contact details for each practitioner (or service) SHOULD be specified through additional additionalContact entries." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.extension:coverage">
<path value="ServiceRequest.extension" />
<sliceName value="coverage" />
<short value="The funding category for the Service Request" />
<definition value="SHALL be present for Genomic Order Management test orders. Extension for recording how work against the test order is being funded. The ValueSet bound to this extension is currently under review by the NHS England Genomics Informatics Working Advisory Group and subject to change." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="1" />
<max value="1" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.extension:genomicParticipantCount">
<path value="ServiceRequest.extension" />
<sliceName value="genomicParticipantCount" />
<short value="Optional Extensions Element" />
<definition value="Genomics specific extension used to record the total number of participants in a group test request.(e.g. family, duo / trio). SHALL be provided on the Proband test request which is part of a group. This will be copied to the RequestGroup to inform lab orchestration." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.extension:genomicPatientRole">
<path value="ServiceRequest.extension" />
<sliceName value="genomicPatientRole" />
<short value="Optional Extensions Element" />
<definition value="Genomics specific extension to support family testing. SHALL be present on requests in Duo/Trio use cases where there is a need to differentiate a request for a Proband (which needs to be reported on), from the request for a consultand, which may not result in a report.\nIt is expected that this will impact the Tasks spun up by the central service, though this is currently still under development." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<strength value="required" />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-patient-role" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.modifierExtension">
<path value="ServiceRequest.modifierExtension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Extensions that cannot be ignored" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.identifier">
<path value="ServiceRequest.identifier" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Identifiers assigned to this order" />
<definition value="Automatically assigned by the central service, though source systems MAY provide a local identifier for tracking within their own system, in which case the central order number is appended to the identifiers array." />
<comment value="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." />
<min value="1" />
<max value="*" />
<path value="ServiceRequest.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="workflow" />
<map value="Request.identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="ORC.2, ORC.3, RF1-6 / RF1-11," />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.identifier" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder">
<path value="ServiceRequest.identifier" />
<sliceName value="identifierGMSOrder" />
<short value="Identifiers assigned to this order" />
<definition value="Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="workflow" />
<map value="Request.identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="ORC.2, ORC.3, RF1-6 / RF1-11," />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.identifier" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.id">
<path value="ServiceRequest.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.extension">
<path value="ServiceRequest.identifier.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.use">
<path value="ServiceRequest.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="0" />
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.type">
<path value="ServiceRequest.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="0" />
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.system">
<path value="ServiceRequest.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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." />
<min value="1" />
<max value="1" />
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/Id/GMSOrder" />
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.value">
<path value="ServiceRequest.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](extension-rendered-value.html). 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." />
<min value="1" />
<max value="1" />
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.period">
<path value="ServiceRequest.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="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").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="0" />
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<code value="Period" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.assigner">
<path value="ServiceRequest.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="0" />
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier">
<path value="ServiceRequest.identifier" />
<sliceName value="localIdentifier" />
<short value="Identifiers assigned to this order" />
<definition value="Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller." />
<comment value="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." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="workflow" />
<map value="Request.identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="v2" />
<map value="ORC.2, ORC.3, RF1-6 / RF1-11," />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.identifier" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.id">
<path value="ServiceRequest.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.extension">
<path value="ServiceRequest.identifier.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.use">
<path value="ServiceRequest.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.type">
<path value="ServiceRequest.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.system">
<path value="ServiceRequest.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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." />
<min value="1" />
<max value="1" />
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/local-identifier/servicerequest" />
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.value">
<path value="ServiceRequest.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](extension-rendered-value.html). 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." />
<min value="1" />
<max value="1" />
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.period">
<path value="ServiceRequest.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="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").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="1" />
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<code value="Period" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner">
<path value="ServiceRequest.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="1" />
<max value="1" />
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.id">
<path value="ServiceRequest.identifier.assigner.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.extension">
<path value="ServiceRequest.identifier.assigner.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.reference">
<path value="ServiceRequest.identifier.assigner.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="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." />
<min value="0" />
<max value="0" />
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.type">
<path value="ServiceRequest.identifier.assigner.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe 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)." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.identifier">
<path value="ServiceRequest.identifier.assigner.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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)." />
<min value="1" />
<max value="1" />
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<code value="Identifier" />
</type>
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
</fixedIdentifier>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.identifier.assigner.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.instantiatesCanonical">
<path value="ServiceRequest.instantiatesCanonical" />
<short value="Instantiates FHIR protocol or definition" />
<definition value="The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest." />
<comment value="Note: This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). 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." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.instantiatesCanonical" />
<min value="0" />
<max value="*" />
</base>
<code value="canonical" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PlanDefinition" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.instantiatesCanonical" />
</mapping>
<identity value="v2" />
<map value="Varies by domain" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=DEFN].target" />
</mapping>
</element>
<element id="ServiceRequest.instantiatesUri">
<path value="ServiceRequest.instantiatesUri" />
<short value="Instantiates external protocol or definition" />
<definition value="The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest." />
<comment value="This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.instantiatesUri" />
<min value="0" />
<max value="*" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.instantiatesUri" />
</mapping>
<identity value="v2" />
<map value="Varies by domain" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=DEFN].target" />
</mapping>
</element>
<element id="ServiceRequest.basedOn">
<path value="ServiceRequest.basedOn" />
<short value="What request fulfills" />
<definition value="SHALL reference a parent request where this ServiceRequest is based on a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or **Germline Late tests in the Tumour First/Germline Late scenario** (to link tests where prior requests contain clinical context).\nIt is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.\n\nWhere multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available, making the sample to be reprocessed unambiguous. In cases the data is required, rather than reprocessing of the sample itself, referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHALL be referenced from ServiceRequest.specimen as above. If multiple outputs are associated with a previous request, i.e. data from multiple samples, a ServiceRequest SHOULD reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo." />
<comment value="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." />
<alias value="fulfills" />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.basedOn" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
<targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.basedOn" />
</mapping>
<identity value="v2" />
<map value="ORC.8 (plus others)" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=FLFS].target" />
</mapping>
</element>
<element id="ServiceRequest.replaces">
<path value="ServiceRequest.replaces" />
<short value="What request replaces" />
<definition value="The request takes the place of the referenced completed or terminated request(s)." />
<comment value="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." />
<alias value="supersedes" />
<alias value="prior" />
<alias value="renewed order" />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.replaces" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.replaces" />
</mapping>
<identity value="v2" />
<map value="Handled by message location of ORC (ORC.1=RO or RU)" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=RPLC].target" />
</mapping>
</element>
<element id="ServiceRequest.requisition">
<path value="ServiceRequest.requisition" />
<short value="Composite Request ID" />
<definition value="SHALL be added for Duo/Trio (familial) requests in order to link tests together. Requisition Identifiers are used to generate RequestGroup resources that assist with management of linked requests. SHALL NOT be populated for other types of test (singleton) or other scenarios where requests/results need to be linked (see `ServiceRequest.basedOn` guidance).\nFor cases where the requisition identifier is required, it is expected that this is provided by client systems, as there are no rules on the central service that would be able to determine whether the test request is part of a Duo/Trio. As there are no central naming systems for requisition identifiers, it is expected the identifiers will be local identifiers following guidance on Referencing and Identifiers. Other mechanisms for determining or setting the requisition identifier, e.g. by the central service, or deterministically using patient/request identifiers are being investigated by the NHS England Genomics Unit.\n\nFor subsequent requests which are part of a group, it is expected the requisition identifier will be retrieved from the prior request, e.g. for the proband, either from the central broker or via some offline means, and will be recreated on the additional request exactly, including system and assigner, so the requests can be linked." />
<comment value="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." />
<requirements value="Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes." />
<alias value="grouperId" />
<alias value="groupIdentifier" />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.requisition" />
<min value="0" />
<max value="1" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="workflow" />
<map value="Request.groupIdentifier" />
</mapping>
<identity value="v2" />
<map value="ORC.4" />
</mapping>
<identity value="rim" />
<map value=".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier" />
</mapping>
</element>
<element id="ServiceRequest.status">
<path value="ServiceRequest.status" />
<short value="draft | active | on-hold | revoked | completed | entered-in-error | unknown" />
<definition value="SHALL be provided. ServiceRequests SHOULD be marked as `draft` until ready to be acted upon, after which the user should mark the ServiceRequest as `active`.\nA ServiceRequest with the status of draft is assumed to be incomplete, i.e. missing information required for further processing. As such, a central order management broker SHOULD refrain from adding Tasks for the ServiceRequest until it is marked as active, at which time the necessary Tasks are spun up automatically by the broker (this is to be tested within the Genomic Order Management beta). Keeping a ServiceRequest in the draft state allows other parties to populate additional data required, such as phenotypic information from a dedicated service, or further information via a web portal. It is expected that draft ServiceRequests will be purged from the system after a period of inactivity with appropriate warnings (yet to be determined) to avoid stale orders from obscuring live tests/results.\n\nA ServiceRequest may be marked as 'on-hold' if work against it cannot continue temporarily, e.g. due to certain prerequisite information not being provided. A ServiceRequest SHOULD be marked as 'revoked' if cancelled, either by the lab performing work against the order or at the request of the requesting clinician, though in each case a Provenance resource SHALL be provided to capture why the state change has occurred. The requesting clinician may also mark the ServiceRequest as entered-in-error, though implications for work already in progress needs to be investigated further.\n\nA ServiceRequest SHOULD only be marked as completed by the requesting clinician upon receipt and review of the resulting DiagnosticReport." />
<comment value="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 [Interactions](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/design/interactions.page.md) for general discussion) or using the [Task](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/fhirassets/allassets/profiles/genomics-task.page.md) resource." />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.status" />
<min value="1" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestStatus" />
</extension>
<strength value="required" />
<description value="The status of a service order." />
<valueSet value="http://hl7.org/fhir/ValueSet/request-status|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.status" />
</mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<identity value="v2" />
<map value="ORC.5,RF1-1" />
</mapping>
<identity value="rim" />
<map value=".status" />
</mapping>
<identity value="quick" />
<map value="Action.currentStatus" />
</mapping>
</element>
<element id="ServiceRequest.intent">
<path value="ServiceRequest.intent" />
<short value="proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option" />
<definition value="SHALL be provided. ServiceRequests SHOULD be marked as 'order' unless they have been raised by a lab in response to an existing ServiceRequest, in which case they SHOULD be marked as 'reflex-order'. For reflex orders, the ServiceRequest.basedOn field SHALL be populated with the original ServiceRequest, for traceability." />
<comment value="This element is labeled as a modifier because the intent alters when and how the resource is actually applicable." />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.intent" />
<min value="1" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isModifier value="true" />
<isModifierReason value="This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestIntent" />
</extension>
<strength value="required" />
<description value="The kind of service request." />
<valueSet value="http://hl7.org/fhir/ValueSet/request-intent|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.intent" />
</mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value=".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)" />
</mapping>
</element>
<element id="ServiceRequest.category">
<path value="ServiceRequest.category" />
<type value="value" />
<path value="coding.system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Classification of service" />
<definition value="Category SHALL be populated with the reason for the request being ordered e.g. Diagnostic, Carrier, Predictive, Stored DNA etc. The final list of applicable codes which can be selected is still under review, the Genomic-ReasonforTesting ValueSet SHOULD be used for this categorisation." />
<comment value="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." />
<requirements value="Used for filtering what service request are retrieved and displayed." />
<min value="1" />
<max value="*" />
<path value="ServiceRequest.category" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestCategory" />
</extension>
<strength value="example" />
<description value="Classification of the requested service." />
<valueSet value="http://hl7.org/fhir/ValueSet/servicerequest-category" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<identity value="v2" />
<map value="RF1-5" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing">
<path value="ServiceRequest.category" />
<sliceName value="genomicsWholeCaseSequencing" />
<short value="Classification of Genomics service" />
<definition value="A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases" />
<comment value="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." />
<requirements value="Used for filtering what service request are retrieved and displayed." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.category" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestCategory" />
</extension>
<strength value="extensible" />
<description value="Classification of the requested service." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<identity value="v2" />
<map value="RF1-5" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.id">
<path value="ServiceRequest.category.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.extension">
<path value="ServiceRequest.category.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding">
<path value="ServiceRequest.category.coding" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.id">
<path value="ServiceRequest.category.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.extension">
<path value="ServiceRequest.category.coding.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.system">
<path value="ServiceRequest.category.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="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." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="0" />
<max value="1" />
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.version">
<path value="ServiceRequest.category.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.code">
<path value="ServiceRequest.category.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to refer to a particular code in the system." />
<min value="0" />
<max value="1" />
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.category.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.userSelected">
<path value="ServiceRequest.category.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="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." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" />
</mapping>
</element>
<element id="ServiceRequest.category:genomicsWholeCaseSequencing.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.category.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="ServiceRequest.category:reasonForTesting">
<path value="ServiceRequest.category" />
<sliceName value="reasonForTesting" />
<short value="Classification of service" />
<definition value="A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure")." />
<comment value="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." />
<requirements value="Used for filtering what service request are retrieved and displayed." />
<min value="1" />
<max value="*" />
<path value="ServiceRequest.category" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestCategory" />
</extension>
<strength value="required" />
<description value="Classification of the requested service." />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-reasonfortesting" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<identity value="v2" />
<map value="RF1-5" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code" />
</mapping>
</element>
<element id="ServiceRequest.priority">
<path value="ServiceRequest.priority" />
<short value="routine | urgent | asap | stat" />
<definition value="ServiceRequests marked as urgent (i.e. not routine) SHOULD populate the extension:priorityReason with why an urgent test is being requested. This SHOULD ideally be coded using SNOMED CT concepts. Multiple priorityReason extensions are allowed within a single ServiceRequest in order to aid post-coordination." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.priority" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<meaningWhenMissing value="If missing, this task should be performed with normal priority" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestPriority" />
</extension>
<strength value="required" />
<description value="Identifies the level of importance to be assigned to actioning the request." />
<valueSet value="http://hl7.org/fhir/ValueSet/request-priority|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.priority" />
</mapping>
<identity value="w5" />
<map value="FiveWs.grade" />
</mapping>
<identity value="v2" />
<map value="TQ1.9, RF1-2" />
</mapping>
<identity value="rim" />
<map value=".priorityCode" />
</mapping>
</element>
<element id="ServiceRequest.priority.id">
<path value="ServiceRequest.priority.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.priority.extension">
<path value="ServiceRequest.priority.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.priority.extension:priorityReason">
<path value="ServiceRequest.priority.extension" />
<sliceName value="priorityReason" />
<short value="A SNOMED CT concept representing the reason a Service Request is urgent." />
<definition value="A SNOMED CT concept representing the reason a Service Request is urgent" />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.priority.value">
<path value="ServiceRequest.priority.value" />
<representation value="xmlAttr" />
<short value="Primitive value for code" />
<definition value="Primitive value for code" />
<min value="0" />
<max value="1" />
<path value="string.value" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="code" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/regex">
<valueString value="[^\s]+(\s[^\s]+)*" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<maxLength value="1048576" />
</element>
<element id="ServiceRequest.doNotPerform">
<path value="ServiceRequest.doNotPerform" />
<short value="True if service/procedure should not be performed" />
<definition value="For the purposes of Genomic Test Ordering, the doNotPerform field SHALL NOT be used. All ServiceRequests requests received by the system will be assumed to be orders for services/testing." />
<comment value="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." />
<requirements value="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." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.doNotPerform" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<meaningWhenMissing value="If missing, the request is a positive request e.g. "do perform"" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur." />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.doNotPerform" />
</mapping>
<identity value="rim" />
<map value=".actionNegationInd" />
</mapping>
</element>
<element id="ServiceRequest.code">
<path value="ServiceRequest.code" />
<short value="What is being requested/ordered" />
<definition value="SHOULD be provided if known. If populated, Code SHOULD contain an appropriate test code, preferrably a DGTS Genomic Test code, though NGTD codes MAY be used during the transition period, currently available at https://www.england.nhs.uk/publication/national-genomic-test-directories/. There is currently a prototype DGTS FHIR API in development to support querying/retrieving codes.\nCodes from the Genomic Test Directory SHOULD also specify the version number of the test at the time the test is being ordered, to ensure the test methods used are consistent with that version." />
<comment value="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." />
<alias value="service requested" />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.code" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestCode" />
</extension>
<strength value="preferred" />
<description value="A set of codes that define a procedure or a procedure with explicit context. Selected from the SNOMED CT UK coding system." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="workflow" />
<map value="Request.code" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="PR1-3 / OBR-4 (varies by domain)" />
</mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
<identity value="quick" />
<map value="Procedure.procedureCode" />
</mapping>
</element>
<element id="ServiceRequest.code.id">
<path value="ServiceRequest.code.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.code.extension">
<path value="ServiceRequest.code.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.code.coding">
<path value="ServiceRequest.code.coding" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode">
<path value="ServiceRequest.code.coding" />
<sliceName value="DGTSCode" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.id">
<path value="ServiceRequest.code.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.extension">
<path value="ServiceRequest.code.coding.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.extension:genomicTestCodeVersion">
<path value="ServiceRequest.code.coding.extension" />
<sliceName value="genomicTestCodeVersion" />
<short value="Optional Extensions Element" />
<definition value="Optional Extension Element - found in all resources." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.system">
<path value="ServiceRequest.code.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="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." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="0" />
<max value="1" />
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.version">
<path value="ServiceRequest.code.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.code">
<path value="ServiceRequest.code.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to refer to a particular code in the system." />
<min value="0" />
<max value="1" />
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.code.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="ServiceRequest.code.coding:DGTSCode.userSelected">
<path value="ServiceRequest.code.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="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." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" />
</mapping>
</element>
<element id="ServiceRequest.code.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.code.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail">
<path value="ServiceRequest.orderDetail" />
<short value="Additional order information" />
<definition value="If additional coded details need to captured as part of a test order, e.g. Panels or targeted genes, these SHOULD be represented using the 'orderDetail' field, with the main indication captured using the 'reasonCode' field. If completely separate pathways/samples etc. are required for processing against the codes, it is expected these would be requested via multiple ServiceRequests instead of a single ServiceRequest with multiple orderDetail codes. The exact cut-off for when orderDetail vs. multiple ServiceRequest should be used is still being investigated. An appropriate code(Panel codes) SHOULD come from the following NamingSystem: England-GenomicTestPanelCode\nFor Cancer WGS, where no panel or test-level details are relevant, orderDetail SHOULD be omitted." />
<comment value="For information from the medical record intended to support the delivery of the requested services, use the `supportingInformation` element." />
<alias value="detailed instructions" />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.orderDetail" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<condition value="prr-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="OrderDetail" />
</extension>
<strength value="preferred" />
<description value="Codified order entry details which are based on order context." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="NTE" />
</mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
<identity value="quick" />
<map value="Procedure.procedureCode" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.id">
<path value="ServiceRequest.orderDetail.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.extension">
<path value="ServiceRequest.orderDetail.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding">
<path value="ServiceRequest.orderDetail.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode">
<path value="ServiceRequest.orderDetail.coding" />
<sliceName value="genomicsTestPanelCode" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.id">
<path value="ServiceRequest.orderDetail.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension">
<path value="ServiceRequest.orderDetail.coding.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension:genomicTestCodeVersion">
<path value="ServiceRequest.orderDetail.coding.extension" />
<sliceName value="genomicTestCodeVersion" />
<short value="Optional Extensions Element" />
<definition value="Optional Extension Element - found in all resources." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.system">
<path value="ServiceRequest.orderDetail.coding.system" />
<short value="Genomics Test Panel Code" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="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." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="0" />
<max value="1" />
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestPanelCode" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.version">
<path value="ServiceRequest.orderDetail.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.code">
<path value="ServiceRequest.orderDetail.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to refer to a particular code in the system." />
<min value="0" />
<max value="1" />
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.orderDetail.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.userSelected">
<path value="ServiceRequest.orderDetail.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="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." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" />
</mapping>
</element>
<element id="ServiceRequest.orderDetail.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.orderDetail.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="ServiceRequest.quantity[x]">
<path value="ServiceRequest.quantity[x]" />
<short value="Service amount" />
<definition value="An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction)." />
<requirements value="When ordering a service the number of service items may need to be specified separately from the the service item." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.quantity[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="Quantity" />
</type>
<code value="Ratio" />
</type>
<code value="Range" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="NTE" />
</mapping>
<identity value="rim" />
<map value=".quantity" />
</mapping>
</element>
<element id="ServiceRequest.subject">
<path value="ServiceRequest.subject" />
<short value="Individual or Entity the service is ordered for" />
<definition value="SHALL be provided. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS" />
<comment value="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." />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.subject" />
<min value="1" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.subject" />
</mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<identity value="v2" />
<map value="PID" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].role" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.subject" />
</mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="ServiceRequest.encounter">
<path value="ServiceRequest.encounter" />
<short value="Encounter in which the request was created" />
<definition value="An encounter that provides additional information about the healthcare context in which this request is made." />
<comment value="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." />
<alias value="context" />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.encounter" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.encounter" />
</mapping>
<identity value="w5" />
<map value="FiveWs.context" />
</mapping>
<identity value="v2" />
<map value="PV1" />
</mapping>
<identity value="rim" />
<map value=".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.encounter" />
</mapping>
</element>
<element id="ServiceRequest.occurrence[x]">
<path value="ServiceRequest.occurrence[x]" />
<short value="When service should occur" />
<definition value="If a result is required by a specific date, this MAY be indicated though occurrenceDateTime, though there is no guarantee from the GMS that the ServiceRequest will be processed in the time frame specified." />
<alias value="schedule" />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.occurrence[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="dateTime" />
</type>
<code value="Period" />
</type>
<code value="Timing" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.occurrence[x]" />
</mapping>
<identity value="w5" />
<map value="FiveWs.planned" />
</mapping>
<identity value="v2" />
<map value="TQ1/TQ2, OBR-7/OBR-8" />
</mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
<identity value="quick" />
<map value="Procedure.procedureSchedule" />
</mapping>
</element>
<element id="ServiceRequest.asNeeded[x]">
<path value="ServiceRequest.asNeeded[x]" />
<short value="Preconditions for service" />
<definition value="If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.asNeeded[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureAsNeededReason" />
</extension>
<strength value="example" />
<description value="A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc." />
<valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value" />
</mapping>
<identity value="quick" />
<map value="Proposal.prnReason.reason" />
</mapping>
</element>
<element id="ServiceRequest.authoredOn">
<path value="ServiceRequest.authoredOn" />
<short value="Date request signed" />
<definition value="SHALL be populated by the client upon submission, either manually by the user or automatically by the system integrating with the central GMS." />
<alias value="orderedOn" />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.authoredOn" />
<min value="0" />
<max value="1" />
</base>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="workflow" />
<map value="Request.authoredOn" />
</mapping>
<identity value="w5" />
<map value="FiveWs.recorded" />
</mapping>
<identity value="v2" />
<map value="ORC.9, RF1-7 / RF1-9" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=AUT].time" />
</mapping>
<identity value="quick" />
<map value="Proposal.proposedAtTime" />
</mapping>
</element>
<element id="ServiceRequest.requester">
<path value="ServiceRequest.requester" />
<short value="Who/what is requesting service" />
<definition value="SHALL be populated on all ServiceRequests submitted to the central GMS. This SHALL reference a PractitionerRole resource also submitted to the system (either within a single transaction or previously POSTed)." />
<comment value="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." />
<alias value="author" />
<alias value="orderer" />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.requester" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.requester" />
</mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<identity value="v2" />
<map value="ORC.12, PRT" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=AUT].role" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.statementAuthor" />
</mapping>
</element>
<element id="ServiceRequest.performerType">
<path value="ServiceRequest.performerType" />
<short value="Performer role" />
<definition value="Desired type of performer for doing the requested service." />
<comment value="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”." />
<alias value="specialty" />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.performerType" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestParticipantRole" />
</extension>
<strength value="example" />
<description value="Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc." />
<valueSet value="http://hl7.org/fhir/ValueSet/participant-role" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="workflow" />
<map value="Request.performerType" />
</mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<identity value="v2" />
<map value="PRT, RF!-3" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code" />
</mapping>
</element>
<element id="ServiceRequest.performer">
<path value="ServiceRequest.performer" />
<short value="Requested performer" />
<definition value="Allows a requester to assign processing of the ServiceRequest to a particular organization (e.g. a remote GLH). The performer field SHOULD be populated with the ODS code for the managing organization/GLH.\nIn the future state, ServiceRequests may be kept open, by not specifying a performer, allowing them to be picked up by the local GLH or otherwise routed based on by test routing (TBC)." />
<comment value="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](extension-request-performerorder.html). Use CareTeam to represent a group of performers (for example, Practitioner A *and* Practitioner B)." />
<alias value="request recipient" />
<min value="0" />
<max value="1" />
<path value="ServiceRequest.performer" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.performer" />
</mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<identity value="v2" />
<map value="PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]" />
</mapping>
</element>
<element id="ServiceRequest.performer.id">
<path value="ServiceRequest.performer.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.performer.extension">
<path value="ServiceRequest.performer.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.performer.reference">
<path value="ServiceRequest.performer.reference" />
<short value="Literal reference, Relative, internal or absolute URL" />
<definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Reference.reference" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<condition value="ref-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.performer.type">
<path value="ServiceRequest.performer.type" />
<short value="Type the reference refers to (e.g. "Patient")" />
<definition value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe 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)." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Reference.type" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="FHIRResourceTypeExt" />
</extension>
<strength value="extensible" />
<description value="Aa resource (or, for logical models, the URI of the logical model)." />
<valueSet value="http://hl7.org/fhir/ValueSet/resource-types" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier">
<path value="ServiceRequest.performer.identifier" />
<short value="Logical reference, when literal reference is not known" />
<definition value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
<comment value="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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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)." />
<min value="1" />
<max value="1" />
<path value="Reference.identifier" />
<min value="0" />
<max value="1" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="rim" />
<map value=".identifier" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.id">
<path value="ServiceRequest.performer.identifier.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.extension">
<path value="ServiceRequest.performer.identifier.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.use">
<path value="ServiceRequest.performer.identifier.use" />
<short value="usual | official | temp | secondary | old (If known)" />
<definition value="The purpose of this identifier." />
<comment value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary." />
<requirements value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers." />
<min value="0" />
<max value="1" />
<path value="Identifier.use" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one." />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierUse" />
</extension>
<strength value="required" />
<description value="Identifies the purpose for this identifier, if known ." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.type">
<path value="ServiceRequest.performer.identifier.type" />
<short value="Description of identifier" />
<definition value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose." />
<comment value="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." />
<requirements value="Allows users to make use of identifiers when the identifier system is not known." />
<min value="0" />
<max value="1" />
<path value="Identifier.type" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="IdentifierType" />
</extension>
<strength value="extensible" />
<description value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose." />
<valueSet value="http://hl7.org/fhir/ValueSet/identifier-type" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="CX.5" />
</mapping>
<identity value="rim" />
<map value="Role.code or implied by context" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.system">
<path value="ServiceRequest.performer.identifier.system" />
<short value="The namespace for the identifier value" />
<definition value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique." />
<comment value="Identifier.system is always case sensitive." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="Identifier.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/Id/ods-organization-code" />
<label value="General" />
<valueUri value="http://www.acme.com/identifiers/patient" />
</example>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.4 / EI-2-4" />
</mapping>
<identity value="rim" />
<map value="II.root or Role.id.root" />
</mapping>
<identity value="servd" />
<map value="./IdentifierType" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.value">
<path value="ServiceRequest.performer.identifier.value" />
<short value="The value that is unique" />
<definition value="The portion of the identifier typically relevant to the user and which is unique within the context of the system." />
<comment value="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](extension-rendered-value.html). 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." />
<min value="0" />
<max value="1" />
<path value="Identifier.value" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<label value="General" />
<valueString value="123456" />
</example>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX.1 / EI.1" />
</mapping>
<identity value="rim" />
<map value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" />
</mapping>
<identity value="servd" />
<map value="./Value" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.period">
<path value="ServiceRequest.performer.identifier.period" />
<short value="Time period when id is/was valid for use" />
<definition value="Time period during which identifier is/was valid for use." />
<comment value="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").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
<min value="0" />
<max value="1" />
<path value="Identifier.period" />
<min value="0" />
<max value="1" />
</base>
<code value="Period" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="per-1" />
<severity value="error" />
<human value="If present, start SHALL have a lower value than end" />
<expression value="start.hasValue().not() or end.hasValue().not() or (start <= end)" />
<xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))" />
<source value="http://hl7.org/fhir/StructureDefinition/Period" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="DR" />
</mapping>
<identity value="rim" />
<map value="IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]" />
</mapping>
<identity value="v2" />
<map value="CX.7 + CX.8" />
</mapping>
<identity value="rim" />
<map value="Role.effectiveTime or implied by context" />
</mapping>
<identity value="servd" />
<map value="./StartDate and ./EndDate" />
</mapping>
</element>
<element id="ServiceRequest.performer.identifier.assigner">
<path value="ServiceRequest.performer.identifier.assigner" />
<short value="Organization that issued id (may be just text)" />
<definition value="Organization that issued/manages the identifier." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Identifier.assigner" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="CX.4 / (CX.4,CX.9,CX.10)" />
</mapping>
<identity value="rim" />
<map value="II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" />
</mapping>
<identity value="servd" />
<map value="./IdentifierIssuingAuthority" />
</mapping>
</element>
<element id="ServiceRequest.performer.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.performer.display" />
<short value="Text alternative for the resource" />
<definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Reference.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.locationCode">
<path value="ServiceRequest.locationCode" />
<short value="Requested location" />
<definition value="The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center." />
<comment value="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." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.locationCode" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestLocation" />
</extension>
<strength value="example" />
<description value="A location type where services are delivered." />
<valueSet value="http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=LOC].role[scoper.determinerCode=KIND].code" />
</mapping>
</element>
<element id="ServiceRequest.locationReference">
<path value="ServiceRequest.locationReference" />
<short value="Requested location" />
<definition value="A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center." />
<comment value="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." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.locationReference" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=LOC].role[scoper.determinerCode=INSTANCE]" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode">
<path value="ServiceRequest.reasonCode" />
<type value="pattern" />
<path value="coding.system" />
</discriminator>
<rules value="open" />
</slicing>
<short value="Explanation/Justification for procedure or service" />
<definition value="An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in `supportingInfo`." />
<comment value="This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the [CT Scan example](servicerequest-example-di.html)." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.reasonCode" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestReason" />
</extension>
<strength value="preferred" />
<description value="A set of codes that define a reason for a service request." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="workflow" />
<map value="Request.reasonCode" />
</mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<identity value="v2" />
<map value="ORC.16, RF1-10" />
</mapping>
<identity value="rim" />
<map value=".reasonCode" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage">
<path value="ServiceRequest.reasonCode" />
<sliceName value="DGTSTestPackage" />
<short value="Explanation/Justification for procedure or service" />
<definition value="reasonCode SHALL be populated with the Test Package code for the order." />
<comment value="This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the [CT Scan example](servicerequest-example-di.html)." />
<min value="1" />
<max value="1" />
<path value="ServiceRequest.reasonCode" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ServiceRequestReason" />
</extension>
<strength value="preferred" />
<description value="A set of codes that define a reason for a service request." />
<valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="workflow" />
<map value="Request.reasonCode" />
</mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<identity value="v2" />
<map value="ORC.16, RF1-10" />
</mapping>
<identity value="rim" />
<map value=".reasonCode" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.id">
<path value="ServiceRequest.reasonCode.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.extension">
<path value="ServiceRequest.reasonCode.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding">
<path value="ServiceRequest.reasonCode.coding" />
<short value="Code defined by a terminology system" />
<definition value="A reference to a code defined by a terminology system." />
<comment value="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." />
<requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
<min value="0" />
<max value="*" />
<path value="CodeableConcept.coding" />
<min value="0" />
<max value="*" />
</base>
<code value="Coding" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
</mapping>
<identity value="rim" />
<map value="CV" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
</mapping>
<identity value="v2" />
<map value="C*E.1-8, C*E.10-22" />
</mapping>
<identity value="rim" />
<map value="union(., ./translation)" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.id">
<path value="ServiceRequest.reasonCode.coding.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.extension">
<path value="ServiceRequest.reasonCode.coding.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.extension:genomicTestCodeVersion">
<path value="ServiceRequest.reasonCode.coding.extension" />
<sliceName value="genomicTestCodeVersion" />
<short value="Optional Extensions Element" />
<definition value="Optional Extension Element - found in all resources." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.system">
<path value="ServiceRequest.reasonCode.coding.system" />
<short value="Identity of the terminology system" />
<definition value="The identification of the code system that defines the meaning of the symbol in the code." />
<comment value="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." />
<requirements value="Need to be unambiguous about the source of the definition of the symbol." />
<min value="0" />
<max value="1" />
<path value="Coding.system" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<fixedUri value="https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.3" />
</mapping>
<identity value="rim" />
<map value="./codeSystem" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.version">
<path value="ServiceRequest.reasonCode.coding.version" />
<short value="Version of the system - if relevant" />
<definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
<comment value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.version" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.7" />
</mapping>
<identity value="rim" />
<map value="./codeSystemVersion" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.code">
<path value="ServiceRequest.reasonCode.coding.code" />
<short value="Symbol in syntax defined by the system" />
<definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to refer to a particular code in the system." />
<min value="0" />
<max value="1" />
<path value="Coding.code" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.1" />
</mapping>
<identity value="rim" />
<map value="./code" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.display">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.reasonCode.coding.display" />
<short value="Representation defined by the system" />
<definition value="A representation of the meaning of the code in the system, following the rules of the system." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system." />
<min value="0" />
<max value="1" />
<path value="Coding.display" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.2 - but note this is not well followed" />
</mapping>
<identity value="rim" />
<map value="CV.displayName" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.userSelected">
<path value="ServiceRequest.reasonCode.coding.userSelected" />
<short value="If this coding was chosen directly by the user" />
<definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
<comment value="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." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="Coding.userSelected" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="Sometimes implied by being first" />
</mapping>
<identity value="rim" />
<map value="CD.codingRationale" />
</mapping>
<identity value="orim" />
<map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]" />
</mapping>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.text">
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
<valueBoolean value="true" />
</extension>
<path value="ServiceRequest.reasonCode.text" />
<short value="Plain text representation of the concept" />
<definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
<comment value="Very often the text is the same as a displayName of one of the codings." />
<requirements value="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." />
<min value="0" />
<max value="1" />
<path value="CodeableConcept.text" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="C*E.9. But note many systems use C*E.2 for this" />
</mapping>
<identity value="rim" />
<map value="./originalText[mediaType/code="text/plain"]/data" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
</mapping>
</element>
<element id="ServiceRequest.reasonReference">
<path value="ServiceRequest.reasonReference" />
<short value="Explanation/Justification for service or service" />
<definition value="Reference SHOULD be associated to the primary condition being tested for. Required if additional information related to the condition, such as onsetAge, needs to be captured for interpretation." />
<comment value="This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to *Observation* or *Condition* should be used if available. Otherwise when referencing *DiagnosticReport* it should contain a finding in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`. When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](servicerequest-example-di.html)." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.reasonReference" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.reasonReference" />
</mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<identity value="v2" />
<map value="ORC.16" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=RSON].target" />
</mapping>
</element>
<element id="ServiceRequest.insurance">
<path value="ServiceRequest.insurance" />
<short value="Associated insurance coverage" />
<definition value="Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service." />
<comment value="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." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.insurance" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Coverage" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ClaimResponse" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.insurance" />
</mapping>
<identity value="v2" />
<map value="IN1/IN2" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COVBY].target" />
</mapping>
</element>
<element id="ServiceRequest.supportingInfo">
<path value="ServiceRequest.supportingInfo" />
<short value="Additional clinical information" />
<definition value="Any clinical information provided about the patient for whom the testing is being requested SHALL be referenced though the supportingInfo field, to ensure all the information relevant to the ServiceRequest can be easily retrieved. This includes Observations, Conditions, Procedures, FamilyMemberHistories etc.\nThis also includes resources related to family members included as part of testing (consultands), e.g. in Duo/Trio scenarios. In this instance, RelatedPerson and Patient resource references for the consultands SHALL be added to the supportingInfo array, as well as any clinical resources related to these individuals. This is to ensure the number of participants for a given test can be calculated correctly, e.g. through counting the number of RelatedPerson resources referenced from ServiceRequest.supportingInfo plus the subject of the ServiceRequest itself (the proband).\n\nFor WGS testing, where Records of Discussion are required in order to process the test, Consent resources SHOULD also be added to the supportingInfo array once available." />
<comment value="To represent information about how the services are to be delivered use the `instructions` element." />
<alias value="Ask at order entry question" />
<alias value="AOE" />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.supportingInfo" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.supportingInfo" />
</mapping>
<identity value="v2" />
<map value="Accompanying segments" />
</mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=PERT].target" />
</mapping>
</element>
<element id="ServiceRequest.specimen">
<path value="ServiceRequest.specimen" />
<short value="Procedure Samples" />
<definition value="ServiceRequests where the required samples already exist, e.g. in the case where a specimen already in storage needs to be processed, SHOULD reference these samples through the ServiceRequest.specimen field. Where samples need to be collected to support testing, these SHOULD instead reference the ServiceRequest, through Specimen.request (i.e. the service request has prompted collection of the sample), and these Specimen resources do not need to be referenced from within ServiceRequest.supportingInfo. The referenced Specimen resources SHOULD either be contained within the test order transaction bundle or already exist on the central GMS.\nIn the case of Reanalysis or Reinterpretation tests, Specimens related to previous ServiceRequest are not required to be added to the new test request. The links from the previous ServiceRequest can be followed to identify the Specimens that resulted in the data being reanalysed, e.g. (reanalysis) ServiceRequest.basedOn -> (prior) ServiceRequest, (prior) ServiceRequest <- (original) Specimen.request\n\nFor requests based on prior requests where multiple samples 'active' are associated with the prior request. The specific sample to be reprocessed SHALL be referenced from ServiceRequest.specimen." />
<comment value="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](specimen.html) resource points to the ServiceRequest." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.specimen" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Specimen" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="v2" />
<map value="SPM" />
</mapping>
<identity value="rim" />
<map value=".participation[typeCode=SPC].role" />
</mapping>
</element>
<element id="ServiceRequest.bodySite">
<path value="ServiceRequest.bodySite" />
<short value="Location on Body" />
<definition value="Anatomic location where the procedure should be performed. This is the target site." />
<comment value="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](extension-procedure-targetbodystructure.html)." />
<requirements value="Knowing where the procedure is performed is important for tracking if multiple sites are possible." />
<alias value="location" />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.bodySite" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodySite" />
</extension>
<strength value="preferred" />
<description value="Codes describing anatomical locations. May include laterality." />
<valueSet value="http://hl7.org/fhir/ValueSet/body-site" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="v2" />
<map value="SPM" />
</mapping>
<identity value="rim" />
<map value="targetSiteCode" />
</mapping>
<identity value="quick" />
<map value="Procedure.targetBodySite" />
</mapping>
</element>
<element id="ServiceRequest.note">
<path value="ServiceRequest.note" />
<short value="Comments" />
<definition value="Any information which cannot be readily be structured SHOULD be entered into the note field, though prolific use of the field to capture clinical information which better fits in level 3/4 FHIR resources is discouraged.\nTo support disambiguation of notes originating from different fields in a client system, the AnnotationType extension MAY be used, specifying the UI element name in text (coded elements for the full list of free text UI elements expected within Test Order forms is pending finalisation and addition to the Genomic Order Management MDS). The author element MAY also be used to reference a Practitioner, by identifier or name (string), indicating the person who created the note." />
<comment value="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)." />
<min value="0" />
<max value="*" />
<path value="ServiceRequest.note" />
<min value="0" />
<max value="*" />
</base>
<code value="Annotation" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act" />
</mapping>
<identity value="workflow" />
<map value="Request.note" />
</mapping>
<identity value="v2" />
<map value="NTE" />
</mapping>
<identity value="rim" />
<map value=".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]" />
</mapping>
<identity value="quick" />
<map value="ClinicalStatement.additionalText" />
</mapping>
</element>
<element id="ServiceRequest.note.id">
<path value="ServiceRequest.note.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="ServiceRequest.note.extension">
<path value="ServiceRequest.note.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.note.extension:annotationType">
<path value="ServiceRequest.note.extension" />
<sliceName value="annotationType" />
<short value="The type of annotation" />
<definition value="The type of annotation. This extension can be used to map the v2 NTE-4 comment type field." />
<comment value="This is used to identify the type of annotation." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/annotationType" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="false" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="ServiceRequest.note.author[x]">
<path value="ServiceRequest.note.author[x]" />
<short value="Individual responsible for the annotation" />
<definition value="The individual responsible for making the annotation." />
<comment value="Organization is used when there's no need for specific attribution as to who made the comment." />
<min value="0" />
<max value="1" />
<path value="Annotation.author[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act.participant[typeCode=AUT].role" />
</mapping>
</element>
<element id="ServiceRequest.note.time">
<path value="ServiceRequest.note.time" />
<short value="When the annotation was made" />
<definition value="Indicates when this particular annotation was made." />
<min value="0" />
<max value="1" />
<path value="Annotation.time" />
<min value="0" />
<max value="1" />
</base>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act.effectiveTime" />
</mapping>
</element>
<element id="ServiceRequest.note.text">
<path value="ServiceRequest.note.text" />
<short value="The annotation - text content (as markdown)" />
<definition value="The text of the annotation in markdown format." />
<comment value="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/" />
<min value="1" />
<max value="1" />
<path value="Annotation.text" />
<min value="1" />
<max value="1" />
</base>
<code value="markdown" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act.text" />
</mapping>
</element>
<element id="ServiceRequest.patientInstruction">
<path value="ServiceRequest.patientInstruction" />
<short value="Patient or consumer-oriented instructions" />
<definition value="Instructions in terms that are understood by the patient or consumer." />
<comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.patientInstruction" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="NTE" />
</mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
</element>
<element id="ServiceRequest.relevantHistory">
<path value="ServiceRequest.relevantHistory" />
<short value="Request provenance" />
<definition value="Key events in the history of the request." />
<comment value="This might not include provenances for all versions of the request – only those deemed “relevant” or important.\nThis 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\nAll Provenances should have some historical version of this Request as their subject." />
<min value="0" />
<max value="0" />
<path value="ServiceRequest.relevantHistory" />
<min value="0" />
<max value="*" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="workflow" />
<map value="Request.relevantHistory" />
</mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]" />
</mapping>
</element>
</snapshot>
<element id="ServiceRequest.extension">
<path value="ServiceRequest.extension" />
<min value="1" />
</element>
<element id="ServiceRequest.extension:additionalContact">
<path value="ServiceRequest.extension" />
<sliceName value="additionalContact" />
<definition value="Extension used for recording additional personnel who should be contacted regarding questions related to a test order. This is separate from the requester or reporting address.\n\nThe additional contact SHOULD be a reference to a PractitionerRole resource wherever possible and SHALL contain contact details for the practitioner.\n\nAdditionally, where are there multiple practitioners involved in providing care who need to be listed as contacts, the contact details for each practitioner (or service) SHOULD be specified through additional additionalContact entries." />
</element>
<element id="ServiceRequest.extension:coverage">
<path value="ServiceRequest.extension" />
<sliceName value="coverage" />
<definition value="SHALL be present for Genomic Order Management test orders. Extension for recording how work against the test order is being funded. The ValueSet bound to this extension is currently under review by the NHS England Genomics Informatics Working Advisory Group and subject to change." />
<min value="1" />
</element>
<element id="ServiceRequest.extension:genomicParticipantCount">
<path value="ServiceRequest.extension" />
<sliceName value="genomicParticipantCount" />
<definition value="Genomics specific extension used to record the total number of participants in a group test request.(e.g. family, duo / trio). SHALL be provided on the Proband test request which is part of a group. This will be copied to the RequestGroup to inform lab orchestration." />
<max value="1" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount" />
</type>
<isModifier value="false" />
</element>
<element id="ServiceRequest.extension:genomicPatientRole">
<path value="ServiceRequest.extension" />
<sliceName value="genomicPatientRole" />
<definition value="Genomics specific extension to support family testing. SHALL be present on requests in Duo/Trio use cases where there is a need to differentiate a request for a Proband (which needs to be reported on), from the request for a consultand, which may not result in a report.\nIt is expected that this will impact the Tasks spun up by the central service, though this is currently still under development." />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role" />
</type>
<isModifier value="false" />
<strength value="required" />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-patient-role" />
</binding>
</element>
<element id="ServiceRequest.identifier">
<path value="ServiceRequest.identifier" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
<definition value="Automatically assigned by the central service, though source systems MAY provide a local identifier for tracking within their own system, in which case the central order number is appended to the identifiers array." />
<min value="1" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder">
<path value="ServiceRequest.identifier" />
<sliceName value="identifierGMSOrder" />
<max value="1" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.use">
<path value="ServiceRequest.identifier.use" />
<max value="0" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.type">
<path value="ServiceRequest.identifier.type" />
<max value="0" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.system">
<path value="ServiceRequest.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/Id/GMSOrder" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.value">
<path value="ServiceRequest.identifier.value" />
<min value="1" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.period">
<path value="ServiceRequest.identifier.period" />
<max value="0" />
</element>
<element id="ServiceRequest.identifier:identifierGMSOrder.assigner">
<path value="ServiceRequest.identifier.assigner" />
<max value="0" />
</element>
<element id="ServiceRequest.identifier:localIdentifier">
<path value="ServiceRequest.identifier" />
<sliceName value="localIdentifier" />
</element>
<element id="ServiceRequest.identifier:localIdentifier.system">
<path value="ServiceRequest.identifier.system" />
<min value="1" />
<fixedUri value="https://fhir.nhs.uk/local-identifier/servicerequest" />
</element>
<element id="ServiceRequest.identifier:localIdentifier.value">
<path value="ServiceRequest.identifier.value" />
<min value="1" />
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner">
<path value="ServiceRequest.identifier.assigner" />
<min value="1" />
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.reference">
<path value="ServiceRequest.identifier.assigner.reference" />
<max value="0" />
</element>
<element id="ServiceRequest.identifier:localIdentifier.assigner.identifier">
<path value="ServiceRequest.identifier.assigner.identifier" />
<min value="1" />
<system value="https://fhir.nhs.uk/Id/ods-organization-code" />
</fixedIdentifier>
</element>
<element id="ServiceRequest.basedOn">
<path value="ServiceRequest.basedOn" />
<definition value="SHALL reference a parent request where this ServiceRequest is based on a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or **Germline Late tests in the Tumour First/Germline Late scenario** (to link tests where prior requests contain clinical context).\nIt is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.\n\nWhere multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available, making the sample to be reprocessed unambiguous. In cases the data is required, rather than reprocessing of the sample itself, referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHALL be referenced from ServiceRequest.specimen as above. If multiple outputs are associated with a previous request, i.e. data from multiple samples, a ServiceRequest SHOULD reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo." />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
<targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.replaces">
<path value="ServiceRequest.replaces" />
<max value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics" />
</type>
</element>
<element id="ServiceRequest.requisition">
<path value="ServiceRequest.requisition" />
<definition value="SHALL be added for Duo/Trio (familial) requests in order to link tests together. Requisition Identifiers are used to generate RequestGroup resources that assist with management of linked requests. SHALL NOT be populated for other types of test (singleton) or other scenarios where requests/results need to be linked (see `ServiceRequest.basedOn` guidance).\nFor cases where the requisition identifier is required, it is expected that this is provided by client systems, as there are no rules on the central service that would be able to determine whether the test request is part of a Duo/Trio. As there are no central naming systems for requisition identifiers, it is expected the identifiers will be local identifiers following guidance on Referencing and Identifiers. Other mechanisms for determining or setting the requisition identifier, e.g. by the central service, or deterministically using patient/request identifiers are being investigated by the NHS England Genomics Unit.\n\nFor subsequent requests which are part of a group, it is expected the requisition identifier will be retrieved from the prior request, e.g. for the proband, either from the central broker or via some offline means, and will be recreated on the additional request exactly, including system and assigner, so the requests can be linked." />
</element>
<element id="ServiceRequest.status">
<path value="ServiceRequest.status" />
<definition value="SHALL be provided. ServiceRequests SHOULD be marked as `draft` until ready to be acted upon, after which the user should mark the ServiceRequest as `active`.\nA ServiceRequest with the status of draft is assumed to be incomplete, i.e. missing information required for further processing. As such, a central order management broker SHOULD refrain from adding Tasks for the ServiceRequest until it is marked as active, at which time the necessary Tasks are spun up automatically by the broker (this is to be tested within the Genomic Order Management beta). Keeping a ServiceRequest in the draft state allows other parties to populate additional data required, such as phenotypic information from a dedicated service, or further information via a web portal. It is expected that draft ServiceRequests will be purged from the system after a period of inactivity with appropriate warnings (yet to be determined) to avoid stale orders from obscuring live tests/results.\n\nA ServiceRequest may be marked as 'on-hold' if work against it cannot continue temporarily, e.g. due to certain prerequisite information not being provided. A ServiceRequest SHOULD be marked as 'revoked' if cancelled, either by the lab performing work against the order or at the request of the requesting clinician, though in each case a Provenance resource SHALL be provided to capture why the state change has occurred. The requesting clinician may also mark the ServiceRequest as entered-in-error, though implications for work already in progress needs to be investigated further.\n\nA ServiceRequest SHOULD only be marked as completed by the requesting clinician upon receipt and review of the resulting DiagnosticReport." />
<comment value="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 [Interactions](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/design/interactions.page.md) for general discussion) or using the [Task](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/fhirassets/allassets/profiles/genomics-task.page.md) resource." />
</element>
<element id="ServiceRequest.intent">
<path value="ServiceRequest.intent" />
<definition value="SHALL be provided. ServiceRequests SHOULD be marked as 'order' unless they have been raised by a lab in response to an existing ServiceRequest, in which case they SHOULD be marked as 'reflex-order'. For reflex orders, the ServiceRequest.basedOn field SHALL be populated with the original ServiceRequest, for traceability." />
</element>
<element id="ServiceRequest.category">
<path value="ServiceRequest.category" />
<definition value="Category SHALL be populated with the reason for the request being ordered e.g. Diagnostic, Carrier, Predictive, Stored DNA etc. The final list of applicable codes which can be selected is still under review, the Genomic-ReasonforTesting ValueSet SHOULD be used for this categorisation." />
<min value="1" />
</element>
<element id="ServiceRequest.category:reasonForTesting">
<path value="ServiceRequest.category" />
<sliceName value="reasonForTesting" />
<min value="1" />
<strength value="required" />
<valueSet value="https://fhir.nhs.uk/ValueSet/genomics-reasonfortesting" />
</binding>
</element>
<element id="ServiceRequest.priority">
<path value="ServiceRequest.priority" />
<definition value="ServiceRequests marked as urgent (i.e. not routine) SHOULD populate the extension:priorityReason with why an urgent test is being requested. This SHOULD ideally be coded using SNOMED CT concepts. Multiple priorityReason extensions are allowed within a single ServiceRequest in order to aid post-coordination." />
</element>
<element id="ServiceRequest.doNotPerform">
<path value="ServiceRequest.doNotPerform" />
<definition value="For the purposes of Genomic Test Ordering, the doNotPerform field SHALL NOT be used. All ServiceRequests requests received by the system will be assumed to be orders for services/testing." />
<max value="0" />
</element>
<element id="ServiceRequest.code">
<path value="ServiceRequest.code" />
<definition value="SHOULD be provided if known. If populated, Code SHOULD contain an appropriate test code, preferrably a DGTS Genomic Test code, though NGTD codes MAY be used during the transition period, currently available at https://www.england.nhs.uk/publication/national-genomic-test-directories/. There is currently a prototype DGTS FHIR API in development to support querying/retrieving codes.\nCodes from the Genomic Test Directory SHOULD also specify the version number of the test at the time the test is being ordered, to ensure the test methods used are consistent with that version." />
<min value="1" />
</element>
<element id="ServiceRequest.code.coding">
<path value="ServiceRequest.code.coding" />
<type value="pattern" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="ServiceRequest.code.coding:DGTSCode">
<path value="ServiceRequest.code.coding" />
<sliceName value="DGTSCode" />
<max value="1" />
</element>
<element id="ServiceRequest.code.coding:DGTSCode.extension:genomicTestCodeVersion">
<path value="ServiceRequest.code.coding.extension" />
<sliceName value="genomicTestCodeVersion" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</type>
<isModifier value="false" />
</element>
<element id="ServiceRequest.code.coding:DGTSCode.system">
<path value="ServiceRequest.code.coding.system" />
<fixedUri value="https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService" />
</element>
<element id="ServiceRequest.orderDetail">
<path value="ServiceRequest.orderDetail" />
<definition value="If additional coded details need to captured as part of a test order, e.g. Panels or targeted genes, these SHOULD be represented using the 'orderDetail' field, with the main indication captured using the 'reasonCode' field. If completely separate pathways/samples etc. are required for processing against the codes, it is expected these would be requested via multiple ServiceRequests instead of a single ServiceRequest with multiple orderDetail codes. The exact cut-off for when orderDetail vs. multiple ServiceRequest should be used is still being investigated. An appropriate code(Panel codes) SHOULD come from the following NamingSystem: England-GenomicTestPanelCode\nFor Cancer WGS, where no panel or test-level details are relevant, orderDetail SHOULD be omitted." />
</element>
<element id="ServiceRequest.orderDetail.coding">
<path value="ServiceRequest.orderDetail.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode">
<path value="ServiceRequest.orderDetail.coding" />
<sliceName value="genomicsTestPanelCode" />
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension:genomicTestCodeVersion">
<path value="ServiceRequest.orderDetail.coding.extension" />
<sliceName value="genomicTestCodeVersion" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</type>
<isModifier value="false" />
</element>
<element id="ServiceRequest.orderDetail.coding:genomicsTestPanelCode.system">
<path value="ServiceRequest.orderDetail.coding.system" />
<short value="Genomics Test Panel Code" />
<fixedUri value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestPanelCode" />
</element>
<element id="ServiceRequest.quantity[x]">
<path value="ServiceRequest.quantity[x]" />
<max value="0" />
</element>
<element id="ServiceRequest.subject">
<path value="ServiceRequest.subject" />
<definition value="SHALL be provided. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.encounter">
<path value="ServiceRequest.encounter" />
<code value="Reference" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.occurrence[x]">
<path value="ServiceRequest.occurrence[x]" />
<definition value="If a result is required by a specific date, this MAY be indicated though occurrenceDateTime, though there is no guarantee from the GMS that the ServiceRequest will be processed in the time frame specified." />
</element>
<element id="ServiceRequest.asNeeded[x]">
<path value="ServiceRequest.asNeeded[x]" />
<max value="0" />
</element>
<element id="ServiceRequest.authoredOn">
<path value="ServiceRequest.authoredOn" />
<definition value="SHALL be populated by the client upon submission, either manually by the user or automatically by the system integrating with the central GMS." />
<min value="1" />
</element>
<element id="ServiceRequest.requester">
<path value="ServiceRequest.requester" />
<definition value="SHALL be populated on all ServiceRequests submitted to the central GMS. This SHALL reference a PractitionerRole resource also submitted to the system (either within a single transaction or previously POSTed)." />
<min value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.performerType">
<path value="ServiceRequest.performerType" />
<max value="0" />
</element>
<element id="ServiceRequest.performer">
<path value="ServiceRequest.performer" />
<definition value="Allows a requester to assign processing of the ServiceRequest to a particular organization (e.g. a remote GLH). The performer field SHOULD be populated with the ODS code for the managing organization/GLH.\nIn the future state, ServiceRequests may be kept open, by not specifying a performer, allowing them to be picked up by the local GLH or otherwise routed based on by test routing (TBC)." />
<max value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.performer.identifier">
<path value="ServiceRequest.performer.identifier" />
<min value="1" />
</element>
<element id="ServiceRequest.performer.identifier.system">
<path value="ServiceRequest.performer.identifier.system" />
<fixedUri value="https://fhir.nhs.uk/Id/ods-organization-code" />
</element>
<element id="ServiceRequest.locationCode">
<path value="ServiceRequest.locationCode" />
<max value="0" />
</element>
<element id="ServiceRequest.locationReference">
<path value="ServiceRequest.locationReference" />
<max value="0" />
</element>
<element id="ServiceRequest.reasonCode">
<path value="ServiceRequest.reasonCode" />
<type value="pattern" />
<path value="coding.system" />
</discriminator>
<rules value="open" />
</slicing>
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage">
<path value="ServiceRequest.reasonCode" />
<sliceName value="DGTSTestPackage" />
<definition value="reasonCode SHALL be populated with the Test Package code for the order." />
<min value="1" />
<max value="1" />
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.extension:genomicTestCodeVersion">
<path value="ServiceRequest.reasonCode.coding.extension" />
<sliceName value="genomicTestCodeVersion" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version" />
</type>
<isModifier value="false" />
</element>
<element id="ServiceRequest.reasonCode:DGTSTestPackage.coding.system">
<path value="ServiceRequest.reasonCode.coding.system" />
<fixedUri value="https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService" />
</element>
<element id="ServiceRequest.reasonReference">
<path value="ServiceRequest.reasonReference" />
<definition value="Reference SHOULD be associated to the primary condition being tested for. Required if additional information related to the condition, such as onsetAge, needs to be captured for interpretation." />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.insurance">
<path value="ServiceRequest.insurance" />
<max value="0" />
</element>
<element id="ServiceRequest.supportingInfo">
<path value="ServiceRequest.supportingInfo" />
<definition value="Any clinical information provided about the patient for whom the testing is being requested SHALL be referenced though the supportingInfo field, to ensure all the information relevant to the ServiceRequest can be easily retrieved. This includes Observations, Conditions, Procedures, FamilyMemberHistories etc.\nThis also includes resources related to family members included as part of testing (consultands), e.g. in Duo/Trio scenarios. In this instance, RelatedPerson and Patient resource references for the consultands SHALL be added to the supportingInfo array, as well as any clinical resources related to these individuals. This is to ensure the number of participants for a given test can be calculated correctly, e.g. through counting the number of RelatedPerson resources referenced from ServiceRequest.supportingInfo plus the subject of the ServiceRequest itself (the proband).\n\nFor WGS testing, where Records of Discussion are required in order to process the test, Consent resources SHOULD also be added to the supportingInfo array once available." />
<code value="Reference" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.specimen">
<path value="ServiceRequest.specimen" />
<definition value="ServiceRequests where the required samples already exist, e.g. in the case where a specimen already in storage needs to be processed, SHOULD reference these samples through the ServiceRequest.specimen field. Where samples need to be collected to support testing, these SHOULD instead reference the ServiceRequest, through Specimen.request (i.e. the service request has prompted collection of the sample), and these Specimen resources do not need to be referenced from within ServiceRequest.supportingInfo. The referenced Specimen resources SHOULD either be contained within the test order transaction bundle or already exist on the central GMS.\nIn the case of Reanalysis or Reinterpretation tests, Specimens related to previous ServiceRequest are not required to be added to the new test request. The links from the previous ServiceRequest can be followed to identify the Specimens that resulted in the data being reanalysed, e.g. (reanalysis) ServiceRequest.basedOn -> (prior) ServiceRequest, (prior) ServiceRequest <- (original) Specimen.request\n\nFor requests based on prior requests where multiple samples 'active' are associated with the prior request. The specific sample to be reprocessed SHALL be referenced from ServiceRequest.specimen." />
<code value="Reference" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
<element id="ServiceRequest.bodySite">
<path value="ServiceRequest.bodySite" />
<max value="0" />
</element>
<element id="ServiceRequest.note">
<path value="ServiceRequest.note" />
<definition value="Any information which cannot be readily be structured SHOULD be entered into the note field, though prolific use of the field to capture clinical information which better fits in level 3/4 FHIR resources is discouraged.\nTo support disambiguation of notes originating from different fields in a client system, the AnnotationType extension MAY be used, specifying the UI element name in text (coded elements for the full list of free text UI elements expected within Test Order forms is pending finalisation and addition to the Genomic Order Management MDS). The author element MAY also be used to reference a Practitioner, by identifier or name (string), indicating the person who created the note." />
</element>
<element id="ServiceRequest.note.extension:annotationType">
<path value="ServiceRequest.note.extension" />
<sliceName value="annotationType" />
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/annotationType" />
</type>
<isModifier value="false" />
</element>
<element id="ServiceRequest.patientInstruction">
<path value="ServiceRequest.patientInstruction" />
<max value="0" />
</element>
<element id="ServiceRequest.relevantHistory">
<path value="ServiceRequest.relevantHistory" />
<max value="0" />
</element>
</differential>
</StructureDefinition>

JSON View

{
"resourceType": "StructureDefinition",
"id": "NHSEngland-ServiceRequest-Genomics",
"url": "https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics",
"version": "0.3.0",
"name": "NHSEngland_ServiceRequest_Genomics",
"title": "NHSEngland ServiceRequest Genomics",
"status": "active",
"date": "2026-04-16",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work",
"rank": 1
}
]
}
],
"description": "This profile defines the Genomics constraints and extensions on the UK Core FHIR resource [ServiceRequest](https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest).",
"purpose": "Focal resource for test order messages. All additional information or resources SHOULD be linked back to the ServiceRequest or be referenced from the ServiceRequest directly.\n\nServiceRequests which have been updated post submission SHALL be accompanied by Provenance resources, referencing the ServiceRequest which detail when the resource was changed, who made the change and why.\n\nNote on inheritance from prior requests\nIt is expected that the ServiceRequest.basedOn SHALL reference a parent request where this ServiceRequest is based a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or Germline Late tests in the Tumour First/Germline Late scenario (to link prior test which contain clinical context).\n\nIt is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.\n\nWhere multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available. Additionally, in most cases the data is required, rather than reprocessing of the sample itself, in which case referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHOULD be referenced from ServiceRequest.specimen as above. If multiple outputs, i.e. data from multiple samples, are associated with a previous request, a ServiceRequest MAY reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo.",
"copyright": "Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\\\\\"License\\\\\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\\\\\"AS IS\\\\\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "ServiceRequest",
"baseDefinition": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest",
"derivation": "constraint",
"element": [
{
"id": "ServiceRequest",
"path": "ServiceRequest",
"short": "A request for a service to be performed",
"definition": "A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.",
"alias": [
"diagnostic request",
"referral",
"referral request",
"transfer of care request"
],
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest",
"min": 0,
"max": "*"
},
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "prr-1",
"severity": "error",
"human": "orderDetail SHALL only be present if code is present",
"expression": "orderDetail.empty() or code.exists()",
"xpath": "exists(f:code) or not(exists(f:orderDetail))",
"source": "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Request"
},
{
"identity": "v2",
"map": "ORC"
},
{
"identity": "rim",
"map": "Act[moodCode<=INT]"
}
]
},
{
"id": "ServiceRequest.id",
"path": "ServiceRequest.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
}
],
"code": "id"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.meta",
"path": "ServiceRequest.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.implicitRules",
"path": "ServiceRequest.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.language",
"path": "ServiceRequest.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.text",
"path": "ServiceRequest.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "ServiceRequest.contained",
"path": "ServiceRequest.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.extension",
"path": "ServiceRequest.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 1,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.extension:sourceOfServiceRequest",
"path": "ServiceRequest.extension",
"sliceName": "sourceOfServiceRequest",
"short": "This represents the source of referral",
"definition": "This represents the source of referral.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SourceOfServiceRequest"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.extension:additionalContact",
"path": "ServiceRequest.extension",
"sliceName": "additionalContact",
"short": "Details of an additional contact",
"definition": "Extension used for recording additional personnel who should be contacted regarding questions related to a test order. This is separate from the requester or reporting address.\n\nThe additional contact SHOULD be a reference to a PractitionerRole resource wherever possible and SHALL contain contact details for the practitioner.\n\nAdditionally, where are there multiple practitioners involved in providing care who need to be listed as contacts, the contact details for each practitioner (or service) SHOULD be specified through additional additionalContact entries.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.extension:coverage",
"path": "ServiceRequest.extension",
"sliceName": "coverage",
"short": "The funding category for the Service Request",
"definition": "SHALL be present for Genomic Order Management test orders. Extension for recording how work against the test order is being funded. The ValueSet bound to this extension is currently under review by the NHS England Genomics Informatics Working Advisory Group and subject to change.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 1,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.extension:genomicParticipantCount",
"path": "ServiceRequest.extension",
"sliceName": "genomicParticipantCount",
"short": "Optional Extensions Element",
"definition": "Genomics specific extension used to record the total number of participants in a group test request.(e.g. family, duo / trio). SHALL be provided on the Proband test request which is part of a group. This will be copied to the RequestGroup to inform lab orchestration.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.extension:genomicPatientRole",
"path": "ServiceRequest.extension",
"sliceName": "genomicPatientRole",
"short": "Optional Extensions Element",
"definition": "Genomics specific extension to support family testing. SHALL be present on requests in Duo/Trio use cases where there is a need to differentiate a request for a Proband (which needs to be reported on), from the request for a consultand, which may not result in a report.\nIt is expected that this will impact the Tasks spun up by the central service, though this is currently still under development.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"binding": {
"strength": "required",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-patient-role"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.modifierExtension",
"path": "ServiceRequest.modifierExtension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.identifier",
"path": "ServiceRequest.identifier",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"short": "Identifiers assigned to this order",
"definition": "Automatically assigned by the central service, though source systems MAY provide a local identifier for tracking within their own system, in which case the central order number is appended to the identifiers array.",
"comment": "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.",
"min": 1,
"max": "*",
"base": {
"path": "ServiceRequest.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Request.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "ORC.2, ORC.3, RF1-6 / RF1-11,"
},
{
"identity": "rim",
"map": ".identifier"
},
{
"identity": "quick",
"map": "ClinicalStatement.identifier"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder",
"path": "ServiceRequest.identifier",
"sliceName": "identifierGMSOrder",
"short": "Identifiers assigned to this order",
"definition": "Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Request.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "ORC.2, ORC.3, RF1-6 / RF1-11,"
},
{
"identity": "rim",
"map": ".identifier"
},
{
"identity": "quick",
"map": "ClinicalStatement.identifier"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.id",
"path": "ServiceRequest.identifier.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.extension",
"path": "ServiceRequest.identifier.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.use",
"path": "ServiceRequest.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.type",
"path": "ServiceRequest.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.system",
"path": "ServiceRequest.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/Id/GMSOrder",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.value",
"path": "ServiceRequest.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](extension-rendered-value.html). 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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.period",
"path": "ServiceRequest.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "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\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.assigner",
"path": "ServiceRequest.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 0,
"max": "0",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier",
"path": "ServiceRequest.identifier",
"sliceName": "localIdentifier",
"short": "Identifiers assigned to this order",
"definition": "Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.",
"comment": "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.",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Request.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "ORC.2, ORC.3, RF1-6 / RF1-11,"
},
{
"identity": "rim",
"map": ".identifier"
},
{
"identity": "quick",
"map": "ClinicalStatement.identifier"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.id",
"path": "ServiceRequest.identifier.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.extension",
"path": "ServiceRequest.identifier.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.use",
"path": "ServiceRequest.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.type",
"path": "ServiceRequest.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.system",
"path": "ServiceRequest.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/local-identifier/servicerequest",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.value",
"path": "ServiceRequest.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](extension-rendered-value.html). 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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.period",
"path": "ServiceRequest.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "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\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner",
"path": "ServiceRequest.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 1,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.id",
"path": "ServiceRequest.identifier.assigner.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.extension",
"path": "ServiceRequest.identifier.assigner.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.reference",
"path": "ServiceRequest.identifier.assigner.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "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.",
"min": 0,
"max": "0",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1",
"ref-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.type",
"path": "ServiceRequest.identifier.assigner.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe 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).",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.identifier",
"path": "ServiceRequest.identifier.assigner.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"min": 1,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"system": "https://fhir.nhs.uk/Id/ods-organization-code"
},
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.identifier.assigner.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.instantiatesCanonical",
"path": "ServiceRequest.instantiatesCanonical",
"short": "Instantiates FHIR protocol or definition",
"definition": "The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.",
"comment": "Note: This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). 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.",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.instantiatesCanonical",
"min": 0,
"max": "*"
},
"type": [
{
"code": "canonical",
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/PlanDefinition"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.instantiatesCanonical"
},
{
"identity": "v2",
"map": "Varies by domain"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=DEFN].target"
}
]
},
{
"id": "ServiceRequest.instantiatesUri",
"path": "ServiceRequest.instantiatesUri",
"short": "Instantiates external protocol or definition",
"definition": "The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.",
"comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.instantiatesUri",
"min": 0,
"max": "*"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.instantiatesUri"
},
{
"identity": "v2",
"map": "Varies by domain"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=DEFN].target"
}
]
},
{
"id": "ServiceRequest.basedOn",
"path": "ServiceRequest.basedOn",
"short": "What request fulfills",
"definition": "SHALL reference a parent request where this ServiceRequest is based on a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or **Germline Late tests in the Tumour First/Germline Late scenario** (to link tests where prior requests contain clinical context).\nIt is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.\n\nWhere multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available, making the sample to be reprocessed unambiguous. In cases the data is required, rather than reprocessing of the sample itself, referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHALL be referenced from ServiceRequest.specimen as above. If multiple outputs are associated with a previous request, i.e. data from multiple samples, a ServiceRequest SHOULD reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo.",
"comment": "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.",
"alias": [
"fulfills"
],
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.basedOn",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.basedOn"
},
{
"identity": "v2",
"map": "ORC.8 (plus others)"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=FLFS].target"
}
]
},
{
"id": "ServiceRequest.replaces",
"path": "ServiceRequest.replaces",
"short": "What request replaces",
"definition": "The request takes the place of the referenced completed or terminated request(s).",
"comment": "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.",
"alias": [
"supersedes",
"prior",
"renewed order"
],
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.replaces",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.replaces"
},
{
"identity": "v2",
"map": "Handled by message location of ORC (ORC.1=RO or RU)"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=RPLC].target"
}
]
},
{
"id": "ServiceRequest.requisition",
"path": "ServiceRequest.requisition",
"short": "Composite Request ID",
"definition": "SHALL be added for Duo/Trio (familial) requests in order to link tests together. Requisition Identifiers are used to generate RequestGroup resources that assist with management of linked requests. SHALL NOT be populated for other types of test (singleton) or other scenarios where requests/results need to be linked (see `ServiceRequest.basedOn` guidance).\nFor cases where the requisition identifier is required, it is expected that this is provided by client systems, as there are no rules on the central service that would be able to determine whether the test request is part of a Duo/Trio. As there are no central naming systems for requisition identifiers, it is expected the identifiers will be local identifiers following guidance on Referencing and Identifiers. Other mechanisms for determining or setting the requisition identifier, e.g. by the central service, or deterministically using patient/request identifiers are being investigated by the NHS England Genomics Unit.\n\nFor subsequent requests which are part of a group, it is expected the requisition identifier will be retrieved from the prior request, e.g. for the proband, either from the central broker or via some offline means, and will be recreated on the additional request exactly, including system and assigner, so the requests can be linked.",
"comment": "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.",
"requirements": "Some business processes need to know if multiple items were ordered as part of the same \"requisition\" for billing or other purposes.",
"alias": [
"grouperId",
"groupIdentifier"
],
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.requisition",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Request.groupIdentifier"
},
{
"identity": "v2",
"map": "ORC.4"
},
{
"identity": "rim",
"map": ".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier"
}
]
},
{
"id": "ServiceRequest.status",
"path": "ServiceRequest.status",
"short": "draft | active | on-hold | revoked | completed | entered-in-error | unknown",
"definition": "SHALL be provided. ServiceRequests SHOULD be marked as `draft` until ready to be acted upon, after which the user should mark the ServiceRequest as `active`.\nA ServiceRequest with the status of draft is assumed to be incomplete, i.e. missing information required for further processing. As such, a central order management broker SHOULD refrain from adding Tasks for the ServiceRequest until it is marked as active, at which time the necessary Tasks are spun up automatically by the broker (this is to be tested within the Genomic Order Management beta). Keeping a ServiceRequest in the draft state allows other parties to populate additional data required, such as phenotypic information from a dedicated service, or further information via a web portal. It is expected that draft ServiceRequests will be purged from the system after a period of inactivity with appropriate warnings (yet to be determined) to avoid stale orders from obscuring live tests/results.\n\nA ServiceRequest may be marked as 'on-hold' if work against it cannot continue temporarily, e.g. due to certain prerequisite information not being provided. A ServiceRequest SHOULD be marked as 'revoked' if cancelled, either by the lab performing work against the order or at the request of the requesting clinician, though in each case a Provenance resource SHALL be provided to capture why the state change has occurred. The requesting clinician may also mark the ServiceRequest as entered-in-error, though implications for work already in progress needs to be investigated further.\n\nA ServiceRequest SHOULD only be marked as completed by the requesting clinician upon receipt and review of the resulting DiagnosticReport.",
"comment": "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 [Interactions](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/design/interactions.page.md) for general discussion) or using the [Task](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/fhirassets/allassets/profiles/genomics-task.page.md) resource.",
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestStatus"
}
],
"strength": "required",
"description": "The status of a service order.",
"valueSet": "http://hl7.org/fhir/ValueSet/request-status|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "v2",
"map": "ORC.5,RF1-1"
},
{
"identity": "rim",
"map": ".status"
},
{
"identity": "quick",
"map": "Action.currentStatus"
}
]
},
{
"id": "ServiceRequest.intent",
"path": "ServiceRequest.intent",
"short": "proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option",
"definition": "SHALL be provided. ServiceRequests SHOULD be marked as 'order' unless they have been raised by a lab in response to an existing ServiceRequest, in which case they SHOULD be marked as 'reflex-order'. For reflex orders, the ServiceRequest.basedOn field SHALL be populated with the original ServiceRequest, for traceability.",
"comment": "This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.",
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.intent",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isModifier": true,
"isModifierReason": "This element changes the interpretation of all descriptive attributes. For example \"the time the request is recommended to occur\" vs. \"the time the request is authorized to occur\" or \"who is recommended to perform the request\" vs. \"who is authorized to perform the request",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestIntent"
}
],
"strength": "required",
"description": "The kind of service request.",
"valueSet": "http://hl7.org/fhir/ValueSet/request-intent|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.intent"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": ".moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)"
}
]
},
{
"id": "ServiceRequest.category",
"path": "ServiceRequest.category",
"slicing": {
{
"type": "value",
"path": "coding.system"
}
],
"rules": "open"
},
"short": "Classification of service",
"definition": "Category SHALL be populated with the reason for the request being ordered e.g. Diagnostic, Carrier, Predictive, Stored DNA etc. The final list of applicable codes which can be selected is still under review, the Genomic-ReasonforTesting ValueSet SHOULD be used for this categorisation.",
"comment": "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.",
"requirements": "Used for filtering what service request are retrieved and displayed.",
"min": 1,
"max": "*",
"base": {
"path": "ServiceRequest.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestCategory"
}
],
"strength": "example",
"description": "Classification of the requested service.",
"valueSet": "http://hl7.org/fhir/ValueSet/servicerequest-category"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "RF1-5"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"INT\"].code"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing",
"path": "ServiceRequest.category",
"sliceName": "genomicsWholeCaseSequencing",
"short": "Classification of Genomics service",
"definition": "A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases",
"comment": "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.",
"requirements": "Used for filtering what service request are retrieved and displayed.",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestCategory"
}
],
"strength": "extensible",
"description": "Classification of the requested service.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "RF1-5"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"INT\"].code"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.id",
"path": "ServiceRequest.category.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.extension",
"path": "ServiceRequest.category.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding",
"path": "ServiceRequest.category.coding",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.id",
"path": "ServiceRequest.category.coding.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.extension",
"path": "ServiceRequest.category.coding.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.system",
"path": "ServiceRequest.category.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "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.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.version",
"path": "ServiceRequest.category.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.code",
"path": "ServiceRequest.category.coding.code",
"short": "Symbol in syntax defined by the system",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.category.coding.display",
"short": "Representation defined by the system",
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.userSelected",
"path": "ServiceRequest.category.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "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.",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
"id": "ServiceRequest.category:genomicsWholeCaseSequencing.text",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.category.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "ServiceRequest.category:reasonForTesting",
"path": "ServiceRequest.category",
"sliceName": "reasonForTesting",
"short": "Classification of service",
"definition": "A code that classifies the service for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
"comment": "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.",
"requirements": "Used for filtering what service request are retrieved and displayed.",
"min": 1,
"max": "*",
"base": {
"path": "ServiceRequest.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestCategory"
}
],
"strength": "required",
"description": "Classification of the requested service.",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-reasonfortesting"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "v2",
"map": "RF1-5"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"INT\"].code"
}
]
},
{
"id": "ServiceRequest.priority",
"path": "ServiceRequest.priority",
"short": "routine | urgent | asap | stat",
"definition": "ServiceRequests marked as urgent (i.e. not routine) SHOULD populate the extension:priorityReason with why an urgent test is being requested. This SHOULD ideally be coded using SNOMED CT concepts. Multiple priorityReason extensions are allowed within a single ServiceRequest in order to aid post-coordination.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.priority",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"meaningWhenMissing": "If missing, this task should be performed with normal priority",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestPriority"
}
],
"strength": "required",
"description": "Identifies the level of importance to be assigned to actioning the request.",
"valueSet": "http://hl7.org/fhir/ValueSet/request-priority|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.priority"
},
{
"identity": "w5",
"map": "FiveWs.grade"
},
{
"identity": "v2",
"map": "TQ1.9, RF1-2"
},
{
"identity": "rim",
"map": ".priorityCode"
}
]
},
{
"id": "ServiceRequest.priority.id",
"path": "ServiceRequest.priority.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.priority.extension",
"path": "ServiceRequest.priority.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.priority.extension:priorityReason",
"path": "ServiceRequest.priority.extension",
"sliceName": "priorityReason",
"short": "A SNOMED CT concept representing the reason a Service Request is urgent.",
"definition": "A SNOMED CT concept representing the reason a Service Request is urgent",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.priority.value",
"path": "ServiceRequest.priority.value",
"xmlAttr"
],
"short": "Primitive value for code",
"definition": "Primitive value for code",
"min": 0,
"max": "1",
"base": {
"path": "string.value",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "code"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/regex",
"valueString": "[^\\s]+(\\s[^\\s]+)*"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"maxLength": 1048576
},
{
"id": "ServiceRequest.doNotPerform",
"path": "ServiceRequest.doNotPerform",
"short": "True if service/procedure should not be performed",
"definition": "For the purposes of Genomic Test Ordering, the doNotPerform field SHALL NOT be used. All ServiceRequests requests received by the system will be assumed to be orders for services/testing.",
"comment": "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.",
"requirements": "Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.doNotPerform",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"meaningWhenMissing": "If missing, the request is a positive request e.g. \"do perform\"",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.doNotPerform"
},
{
"identity": "rim",
"map": ".actionNegationInd"
}
]
},
{
"id": "ServiceRequest.code",
"path": "ServiceRequest.code",
"short": "What is being requested/ordered",
"definition": "SHOULD be provided if known. If populated, Code SHOULD contain an appropriate test code, preferrably a DGTS Genomic Test code, though NGTD codes MAY be used during the transition period, currently available at https://www.england.nhs.uk/publication/national-genomic-test-directories/. There is currently a prototype DGTS FHIR API in development to support querying/retrieving codes.\nCodes from the Genomic Test Directory SHOULD also specify the version number of the test at the time the test is being ordered, to ensure the test methods used are consistent with that version.",
"comment": "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.",
"alias": [
"service requested"
],
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestCode"
}
],
"strength": "preferred",
"description": "A set of codes that define a procedure or a procedure with explicit context. Selected from the SNOMED CT UK coding system.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Request.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "PR1-3 / OBR-4 (varies by domain)"
},
{
"identity": "rim",
"map": ".code"
},
{
"identity": "quick",
"map": "Procedure.procedureCode"
}
]
},
{
"id": "ServiceRequest.code.id",
"path": "ServiceRequest.code.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.code.extension",
"path": "ServiceRequest.code.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.code.coding",
"path": "ServiceRequest.code.coding",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode",
"path": "ServiceRequest.code.coding",
"sliceName": "DGTSCode",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.id",
"path": "ServiceRequest.code.coding.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.extension",
"path": "ServiceRequest.code.coding.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.extension:genomicTestCodeVersion",
"path": "ServiceRequest.code.coding.extension",
"sliceName": "genomicTestCodeVersion",
"short": "Optional Extensions Element",
"definition": "Optional Extension Element - found in all resources.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.system",
"path": "ServiceRequest.code.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "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.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.version",
"path": "ServiceRequest.code.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.code",
"path": "ServiceRequest.code.coding.code",
"short": "Symbol in syntax defined by the system",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.code.coding.display",
"short": "Representation defined by the system",
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "ServiceRequest.code.coding:DGTSCode.userSelected",
"path": "ServiceRequest.code.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "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.",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
"id": "ServiceRequest.code.text",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.code.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "ServiceRequest.orderDetail",
"path": "ServiceRequest.orderDetail",
"short": "Additional order information",
"definition": "If additional coded details need to captured as part of a test order, e.g. Panels or targeted genes, these SHOULD be represented using the 'orderDetail' field, with the main indication captured using the 'reasonCode' field. If completely separate pathways/samples etc. are required for processing against the codes, it is expected these would be requested via multiple ServiceRequests instead of a single ServiceRequest with multiple orderDetail codes. The exact cut-off for when orderDetail vs. multiple ServiceRequest should be used is still being investigated. An appropriate code(Panel codes) SHOULD come from the following NamingSystem: England-GenomicTestPanelCode\nFor Cancer WGS, where no panel or test-level details are relevant, orderDetail SHOULD be omitted.",
"comment": "For information from the medical record intended to support the delivery of the requested services, use the `supportingInformation` element.",
"alias": [
"detailed instructions"
],
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.orderDetail",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1",
"prr-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "OrderDetail"
}
],
"strength": "preferred",
"description": "Codified order entry details which are based on order context.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "NTE"
},
{
"identity": "rim",
"map": ".code"
},
{
"identity": "quick",
"map": "Procedure.procedureCode"
}
]
},
{
"id": "ServiceRequest.orderDetail.id",
"path": "ServiceRequest.orderDetail.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.orderDetail.extension",
"path": "ServiceRequest.orderDetail.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding",
"path": "ServiceRequest.orderDetail.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"rules": "open"
},
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode",
"path": "ServiceRequest.orderDetail.coding",
"sliceName": "genomicsTestPanelCode",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.id",
"path": "ServiceRequest.orderDetail.coding.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension",
"path": "ServiceRequest.orderDetail.coding.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension:genomicTestCodeVersion",
"path": "ServiceRequest.orderDetail.coding.extension",
"sliceName": "genomicTestCodeVersion",
"short": "Optional Extensions Element",
"definition": "Optional Extension Element - found in all resources.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.system",
"path": "ServiceRequest.orderDetail.coding.system",
"short": "Genomics Test Panel Code",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "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.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestPanelCode",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.version",
"path": "ServiceRequest.orderDetail.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.code",
"path": "ServiceRequest.orderDetail.coding.code",
"short": "Symbol in syntax defined by the system",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.orderDetail.coding.display",
"short": "Representation defined by the system",
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.userSelected",
"path": "ServiceRequest.orderDetail.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "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.",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
"id": "ServiceRequest.orderDetail.text",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.orderDetail.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "ServiceRequest.quantity[x]",
"path": "ServiceRequest.quantity[x]",
"short": "Service amount",
"definition": "An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).",
"requirements": "When ordering a service the number of service items may need to be specified separately from the the service item.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.quantity[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
},
{
"code": "Ratio"
},
{
"code": "Range"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "NTE"
},
{
"identity": "rim",
"map": ".quantity"
}
]
},
{
"id": "ServiceRequest.subject",
"path": "ServiceRequest.subject",
"short": "Individual or Entity the service is ordered for",
"definition": "SHALL be provided. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS",
"comment": "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.",
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.subject",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].role"
},
{
"identity": "quick",
"map": "ClinicalStatement.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "ServiceRequest.encounter",
"path": "ServiceRequest.encounter",
"short": "Encounter in which the request was created",
"definition": "An encounter that provides additional information about the healthcare context in which this request is made.",
"comment": "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.",
"alias": [
"context"
],
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.encounter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Encounter"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.encounter"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "v2",
"map": "PV1"
},
{
"identity": "rim",
"map": ".inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]"
},
{
"identity": "quick",
"map": "ClinicalStatement.encounter"
}
]
},
{
"id": "ServiceRequest.occurrence[x]",
"path": "ServiceRequest.occurrence[x]",
"short": "When service should occur",
"definition": "If a result is required by a specific date, this MAY be indicated though occurrenceDateTime, though there is no guarantee from the GMS that the ServiceRequest will be processed in the time frame specified.",
"alias": [
"schedule"
],
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.occurrence[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
},
{
"code": "Timing"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.planned"
},
{
"identity": "v2",
"map": "TQ1/TQ2, OBR-7/OBR-8"
},
{
"identity": "rim",
"map": ".effectiveTime"
},
{
"identity": "quick",
"map": "Procedure.procedureSchedule"
}
]
},
{
"id": "ServiceRequest.asNeeded[x]",
"path": "ServiceRequest.asNeeded[x]",
"short": "Preconditions for service",
"definition": "If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example \"pain\", \"on flare-up\", etc.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.asNeeded[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
},
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureAsNeededReason"
}
],
"strength": "example",
"description": "A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example \"pain\", \"on flare-up\", etc.",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code=\"Assertion\"].value"
},
{
"identity": "quick",
"map": "Proposal.prnReason.reason"
}
]
},
{
"id": "ServiceRequest.authoredOn",
"path": "ServiceRequest.authoredOn",
"short": "Date request signed",
"definition": "SHALL be populated by the client upon submission, either manually by the user or automatically by the system integrating with the central GMS.",
"alias": [
"orderedOn"
],
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.authoredOn",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Request.authoredOn"
},
{
"identity": "w5",
"map": "FiveWs.recorded"
},
{
"identity": "v2",
"map": "ORC.9, RF1-7 / RF1-9"
},
{
"identity": "rim",
"map": ".participation[typeCode=AUT].time"
},
{
"identity": "quick",
"map": "Proposal.proposedAtTime"
}
]
},
{
"id": "ServiceRequest.requester",
"path": "ServiceRequest.requester",
"short": "Who/what is requesting service",
"definition": "SHALL be populated on all ServiceRequests submitted to the central GMS. This SHALL reference a PractitionerRole resource also submitted to the system (either within a single transaction or previously POSTed).",
"comment": "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.",
"alias": [
"author",
"orderer"
],
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.requester",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.requester"
},
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "v2",
"map": "ORC.12, PRT"
},
{
"identity": "rim",
"map": ".participation[typeCode=AUT].role"
},
{
"identity": "quick",
"map": "ClinicalStatement.statementAuthor"
}
]
},
{
"id": "ServiceRequest.performerType",
"path": "ServiceRequest.performerType",
"short": "Performer role",
"definition": "Desired type of performer for doing the requested service.",
"comment": "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”.",
"alias": [
"specialty"
],
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.performerType",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestParticipantRole"
}
],
"strength": "example",
"description": "Indicates specific responsibility of an individual within the care team, such as \"Primary physician\", \"Team coordinator\", \"Caregiver\", etc.",
"valueSet": "http://hl7.org/fhir/ValueSet/participant-role"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Request.performerType"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "PRT, RF!-3"
},
{
"identity": "rim",
"map": ".participation[typeCode=PRF].role[scoper.determinerCode=KIND].code"
}
]
},
{
"id": "ServiceRequest.performer",
"path": "ServiceRequest.performer",
"short": "Requested performer",
"definition": "Allows a requester to assign processing of the ServiceRequest to a particular organization (e.g. a remote GLH). The performer field SHOULD be populated with the ODS code for the managing organization/GLH.\nIn the future state, ServiceRequests may be kept open, by not specifying a performer, allowing them to be picked up by the local GLH or otherwise routed based on by test routing (TBC).",
"comment": "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](extension-request-performerorder.html). Use CareTeam to represent a group of performers (for example, Practitioner A *and* Practitioner B).",
"alias": [
"request recipient"
],
"min": 0,
"max": "1",
"base": {
"path": "ServiceRequest.performer",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.performer"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT"
},
{
"identity": "rim",
"map": ".participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]"
}
]
},
{
"id": "ServiceRequest.performer.id",
"path": "ServiceRequest.performer.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.performer.extension",
"path": "ServiceRequest.performer.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.performer.reference",
"path": "ServiceRequest.performer.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1",
"ref-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.performer.type",
"path": "ServiceRequest.performer.type",
"short": "Type the reference refers to (e.g. \"Patient\")",
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe 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).",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
}
],
"strength": "extensible",
"description": "Aa resource (or, for logical models, the URI of the logical model).",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.performer.identifier",
"path": "ServiceRequest.performer.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"min": 1,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "ServiceRequest.performer.identifier.id",
"path": "ServiceRequest.performer.identifier.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.performer.identifier.extension",
"path": "ServiceRequest.performer.identifier.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.performer.identifier.use",
"path": "ServiceRequest.performer.identifier.use",
"short": "usual | official | temp | secondary | old (If known)",
"definition": "The purpose of this identifier.",
"comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
"requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.use",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.",
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierUse"
}
],
"strength": "required",
"description": "Identifies the purpose for this identifier, if known .",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "ServiceRequest.performer.identifier.type",
"path": "ServiceRequest.performer.identifier.type",
"short": "Description of identifier",
"definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
"comment": "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.",
"requirements": "Allows users to make use of identifiers when the identifier system is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "IdentifierType"
}
],
"strength": "extensible",
"description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.",
"valueSet": "http://hl7.org/fhir/ValueSet/identifier-type"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "CX.5"
},
{
"identity": "rim",
"map": "Role.code or implied by context"
}
]
},
{
"id": "ServiceRequest.performer.identifier.system",
"path": "ServiceRequest.performer.identifier.system",
"short": "The namespace for the identifier value",
"definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.",
"comment": "Identifier.system is always case sensitive.",
"requirements": "There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/Id/ods-organization-code",
"example": [
{
"label": "General",
"valueUri": "http://www.acme.com/identifiers/patient"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.4 / EI-2-4"
},
{
"identity": "rim",
"map": "II.root or Role.id.root"
},
{
"identity": "servd",
"map": "./IdentifierType"
}
]
},
{
"id": "ServiceRequest.performer.identifier.value",
"path": "ServiceRequest.performer.identifier.value",
"short": "The value that is unique",
"definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.",
"comment": "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](extension-rendered-value.html). 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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"example": [
{
"label": "General",
"valueString": "123456"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX.1 / EI.1"
},
{
"identity": "rim",
"map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
},
{
"identity": "servd",
"map": "./Value"
}
]
},
{
"id": "ServiceRequest.performer.identifier.period",
"path": "ServiceRequest.performer.identifier.period",
"short": "Time period when id is/was valid for use",
"definition": "Time period during which identifier is/was valid for use.",
"comment": "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\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "per-1",
"severity": "error",
"human": "If present, start SHALL have a lower value than end",
"expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)",
"xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))",
"source": "http://hl7.org/fhir/StructureDefinition/Period"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR"
},
{
"identity": "rim",
"map": "IVL<TS>[lowClosed=\"true\" and highClosed=\"true\"] or URG<TS>[lowClosed=\"true\" and highClosed=\"true\"]"
},
{
"identity": "v2",
"map": "CX.7 + CX.8"
},
{
"identity": "rim",
"map": "Role.effectiveTime or implied by context"
},
{
"identity": "servd",
"map": "./StartDate and ./EndDate"
}
]
},
{
"id": "ServiceRequest.performer.identifier.assigner",
"path": "ServiceRequest.performer.identifier.assigner",
"short": "Organization that issued id (may be just text)",
"definition": "Organization that issued/manages the identifier.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Identifier.assigner",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "CX.4 / (CX.4,CX.9,CX.10)"
},
{
"identity": "rim",
"map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper"
},
{
"identity": "servd",
"map": "./IdentifierIssuingAuthority"
}
]
},
{
"id": "ServiceRequest.performer.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.performer.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.locationCode",
"path": "ServiceRequest.locationCode",
"short": "Requested location",
"definition": "The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.",
"comment": "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.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.locationCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestLocation"
}
],
"strength": "example",
"description": "A location type where services are delivered.",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "rim",
"map": ".participation[typeCode=LOC].role[scoper.determinerCode=KIND].code"
}
]
},
{
"id": "ServiceRequest.locationReference",
"path": "ServiceRequest.locationReference",
"short": "Requested location",
"definition": "A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.",
"comment": "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.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.locationReference",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Location"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "rim",
"map": ".participation[typeCode=LOC].role[scoper.determinerCode=INSTANCE]"
}
]
},
{
"id": "ServiceRequest.reasonCode",
"path": "ServiceRequest.reasonCode",
"slicing": {
{
"type": "pattern",
"path": "coding.system"
}
],
"rules": "open"
},
"short": "Explanation/Justification for procedure or service",
"definition": "An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in `supportingInfo`.",
"comment": "This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the [CT Scan example](servicerequest-example-di.html).",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.reasonCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestReason"
}
],
"strength": "preferred",
"description": "A set of codes that define a reason for a service request.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Request.reasonCode"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "v2",
"map": "ORC.16, RF1-10"
},
{
"identity": "rim",
"map": ".reasonCode"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage",
"path": "ServiceRequest.reasonCode",
"sliceName": "DGTSTestPackage",
"short": "Explanation/Justification for procedure or service",
"definition": "reasonCode SHALL be populated with the Test Package code for the order.",
"comment": "This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the [CT Scan example](servicerequest-example-di.html).",
"min": 1,
"max": "1",
"base": {
"path": "ServiceRequest.reasonCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ServiceRequestReason"
}
],
"strength": "preferred",
"description": "A set of codes that define a reason for a service request.",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Request.reasonCode"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "v2",
"map": "ORC.16, RF1-10"
},
{
"identity": "rim",
"map": ".reasonCode"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.id",
"path": "ServiceRequest.reasonCode.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.extension",
"path": "ServiceRequest.reasonCode.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding",
"path": "ServiceRequest.reasonCode.coding",
"short": "Code defined by a terminology system",
"definition": "A reference to a code defined by a terminology system.",
"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.",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"max": "*",
"base": {
"path": "CodeableConcept.coding",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
},
{
"identity": "rim",
"map": "CV"
},
{
"identity": "orim",
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
},
{
"identity": "v2",
"map": "C*E.1-8, C*E.10-22"
},
{
"identity": "rim",
"map": "union(., ./translation)"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.id",
"path": "ServiceRequest.reasonCode.coding.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.extension",
"path": "ServiceRequest.reasonCode.coding.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.extension:genomicTestCodeVersion",
"path": "ServiceRequest.reasonCode.coding.extension",
"sliceName": "genomicTestCodeVersion",
"short": "Optional Extensions Element",
"definition": "Optional Extension Element - found in all resources.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.system",
"path": "ServiceRequest.reasonCode.coding.system",
"short": "Identity of the terminology system",
"definition": "The identification of the code system that defines the meaning of the symbol in the code.",
"comment": "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.",
"requirements": "Need to be unambiguous about the source of the definition of the symbol.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.system",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"fixedUri": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.3"
},
{
"identity": "rim",
"map": "./codeSystem"
},
{
"identity": "orim",
"map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.version",
"path": "ServiceRequest.reasonCode.coding.version",
"short": "Version of the system - if relevant",
"definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.version",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.7"
},
{
"identity": "rim",
"map": "./codeSystemVersion"
},
{
"identity": "orim",
"map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.code",
"path": "ServiceRequest.reasonCode.coding.code",
"short": "Symbol in syntax defined by the system",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to refer to a particular code in the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.1"
},
{
"identity": "rim",
"map": "./code"
},
{
"identity": "orim",
"map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.display",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.reasonCode.coding.display",
"short": "Representation defined by the system",
"definition": "A representation of the meaning of the code in the system, following the rules of the system.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.2 - but note this is not well followed"
},
{
"identity": "rim",
"map": "CV.displayName"
},
{
"identity": "orim",
"map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.userSelected",
"path": "ServiceRequest.reasonCode.coding.userSelected",
"short": "If this coding was chosen directly by the user",
"definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
"comment": "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.",
"requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
"min": 0,
"max": "1",
"base": {
"path": "Coding.userSelected",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "Sometimes implied by being first"
},
{
"identity": "rim",
"map": "CD.codingRationale"
},
{
"identity": "orim",
"map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]"
}
]
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.text",
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "ServiceRequest.reasonCode.text",
"short": "Plain text representation of the concept",
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"max": "1",
"base": {
"path": "CodeableConcept.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "C*E.9. But note many systems use C*E.2 for this"
},
{
"identity": "rim",
"map": "./originalText[mediaType/code=\"text/plain\"]/data"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
}
]
},
{
"id": "ServiceRequest.reasonReference",
"path": "ServiceRequest.reasonReference",
"short": "Explanation/Justification for service or service",
"definition": "Reference SHOULD be associated to the primary condition being tested for. Required if additional information related to the condition, such as onsetAge, needs to be captured for interpretation.",
"comment": "This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to *Observation* or *Condition* should be used if available. Otherwise when referencing *DiagnosticReport* it should contain a finding in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`. When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](servicerequest-example-di.html).",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.reasonReference",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.reasonReference"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "v2",
"map": "ORC.16"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=RSON].target"
}
]
},
{
"id": "ServiceRequest.insurance",
"path": "ServiceRequest.insurance",
"short": "Associated insurance coverage",
"definition": "Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.",
"comment": "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.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.insurance",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Coverage",
"http://hl7.org/fhir/StructureDefinition/ClaimResponse"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.insurance"
},
{
"identity": "v2",
"map": "IN1/IN2"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COVBY].target"
}
]
},
{
"id": "ServiceRequest.supportingInfo",
"path": "ServiceRequest.supportingInfo",
"short": "Additional clinical information",
"definition": "Any clinical information provided about the patient for whom the testing is being requested SHALL be referenced though the supportingInfo field, to ensure all the information relevant to the ServiceRequest can be easily retrieved. This includes Observations, Conditions, Procedures, FamilyMemberHistories etc.\nThis also includes resources related to family members included as part of testing (consultands), e.g. in Duo/Trio scenarios. In this instance, RelatedPerson and Patient resource references for the consultands SHALL be added to the supportingInfo array, as well as any clinical resources related to these individuals. This is to ensure the number of participants for a given test can be calculated correctly, e.g. through counting the number of RelatedPerson resources referenced from ServiceRequest.supportingInfo plus the subject of the ServiceRequest itself (the proband).\n\nFor WGS testing, where Records of Discussion are required in order to process the test, Consent resources SHOULD also be added to the supportingInfo array once available.",
"comment": "To represent information about how the services are to be delivered use the `instructions` element.",
"alias": [
"Ask at order entry question",
"AOE"
],
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.supportingInfo",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Resource"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.supportingInfo"
},
{
"identity": "v2",
"map": "Accompanying segments"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=PERT].target"
}
]
},
{
"id": "ServiceRequest.specimen",
"path": "ServiceRequest.specimen",
"short": "Procedure Samples",
"definition": "ServiceRequests where the required samples already exist, e.g. in the case where a specimen already in storage needs to be processed, SHOULD reference these samples through the ServiceRequest.specimen field. Where samples need to be collected to support testing, these SHOULD instead reference the ServiceRequest, through Specimen.request (i.e. the service request has prompted collection of the sample), and these Specimen resources do not need to be referenced from within ServiceRequest.supportingInfo. The referenced Specimen resources SHOULD either be contained within the test order transaction bundle or already exist on the central GMS.\nIn the case of Reanalysis or Reinterpretation tests, Specimens related to previous ServiceRequest are not required to be added to the new test request. The links from the previous ServiceRequest can be followed to identify the Specimens that resulted in the data being reanalysed, e.g. (reanalysis) ServiceRequest.basedOn -> (prior) ServiceRequest, (prior) ServiceRequest <- (original) Specimen.request\n\nFor requests based on prior requests where multiple samples 'active' are associated with the prior request. The specific sample to be reprocessed SHALL be referenced from ServiceRequest.specimen.",
"comment": "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](specimen.html) resource points to the ServiceRequest.",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.specimen",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Specimen"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "v2",
"map": "SPM"
},
{
"identity": "rim",
"map": ".participation[typeCode=SPC].role"
}
]
},
{
"id": "ServiceRequest.bodySite",
"path": "ServiceRequest.bodySite",
"short": "Location on Body",
"definition": "Anatomic location where the procedure should be performed. This is the target site.",
"comment": "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](extension-procedure-targetbodystructure.html).",
"requirements": "Knowing where the procedure is performed is important for tracking if multiple sites are possible.",
"alias": [
"location"
],
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.bodySite",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
}
],
"strength": "preferred",
"description": "Codes describing anatomical locations. May include laterality.",
"valueSet": "http://hl7.org/fhir/ValueSet/body-site"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "SPM"
},
{
"identity": "rim",
"map": "targetSiteCode"
},
{
"identity": "quick",
"map": "Procedure.targetBodySite"
}
]
},
{
"id": "ServiceRequest.note",
"path": "ServiceRequest.note",
"short": "Comments",
"definition": "Any information which cannot be readily be structured SHOULD be entered into the note field, though prolific use of the field to capture clinical information which better fits in level 3/4 FHIR resources is discouraged.\nTo support disambiguation of notes originating from different fields in a client system, the AnnotationType extension MAY be used, specifying the UI element name in text (coded elements for the full list of free text UI elements expected within Test Order forms is pending finalisation and addition to the Genomic Order Management MDS). The author element MAY also be used to reference a Practitioner, by identifier or name (string), indicating the person who created the note.",
"comment": "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).",
"min": 0,
"max": "*",
"base": {
"path": "ServiceRequest.note",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Annotation"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act"
},
{
"identity": "workflow",
"map": "Request.note"
},
{
"identity": "v2",
"map": "NTE"
},
{
"identity": "rim",
"map": ".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"
},
{
"identity": "quick",
"map": "ClinicalStatement.additionalText"
}
]
},
{
"id": "ServiceRequest.note.id",
"path": "ServiceRequest.note.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ServiceRequest.note.extension",
"path": "ServiceRequest.note.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.note.extension:annotationType",
"path": "ServiceRequest.note.extension",
"sliceName": "annotationType",
"short": "The type of annotation",
"definition": "The type of annotation. This extension can be used to map the v2 NTE-4 comment type field.",
"comment": "This is used to identify the type of annotation.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/annotationType"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ServiceRequest.note.author[x]",
"path": "ServiceRequest.note.author[x]",
"short": "Individual responsible for the annotation",
"definition": "The individual responsible for making the annotation.",
"comment": "Organization is used when there's no need for specific attribution as to who made the comment.",
"min": 0,
"max": "1",
"base": {
"path": "Annotation.author[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
},
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.participant[typeCode=AUT].role"
}
]
},
{
"id": "ServiceRequest.note.time",
"path": "ServiceRequest.note.time",
"short": "When the annotation was made",
"definition": "Indicates when this particular annotation was made.",
"min": 0,
"max": "1",
"base": {
"path": "Annotation.time",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.effectiveTime"
}
]
},
{
"id": "ServiceRequest.note.text",
"path": "ServiceRequest.note.text",
"short": "The annotation - text content (as markdown)",
"definition": "The text of the annotation in markdown format.",
"comment": "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/",
"min": 1,
"max": "1",
"base": {
"path": "Annotation.text",
"min": 1,
"max": "1"
},
"type": [
{
"code": "markdown"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text"
}
]
},
{
"id": "ServiceRequest.patientInstruction",
"path": "ServiceRequest.patientInstruction",
"short": "Patient or consumer-oriented instructions",
"definition": "Instructions in terms that are understood by the patient or consumer.",
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.patientInstruction",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "NTE"
},
{
"identity": "rim",
"map": ".text"
}
]
},
{
"id": "ServiceRequest.relevantHistory",
"path": "ServiceRequest.relevantHistory",
"short": "Request provenance",
"definition": "Key events in the history of the request.",
"comment": "This might not include provenances for all versions of the request – only those deemed “relevant” or important.\nThis 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\nAll Provenances should have some historical version of this Request as their subject.",
"min": 0,
"max": "0",
"base": {
"path": "ServiceRequest.relevantHistory",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/Provenance"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Request.relevantHistory"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"
}
]
}
]
},
"element": [
{
"id": "ServiceRequest.extension",
"path": "ServiceRequest.extension",
"min": 1
},
{
"id": "ServiceRequest.extension:additionalContact",
"path": "ServiceRequest.extension",
"sliceName": "additionalContact",
"definition": "Extension used for recording additional personnel who should be contacted regarding questions related to a test order. This is separate from the requester or reporting address.\n\nThe additional contact SHOULD be a reference to a PractitionerRole resource wherever possible and SHALL contain contact details for the practitioner.\n\nAdditionally, where are there multiple practitioners involved in providing care who need to be listed as contacts, the contact details for each practitioner (or service) SHOULD be specified through additional additionalContact entries."
},
{
"id": "ServiceRequest.extension:coverage",
"path": "ServiceRequest.extension",
"sliceName": "coverage",
"definition": "SHALL be present for Genomic Order Management test orders. Extension for recording how work against the test order is being funded. The ValueSet bound to this extension is currently under review by the NHS England Genomics Informatics Working Advisory Group and subject to change.",
"min": 1
},
{
"id": "ServiceRequest.extension:genomicParticipantCount",
"path": "ServiceRequest.extension",
"sliceName": "genomicParticipantCount",
"definition": "Genomics specific extension used to record the total number of participants in a group test request.(e.g. family, duo / trio). SHALL be provided on the Proband test request which is part of a group. This will be copied to the RequestGroup to inform lab orchestration.",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount"
]
}
],
"isModifier": false
},
{
"id": "ServiceRequest.extension:genomicPatientRole",
"path": "ServiceRequest.extension",
"sliceName": "genomicPatientRole",
"definition": "Genomics specific extension to support family testing. SHALL be present on requests in Duo/Trio use cases where there is a need to differentiate a request for a Proband (which needs to be reported on), from the request for a consultand, which may not result in a report.\nIt is expected that this will impact the Tasks spun up by the central service, though this is currently still under development.",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role"
]
}
],
"isModifier": false,
"binding": {
"strength": "required",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-patient-role"
}
},
{
"id": "ServiceRequest.identifier",
"path": "ServiceRequest.identifier",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
},
"definition": "Automatically assigned by the central service, though source systems MAY provide a local identifier for tracking within their own system, in which case the central order number is appended to the identifiers array.",
"min": 1
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder",
"path": "ServiceRequest.identifier",
"sliceName": "identifierGMSOrder",
"max": "1"
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.use",
"path": "ServiceRequest.identifier.use",
"max": "0"
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.type",
"path": "ServiceRequest.identifier.type",
"max": "0"
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.system",
"path": "ServiceRequest.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/Id/GMSOrder"
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.value",
"path": "ServiceRequest.identifier.value",
"min": 1
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.period",
"path": "ServiceRequest.identifier.period",
"max": "0"
},
{
"id": "ServiceRequest.identifier:identifierGMSOrder.assigner",
"path": "ServiceRequest.identifier.assigner",
"max": "0"
},
{
"id": "ServiceRequest.identifier:localIdentifier",
"path": "ServiceRequest.identifier",
"sliceName": "localIdentifier"
},
{
"id": "ServiceRequest.identifier:localIdentifier.system",
"path": "ServiceRequest.identifier.system",
"min": 1,
"fixedUri": "https://fhir.nhs.uk/local-identifier/servicerequest"
},
{
"id": "ServiceRequest.identifier:localIdentifier.value",
"path": "ServiceRequest.identifier.value",
"min": 1
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner",
"path": "ServiceRequest.identifier.assigner",
"min": 1
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.reference",
"path": "ServiceRequest.identifier.assigner.reference",
"max": "0"
},
{
"id": "ServiceRequest.identifier:localIdentifier.assigner.identifier",
"path": "ServiceRequest.identifier.assigner.identifier",
"min": 1,
"system": "https://fhir.nhs.uk/Id/ods-organization-code"
}
},
{
"id": "ServiceRequest.basedOn",
"path": "ServiceRequest.basedOn",
"definition": "SHALL reference a parent request where this ServiceRequest is based on a previous request, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or **Germline Late tests in the Tumour First/Germline Late scenario** (to link tests where prior requests contain clinical context).\nIt is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.\n\nWhere multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available, making the sample to be reprocessed unambiguous. In cases the data is required, rather than reprocessing of the sample itself, referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHALL be referenced from ServiceRequest.specimen as above. If multiple outputs are associated with a previous request, i.e. data from multiple samples, a ServiceRequest SHOULD reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo.",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.replaces",
"path": "ServiceRequest.replaces",
"max": "1",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics"
]
}
]
},
{
"id": "ServiceRequest.requisition",
"path": "ServiceRequest.requisition",
"definition": "SHALL be added for Duo/Trio (familial) requests in order to link tests together. Requisition Identifiers are used to generate RequestGroup resources that assist with management of linked requests. SHALL NOT be populated for other types of test (singleton) or other scenarios where requests/results need to be linked (see `ServiceRequest.basedOn` guidance).\nFor cases where the requisition identifier is required, it is expected that this is provided by client systems, as there are no rules on the central service that would be able to determine whether the test request is part of a Duo/Trio. As there are no central naming systems for requisition identifiers, it is expected the identifiers will be local identifiers following guidance on Referencing and Identifiers. Other mechanisms for determining or setting the requisition identifier, e.g. by the central service, or deterministically using patient/request identifiers are being investigated by the NHS England Genomics Unit.\n\nFor subsequent requests which are part of a group, it is expected the requisition identifier will be retrieved from the prior request, e.g. for the proband, either from the central broker or via some offline means, and will be recreated on the additional request exactly, including system and assigner, so the requests can be linked."
},
{
"id": "ServiceRequest.status",
"path": "ServiceRequest.status",
"definition": "SHALL be provided. ServiceRequests SHOULD be marked as `draft` until ready to be acted upon, after which the user should mark the ServiceRequest as `active`.\nA ServiceRequest with the status of draft is assumed to be incomplete, i.e. missing information required for further processing. As such, a central order management broker SHOULD refrain from adding Tasks for the ServiceRequest until it is marked as active, at which time the necessary Tasks are spun up automatically by the broker (this is to be tested within the Genomic Order Management beta). Keeping a ServiceRequest in the draft state allows other parties to populate additional data required, such as phenotypic information from a dedicated service, or further information via a web portal. It is expected that draft ServiceRequests will be purged from the system after a period of inactivity with appropriate warnings (yet to be determined) to avoid stale orders from obscuring live tests/results.\n\nA ServiceRequest may be marked as 'on-hold' if work against it cannot continue temporarily, e.g. due to certain prerequisite information not being provided. A ServiceRequest SHOULD be marked as 'revoked' if cancelled, either by the lab performing work against the order or at the request of the requesting clinician, though in each case a Provenance resource SHALL be provided to capture why the state change has occurred. The requesting clinician may also mark the ServiceRequest as entered-in-error, though implications for work already in progress needs to be investigated further.\n\nA ServiceRequest SHOULD only be marked as completed by the requesting clinician upon receipt and review of the resulting DiagnosticReport.",
"comment": "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 [Interactions](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/design/interactions.page.md) for general discussion) or using the [Task](https://simplifier.net/guide/fhir-genomics-implementation-guide/home/fhirassets/allassets/profiles/genomics-task.page.md) resource."
},
{
"id": "ServiceRequest.intent",
"path": "ServiceRequest.intent",
"definition": "SHALL be provided. ServiceRequests SHOULD be marked as 'order' unless they have been raised by a lab in response to an existing ServiceRequest, in which case they SHOULD be marked as 'reflex-order'. For reflex orders, the ServiceRequest.basedOn field SHALL be populated with the original ServiceRequest, for traceability."
},
{
"id": "ServiceRequest.category",
"path": "ServiceRequest.category",
"definition": "Category SHALL be populated with the reason for the request being ordered e.g. Diagnostic, Carrier, Predictive, Stored DNA etc. The final list of applicable codes which can be selected is still under review, the Genomic-ReasonforTesting ValueSet SHOULD be used for this categorisation.",
"min": 1
},
{
"id": "ServiceRequest.category:reasonForTesting",
"path": "ServiceRequest.category",
"sliceName": "reasonForTesting",
"min": 1,
"binding": {
"strength": "required",
"valueSet": "https://fhir.nhs.uk/ValueSet/genomics-reasonfortesting"
}
},
{
"id": "ServiceRequest.priority",
"path": "ServiceRequest.priority",
"definition": "ServiceRequests marked as urgent (i.e. not routine) SHOULD populate the extension:priorityReason with why an urgent test is being requested. This SHOULD ideally be coded using SNOMED CT concepts. Multiple priorityReason extensions are allowed within a single ServiceRequest in order to aid post-coordination."
},
{
"id": "ServiceRequest.doNotPerform",
"path": "ServiceRequest.doNotPerform",
"definition": "For the purposes of Genomic Test Ordering, the doNotPerform field SHALL NOT be used. All ServiceRequests requests received by the system will be assumed to be orders for services/testing.",
"max": "0"
},
{
"id": "ServiceRequest.code",
"path": "ServiceRequest.code",
"definition": "SHOULD be provided if known. If populated, Code SHOULD contain an appropriate test code, preferrably a DGTS Genomic Test code, though NGTD codes MAY be used during the transition period, currently available at https://www.england.nhs.uk/publication/national-genomic-test-directories/. There is currently a prototype DGTS FHIR API in development to support querying/retrieving codes.\nCodes from the Genomic Test Directory SHOULD also specify the version number of the test at the time the test is being ordered, to ensure the test methods used are consistent with that version.",
"min": 1
},
{
"id": "ServiceRequest.code.coding",
"path": "ServiceRequest.code.coding",
"slicing": {
{
"type": "pattern",
"path": "system"
}
],
"rules": "open"
}
},
{
"id": "ServiceRequest.code.coding:DGTSCode",
"path": "ServiceRequest.code.coding",
"sliceName": "DGTSCode",
"max": "1"
},
{
"id": "ServiceRequest.code.coding:DGTSCode.extension:genomicTestCodeVersion",
"path": "ServiceRequest.code.coding.extension",
"sliceName": "genomicTestCodeVersion",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
]
}
],
"isModifier": false
},
{
"id": "ServiceRequest.code.coding:DGTSCode.system",
"path": "ServiceRequest.code.coding.system",
"fixedUri": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService"
},
{
"id": "ServiceRequest.orderDetail",
"path": "ServiceRequest.orderDetail",
"definition": "If additional coded details need to captured as part of a test order, e.g. Panels or targeted genes, these SHOULD be represented using the 'orderDetail' field, with the main indication captured using the 'reasonCode' field. If completely separate pathways/samples etc. are required for processing against the codes, it is expected these would be requested via multiple ServiceRequests instead of a single ServiceRequest with multiple orderDetail codes. The exact cut-off for when orderDetail vs. multiple ServiceRequest should be used is still being investigated. An appropriate code(Panel codes) SHOULD come from the following NamingSystem: England-GenomicTestPanelCode\nFor Cancer WGS, where no panel or test-level details are relevant, orderDetail SHOULD be omitted."
},
{
"id": "ServiceRequest.orderDetail.coding",
"path": "ServiceRequest.orderDetail.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"rules": "open"
}
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode",
"path": "ServiceRequest.orderDetail.coding",
"sliceName": "genomicsTestPanelCode"
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.extension:genomicTestCodeVersion",
"path": "ServiceRequest.orderDetail.coding.extension",
"sliceName": "genomicTestCodeVersion",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
]
}
],
"isModifier": false
},
{
"id": "ServiceRequest.orderDetail.coding:genomicsTestPanelCode.system",
"path": "ServiceRequest.orderDetail.coding.system",
"short": "Genomics Test Panel Code",
"fixedUri": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestPanelCode"
},
{
"id": "ServiceRequest.quantity[x]",
"path": "ServiceRequest.quantity[x]",
"max": "0"
},
{
"id": "ServiceRequest.subject",
"path": "ServiceRequest.subject",
"definition": "SHALL be provided. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.encounter",
"path": "ServiceRequest.encounter",
"type": [
{
"code": "Reference",
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.occurrence[x]",
"path": "ServiceRequest.occurrence[x]",
"definition": "If a result is required by a specific date, this MAY be indicated though occurrenceDateTime, though there is no guarantee from the GMS that the ServiceRequest will be processed in the time frame specified."
},
{
"id": "ServiceRequest.asNeeded[x]",
"path": "ServiceRequest.asNeeded[x]",
"max": "0"
},
{
"id": "ServiceRequest.authoredOn",
"path": "ServiceRequest.authoredOn",
"definition": "SHALL be populated by the client upon submission, either manually by the user or automatically by the system integrating with the central GMS.",
"min": 1
},
{
"id": "ServiceRequest.requester",
"path": "ServiceRequest.requester",
"definition": "SHALL be populated on all ServiceRequests submitted to the central GMS. This SHALL reference a PractitionerRole resource also submitted to the system (either within a single transaction or previously POSTed).",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.performerType",
"path": "ServiceRequest.performerType",
"max": "0"
},
{
"id": "ServiceRequest.performer",
"path": "ServiceRequest.performer",
"definition": "Allows a requester to assign processing of the ServiceRequest to a particular organization (e.g. a remote GLH). The performer field SHOULD be populated with the ODS code for the managing organization/GLH.\nIn the future state, ServiceRequests may be kept open, by not specifying a performer, allowing them to be picked up by the local GLH or otherwise routed based on by test routing (TBC).",
"max": "1",
"type": [
{
"code": "Reference",
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.performer.identifier",
"path": "ServiceRequest.performer.identifier",
"min": 1
},
{
"id": "ServiceRequest.performer.identifier.system",
"path": "ServiceRequest.performer.identifier.system",
"fixedUri": "https://fhir.nhs.uk/Id/ods-organization-code"
},
{
"id": "ServiceRequest.locationCode",
"path": "ServiceRequest.locationCode",
"max": "0"
},
{
"id": "ServiceRequest.locationReference",
"path": "ServiceRequest.locationReference",
"max": "0"
},
{
"id": "ServiceRequest.reasonCode",
"path": "ServiceRequest.reasonCode",
"slicing": {
{
"type": "pattern",
"path": "coding.system"
}
],
"rules": "open"
}
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage",
"path": "ServiceRequest.reasonCode",
"sliceName": "DGTSTestPackage",
"definition": "reasonCode SHALL be populated with the Test Package code for the order.",
"min": 1,
"max": "1"
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.extension:genomicTestCodeVersion",
"path": "ServiceRequest.reasonCode.coding.extension",
"sliceName": "genomicTestCodeVersion",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version"
]
}
],
"isModifier": false
},
{
"id": "ServiceRequest.reasonCode:DGTSTestPackage.coding.system",
"path": "ServiceRequest.reasonCode.coding.system",
"fixedUri": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService"
},
{
"id": "ServiceRequest.reasonReference",
"path": "ServiceRequest.reasonReference",
"definition": "Reference SHOULD be associated to the primary condition being tested for. Required if additional information related to the condition, such as onsetAge, needs to be captured for interpretation.",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-Genomics"
],
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.insurance",
"path": "ServiceRequest.insurance",
"max": "0"
},
{
"id": "ServiceRequest.supportingInfo",
"path": "ServiceRequest.supportingInfo",
"definition": "Any clinical information provided about the patient for whom the testing is being requested SHALL be referenced though the supportingInfo field, to ensure all the information relevant to the ServiceRequest can be easily retrieved. This includes Observations, Conditions, Procedures, FamilyMemberHistories etc.\nThis also includes resources related to family members included as part of testing (consultands), e.g. in Duo/Trio scenarios. In this instance, RelatedPerson and Patient resource references for the consultands SHALL be added to the supportingInfo array, as well as any clinical resources related to these individuals. This is to ensure the number of participants for a given test can be calculated correctly, e.g. through counting the number of RelatedPerson resources referenced from ServiceRequest.supportingInfo plus the subject of the ServiceRequest itself (the proband).\n\nFor WGS testing, where Records of Discussion are required in order to process the test, Consent resources SHOULD also be added to the supportingInfo array once available.",
"type": [
{
"code": "Reference",
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.specimen",
"path": "ServiceRequest.specimen",
"definition": "ServiceRequests where the required samples already exist, e.g. in the case where a specimen already in storage needs to be processed, SHOULD reference these samples through the ServiceRequest.specimen field. Where samples need to be collected to support testing, these SHOULD instead reference the ServiceRequest, through Specimen.request (i.e. the service request has prompted collection of the sample), and these Specimen resources do not need to be referenced from within ServiceRequest.supportingInfo. The referenced Specimen resources SHOULD either be contained within the test order transaction bundle or already exist on the central GMS.\nIn the case of Reanalysis or Reinterpretation tests, Specimens related to previous ServiceRequest are not required to be added to the new test request. The links from the previous ServiceRequest can be followed to identify the Specimens that resulted in the data being reanalysed, e.g. (reanalysis) ServiceRequest.basedOn -> (prior) ServiceRequest, (prior) ServiceRequest <- (original) Specimen.request\n\nFor requests based on prior requests where multiple samples 'active' are associated with the prior request. The specific sample to be reprocessed SHALL be referenced from ServiceRequest.specimen.",
"type": [
{
"code": "Reference",
"referenced",
"bundled"
]
}
]
},
{
"id": "ServiceRequest.bodySite",
"path": "ServiceRequest.bodySite",
"max": "0"
},
{
"id": "ServiceRequest.note",
"path": "ServiceRequest.note",
"definition": "Any information which cannot be readily be structured SHOULD be entered into the note field, though prolific use of the field to capture clinical information which better fits in level 3/4 FHIR resources is discouraged.\nTo support disambiguation of notes originating from different fields in a client system, the AnnotationType extension MAY be used, specifying the UI element name in text (coded elements for the full list of free text UI elements expected within Test Order forms is pending finalisation and addition to the Genomic Order Management MDS). The author element MAY also be used to reference a Practitioner, by identifier or name (string), indicating the person who created the note."
},
{
"id": "ServiceRequest.note.extension:annotationType",
"path": "ServiceRequest.note.extension",
"sliceName": "annotationType",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/annotationType"
]
}
],
"isModifier": false
},
{
"id": "ServiceRequest.patientInstruction",
"path": "ServiceRequest.patientInstruction",
"max": "0"
},
{
"id": "ServiceRequest.relevantHistory",
"path": "ServiceRequest.relevantHistory",
"max": "0"
}
]
}
}



FHIRMDSHL7v2
ServiceRequest.requesterRequester (more details in PractitionerRole resource mappings), PLCM activity - Commissioned service category code, Previous genomic report - Original requester full name, Previous genomic report - Original requester organisation ODS code, Previous genomic report - Original requester reason for request, Previous non genomic report - Original requester full name, Previous non genomic report - Original requester organisation ODS code, Previous non genomic report - Original requester reason for requestVarious ORC/STF segments
ServiceRequest.extension:additionalContactAdditional Contact (more details in PractitionerRole resource mappings)Various STF segments
ServiceRequest.subjectPatient (more details in Patient resource mappings), Patient - Is relativeFirst PID segment in OML message, relatives referenced through NK1 segments
ServiceRequest.identifierTest request - Test request id, PLCM activity - NGIS referral identifier, Previous genomic report - Report lab test numberORC-2, ORC-3
ServiceRequest.extension:coverageTest request - Payment statusIN1-15
ServiceRequest.authoredOnTest request - Date and time request sent, PLCM activity - Financial month, PLCM activity - Financial year, PLCM activity - Turnaround time (calendar days)ORC-9 (for TAT subtracted from OBR-7)
ServiceRequest.priorityTest request - Is urgentTQ1-9
ServiceRequest.extension:priorityReasonTest request - Urgency reasonN/A could possibly use TQ1-10
ServiceRequest.code.coding.systemTest request - Test Directory versionOBR-4.3
ServiceRequest.codeTest request - CI code, Test request - CITT code, PLCM activity - Service code, PLCM activity - Point of delivery code, PLCM activity - Local point of delivery code, PLCM activity - Test method codeOBR-4
ServiceRequest.orderDetailTest request - CI code for multipurpose CITT, Test request - Type of reanalysis, Test request - DNA storage informationNTE segment attached to OBR
ServiceRequest.categoryTest request - Reason for testing, Test request - Reason for reanalysisLikely ORC-29
ServiceRequest.supportingInfoTest request - Detail of reason for reanalysis, Test request - Further informationNTE segments linked to OBR segment for reanalysis reason, Additional segments attached to ORC/OBR
ServiceRequest.occurrenceDateTimeTest request - Date report required byOBR-8
ServiceRequest.performerPLCM activity - ODS code of organisation commissioned to deliver requested testPRD-7 where PRD-1=RT
ServiceRequest.noteRaw specimen/biopsy - Sample to follow reasonNTE segment attached to ORC

Additional Guidance

meta

MAY be used to record details of the originating form, from which the ServiceRequest was populated, including form code and version (under investigation).
"meta": {
  "tag": [
    {
      "system": "http://epr.lth.nhs.uk/CodeSystem/forms",
      "code": "WGS-RareDisease-TestOrderForm",
      "extension": [
        {
          "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version",
          "valueDecimal": "1.0"
      ]
    }
  ]
},

extension:genomicParticipantCount

Genomics specific extension used to record the total number of participants in a group test request.(e.g. family, duo / trio). SHALL be provided on the **Proband** test request only, as part of a group. This will be copied to the RequestGroup to inform lab orchestration.

If more/fewer consultands are identified, it is expected the proband request will be updated to reflect the new participant count, which will in turn update the associated RequestGroup.

"extension": [
  {
   "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTest-ParticipantCount",
   "valueInteger": 3
  },

extension:genomicPatientRole

Genomics specific extension to support family testing. SHALL be present on requests in Duo/Trio use cases where there is a need to differentiate a request for a Proband (which needs to be reported on), from the request for a consultand, which may not result in a report.

It is expected that this will impact the Tasks spun up by the central service, though this is currently still under development.

"extension": [
  {
   "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-Genomic-Patient-Role",
   "valueCodeableConcept": {
    "coding": [
     {
      "system": "https://fhir.nhs.uk/CodeSystem/patient-role-genomics",
      "code": "proband",
      "display": "Proband"
     }
    ]
   }
  },

extension:additionalContact

Extension used for recording additional personnel who should be contacted regarding questions related to a test order. This is separate from the requester or reporting address.

The additional contact SHOULD be a reference to a PractitionerRole resource wherever possible and SHALL contain contact details for the practitioner.

Additionally, where are there multiple practitioners involved in providing care who need to be listed as contacts, the contact details for each practitioner (or service) SHOULD be specified through additional additionalContact entries.

{
    "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact",
    "valueReference": {
        "reference": "PractitionerRole/PractitionerRole-AdditionalContact-Example"
    }
},

extension:coverage

SHALL be present for Genomic Order Management test orders. Extension for recording how work against the test order is being funded. The ValueSet bound to this extension is currently under review by the NHS England Genomics Informatics Working Advisory Group and subject to change.
{
    "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage",
    "valueCoding": {
        "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-FundingCategory",
        "code": "nhs",
        "display": "NHS"
    }
}

extension:servicerequest-order-callback-phone-number

Extension used for recording a callback telephone number for communications relating to the status or result of an order (ServiceRequest). This is separate from the requester or reporting contact details. The callback number SHOULD be a business or service contact number that is monitored during working hours and SHOULD be supplied in international format wherever possible. Additionally, where there are multiple contact numbers relevant to the order workflow, implementers MAY include additional instances of the extension.
  {
    "url": "https://hl7.org/fhir/extensions/StructureDefinition-servicerequest-order-callback-phone-number.html",
    "valueContactPoint": {
      "system": "phone",
      "value": "+44 161 123 4567",
      "use": "work"
    }
  }

identifier

Automatically assigned by the central service, though source systems MAY provide a local identifier for tracking within their own system, in which case the central order number is appended to the identifiers array.
    "identifier":  [
        {
            "system": "https://fhir.nhs.uk/Id/GMSOrder",
            "value": "ROA43728"
        }
    ],

basedOn

SHOULD reference a parent request where this ServiceRequest is based on a previous request, if known, e.g. in the case of reanalysis (where prior outputs/data are used) and cascade testing (where processing of a prior request has triggered the current request), or **Germline Late tests in the Tumour First/Germline Late scenario** (to link tests where prior requests contain clinical context).

Where the prior request cannot be found, relevant information SHOULD be added to the ServiceRequest.note field to support likage by downstream systems.

It is expected that the prior request should be referenced from ServiceRequest.basedOn if data or outputs from the prior request are required in order to properly interpret the current request. If a banked sample needs to be processed, e.g. in the case of a request on Stored DNA, it is expected that this would be referenced directly from ServiceRequest.specimen.

Where multiple samples are associated with a previous request, it is expected only one would be active, e.g. marked as available, making the sample to be reprocessed unambiguous. In cases the data is required, rather than reprocessing of the sample itself, referencing the previous request is sufficient. However, if there are multiple active samples associated with a previous request, and a subset of the samples need to be reprocessed, the sample(s) itself SHALL be referenced from ServiceRequest.specimen as above. If multiple outputs are associated with a previous request, i.e. data from multiple samples, a ServiceRequest SHOULD reference the data to be reinterpreted/reanalysed through ServiceRequest.supportingInfo.

"basedOn":  [
        {
            "reference": "ServiceRequest/ServiceRequest-NonWGSTestOrderForm-FatherOfFayMutlow-Example"
        }
    ],

Non-genomic tests triggering genomic testing: Where a genomic ServiceRequest is initiated following a preceding non-genomic investigation (for example, histopathology, cytogenetics, or other pathology testing), the genomic ServiceRequest SHOULD record the relationship to the originating non-genomic request using ServiceRequest.basedOn. As the originating non-genomic ServiceRequest is outside the scope of the Genomics Broker, ServiceRequest.basedOn SHOULD be populated as a logical reference using the identifier of the originating ServiceRequest, providing traceability to the clinical request that triggered genomic testing.

  "basedOn": [
    {
      "identifier": {
        "system": "http://B82033-pickeringmedicalpractice.com/labrequest",
        "value": "REQ-20220129-000241"
      },
      "display": "Originating histopathology ServiceRequest"
    }
  ]

requisition

SHALL be added for Duo/Trio (familial) requests in order to link tests together. Requisition Identifiers are used to generate RequestGroup resources that assist with management of linked requests. SHALL NOT be populated for other types of test (singleton) or other scenarios where requests/results need to be linked (see `ServiceRequest.basedOn` guidance).

For cases where the requisition identifier is required, it is expected that this is provided by client systems, as there are no rules on the central service that would be able to determine whether the test request is part of a Duo/Trio. As there are no central naming systems for requisition identifiers, it is expected the identifiers will be local identifiers following guidance on Referencing and Identifiers. Other mechanisms for determining or setting the requisition identifier, e.g. by the central service, or deterministically using patient/request identifiers are being investigated by the NHS England Genomics Unit.

For subsequent requests which are part of a group, it is expected the requisition identifier will be retrieved from the prior request, e.g. for the proband, either from the central broker or via some offline means, and will be recreated on the additional request exactly, including system and assigner, so the requests can be linked.

"requisition": {
    "system": "https://fhir.leedssth.nhs.uk//Id/grouptestId",
    "value": "RR-REQ12764",
    "assigner": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "RR8"
        }
    }
},

status

SHALL be provided. ServiceRequests SHOULD be marked as `draft` until ready to be acted upon, after which the user should mark the ServiceRequest as `active`.

A ServiceRequest with the status of draft is assumed to be incomplete, i.e. missing information required for further processing. As such, a central order management broker SHOULD refrain from adding Tasks for the ServiceRequest until it is marked as active, at which time the necessary Tasks are spun up automatically by the broker (this is to be tested within the Genomic Order Management beta). Keeping a ServiceRequest in the draft state allows other parties to populate additional data required, such as phenotypic information from a dedicated service, or further information via a web portal. It is expected that draft ServiceRequests will be purged from the system after a period of inactivity with appropriate warnings (yet to be determined) to avoid stale orders from obscuring live tests/results.

A ServiceRequest may be marked as 'on-hold' if work against it cannot continue temporarily, e.g. due to certain prerequisite information not being provided. A ServiceRequest SHOULD be marked as 'revoked' if cancelled, either by the lab performing work against the order or at the request of the requesting clinician, though in each case a Provenance resource SHALL be provided to capture why the state change has occurred. The requesting clinician may also mark the ServiceRequest as entered-in-error, though implications for work already in progress needs to be investigated further.

A ServiceRequest SHOULD only be marked as completed by the requesting clinician upon receipt and review of the resulting DiagnosticReport.

For the full list of expected/supported ServiceRequest statuses, please see the table below:

Status Description Genomic workflow usage
Draft The request has been created but is not yet complete or ready for action. Saved but not submitted to central service (out of scope for Alpha).
Active The request is in force and ready to be acted upon. Submitted to central service.
On Hold The request (and any implicit authorization to act) has been temporarily withdrawn but is expected to resume in the future. Issue with the authorization for the test (potentially recoverable), not expected to be driven by on-hold statuses of Tasks.
Revoked The request (and any implicit authorization to act) has been terminated prior to the known full completion of the intended actions. No further activity should occur. Unrecoverable issue with order. Either used when the test is no longer needed or there is an is an unrecoverable failure with its fulfillment (driven by the requesting clinician). This status will propagate down to any Tasks which have not already moved into in-progress, Tasks not started will be marked with the status of cancelled.
Completed The activity described by the request has been fully performed. No further activity will occur. Completed order, marked by requestor once DiagnosticReport is received and accepted.
Entered in Error This request should never have existed and should be considered 'void'. (It is possible that real-world decisions were based on it. If real-world activity has occurred, the status should be "revoked" rather than "entered-in-error".) MAY be used for ServiceRequests created in error, can only be set if no Tasks have been started. If a Task has been moved out of its initial state, the status of Revoked SHOULD be used instead. This status will propagate down to Tasks, marking the tasks as entered-in-error.
Unknown The authoring/source system does not know which of the status values currently applies for this request. Note: This concept is not to be used for "other" - one of the listed statuses is presumed to apply, but the authoring/source system does not know which. Should not be used.

For the Genomic Order Management Service central broker, in some instances the ServiceRequest.status value is cascaded down to Tasks which are generated to fulfill that request.

The list of automated state transitions from ServiceRequests to all Tasks pointing to the ServiceRequest via Task.focus are provided in the table below:

ServiceRequest.status Task.status Note
active requested Not implemented within alpha, however it is expected the transition of a ServiceRequest from draft to active will allow Tasks to be spun up with a default state of requested
revoked cancelled Only tasks which have not moved to in-progress or subsequent stages can be automatically marked as cancelled, as these Tasks will require the owners to perform sone form of closure activities upon revokation of a request
entered-in-error entered-in-error This status transition is only permissible if none of the Tasks have moved into in-progress or their subsequent states, if this is the case, the ServiceRequest will need to be marked as revoked instead
on-hold on-hold TBC Not implemented within the alpha but Tasks may be automatically moved to on-hold of the focal request is marked as on-hold, to stop unneccessary processing/work against tasks
completed completed TBC Not implemented within the alpha but Tasks may be automatically moved to completed if the focal request is marked as completed, to reduce orphaned Tasks

It is not expected that Task statuses will propagate up to the ServiceRequest status, though certain task failure types may require revokation of the authorising request (pending investigation).

"status": "active",

intent

SHALL be provided. ServiceRequests SHOULD be marked as 'order' unless they have been raised by a lab in response to an existing ServiceRequest, in which case they SHOULD be marked as 'reflex-order'. For reflex orders, the ServiceRequest.basedOn field SHALL be populated with the original ServiceRequest, for traceability.
"intent": "order",

category

Category SHALL be populated with the reason for the request being ordered e.g. Diagnostic, Carrier, Predictive, Stored DNA etc. The final list of applicable codes which can be selected is still under review, the Genomic-ReasonforTesting ValueSet SHOULD be used for this categorisation.

NOTE: The Genomics Sequencing Category coding is no longer in use as this information is captured within the mastered test data available through the DGTS API.

"category":  [
        {
            "coding": [
                {
                    "system": "https://fhir.nhs.uk/CodeSystem/reasonfortesting-genomics",
                    "code": "diagnostic",
                    "display": "Diagnostic"
                }
            ]
        }
    ],

priority

ServiceRequests marked as urgent (i.e. not routine) SHOULD populate the extension:priorityReason with why an urgent test is being requested. This SHOULD ideally be coded using SNOMED CT concepts. Multiple priorityReason extensions are allowed within a single ServiceRequest in order to aid post-coordination.
"priority": "urgent",
"_priority": {
        "extension" : [ 
            {
                "url" : "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason",
                "valueCodeableConcept" : {
                    "coding": [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "722480002",
                            "display": "Chemotherapy started"
                        }
                    ]
                }
            }
        ]
    }

doNotPerform

For the purposes of Genomic Test Ordering, the doNotPerform field SHALL NOT be used. All ServiceRequests requests received by the system will be assumed to be orders for services/testing.

code

SHOULD be provided if known. If populated, Code SHOULD contain an appropriate test code, preferrably a DGTS Genomic Test code, though NGTD codes MAY be used during the transition period, currently available at https://www.england.nhs.uk/publication/national-genomic-test-directories/. There is currently a prototype DGTS FHIR API in development to support querying/retrieving codes.

Codes from the Genomic Test Directory SHOULD also specify the version number of the test at the time the test is being ordered, to ensure the test methods used are consistent with that version.

"code": {
    "coding": [
        {
            "system": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService",
            "code": "GT1133",
            "display": "Common aneuploidy testing",
            "extension": [
                {
                    "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version",
                    "valueDecimal": 1.0
                }
            ]
        }
    ]
},

orderDetail

If additional coded details need to captured as part of a test order, e.g. Panels or targeted genes, these SHOULD be represented using the 'orderDetail' field, with the indication (TP code) captured within the same field. If completely separate pathways/samples etc. are required for processing against the codes, it is expected these would be requested via multiple ServiceRequests instead of a single ServiceRequest with multiple orderDetail codes. The exact cut-off for when orderDetail vs. multiple ServiceRequest should be used is still being investigated.

It is expected that additional panels would be added as DGTS codes, and would need to concatenate TP and GT numbers, as such they SHOULD use the same system as the primary order code.

Not used in current implementation If a panel code is added as an additional panel, the system SHOULD come from the following NamingSystem: England-GenomicTestPanelCode

For Cancer WGS (or non-WGS tests), where no panel or test-level details are relevant, orderDetail SHOULD be omitted. This can be validated through the primary request being marked as having additional panels available and the additional order codes marked as being available as additional panels (exposed by the DGTS API within Library resources).

Extension-GenomicTestCode-Version:

The DGTS (Genomic Test Services) and PanelApp both maintain release versions and individual test code versions. The Extension-GenomicTestCode-Version has been provided to record specific test code version number, as shown in the snippet below:

"orderDetail": [
 {
  "coding": [
   {
    "system": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService",
    "code": "TP145.GT1132",
    "extension": [
     {
      "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version",
      "valueDecimal": 0.1
     }
    ],
    "display": "Hypertrophic cardiomyopathy - Panel sequencing",
   }
  ]
 }
],

subject

SHALL be provided. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS
"subject": {
        "reference": "Patient/Patient-MeirLieberman-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },

occurrence[x]

If a result is required by a specific date, this MAY be indicated though occurrenceDateTime, though there is no guarantee from the GMS that the ServiceRequest will be processed in the time frame specified.
"occurrenceDateTime": "2023-08-25",

authoredOn

SHALL be populated by the client upon submission, either manually by the user or automatically by the system integrating with the central GMS.
"authoredOn": "2023-08-05",

requester

SHALL be populated on all ServiceRequests submitted to the central GMS. This SHALL reference a PractitionerRole resource also submitted to the system (either within a single transaction or previously POSTed).
"requester": {
        "reference": "PractitionerRole/PractitionerRole-GeneSmithENT-Example"
    },

performer

Allows a requester to assign processing of the ServiceRequest to a particular organization (e.g. a remote GLH). The performer field SHOULD be populated with the ODS code for the managing organization/GLH.

In the future state, ServiceRequests may be kept open, by not specifying a performer, allowing them to be picked up by the local GLH or otherwise routed based on by test routing (TBC).

"performer": [
        {
            "identifier": {
                "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                "value": "RGT01"
            }
        }
    ]

reasonCode

reasonCode SHALL be populated with the Test Package code for the order.
"reasonCode": [
  {
    "coding": [
      {
        "extension": [
          {
            "url": "https://fhir.nhs.uk/England/StructureDefinition/Extension-GenomicTestCode-Version",
            "valueDecimal": 1
          }
        ],
        "system": "https://fhir.nhs.uk/CodeSystem/England-DigitalGenomicTestService",
        "code": "TP229",
        "display": "Likely inborn error of metabolism"
      }
    ]
  }
],

reasonReference

Reference SHOULD be associated to the primary condition being tested for. Required if additional information related to the condition, such as onsetAge, needs to be captured for interpretation.
"reasonReference": {
        "reference": "Condition/Condition-LungTumor-Example"
    },

supportingInfo

Any clinical information provided about the patient for whom the testing is being requested SHALL be referenced though the supportingInfo field, to ensure all the information relevant to the ServiceRequest can be easily retrieved. This includes Observations, Conditions, Procedures, FamilyMemberHistories etc.

This also includes resources related to family members included as part of testing (consultands), e.g. in Duo/Trio scenarios. In this instance, RelatedPerson and Patient resource references for the consultands SHALL be added to the supportingInfo array, as well as any clinical resources related to these individuals. This is to ensure the number of participants for a given test can be calculated correctly, e.g. through counting the number of RelatedPerson resources referenced from ServiceRequest.supportingInfo plus the subject of the ServiceRequest itself (the proband).

For WGS testing, where Records of Discussion are required in order to process the test, Consent resources SHOULD also be added to the supportingInfo array once available.

"supportingInfo":  [
        {
            "reference": "Observation/Observation-DiseaseStatus-Example"
        },
        {
            "reference": "Observation/Observation-GenomicEthnicity-Example"
        },
        {
            "reference": "Observation/Observation-NoPregnancy-Example"
        },
        {
            "reference": "FamilyMemberHistory/FamilyMemberHistory-NonConsanguinousUnion-Example"
        },
        {
            "reference": "Observation/Observation-NoTransplant-Example"
        },
        {
            "reference": "Observation/Observation-NoTransfusion-Example"
        },
        {
            "reference": "Condition/Condition-HearingLoss-Example"
        },
        {
            "reference": "RelatedPerson/RelatedPerson-AliceSmithamProbandMother-Example"
        },
        {
            "reference": "Patient/Patient-PheobeSmithamMother-Example"
        },
    ],

specimen

ServiceRequests where the required samples already exist, e.g. in the case where a specimen already in storage needs to be processed, SHOULD reference these samples through the ServiceRequest.specimen field. Where samples need to be collected to support testing, these SHOULD instead reference the ServiceRequest, through Specimen.request (i.e. the service request has prompted collection of the sample), and these Specimen resources do not need to be referenced from within ServiceRequest.supportingInfo. The referenced Specimen resources SHOULD either be contained within the test order transaction bundle or already exist on the central GMS.

In the case of Reanalysis or Reinterpretation tests, Specimens related to previous ServiceRequest are not required to be added to the new test request. The links from the previous ServiceRequest can be followed to identify the Specimens that resulted in the data being reanalysed, e.g. (reanalysis) ServiceRequest.basedOn -> (prior) ServiceRequest, (prior) ServiceRequest <- (original) Specimen.request

For requests based on prior requests where multiple samples 'active' are associated with the prior request. The specific sample to be reprocessed SHALL be referenced from ServiceRequest.specimen.

"specimen": [
        {
            "reference": "Specimen/Specimen-BloodSerum-Example"
        }
    ],

note

Any information which cannot be readily be structured SHOULD be entered into the note field, though prolific use of the field to capture clinical information which better fits in level 3/4 FHIR resources is discouraged.

To support disambiguation of notes originating from different fields in a client system, the AnnotationType extension SHOULD be used, specifying the UI element name in text (coded elements for the full list of free text UI elements expected within Test Order forms is pending finalisation and addition to the Genomic Order Management MDS). The author element MAY also be used to reference a Practitioner, by identifier or name (string), indicating the person who created the note.

NOTE: Due to architectural constraints in storing ethnicity and birth sex on the PDS record, these elements MAY appear in the notes element as an interim measure, until they are added to the master patient index.

"note":  [
        {
            "extension": [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/annotationType",
                    "valueCodeableConcept": {
                        "coding": [
                            {
                                "system": "https://fhir.nhs.uk/CodeSystem/mds-questiontag-genomics",
                                "code": "P-10",
                                "display": "Patient - Sex defined at birth"
                            }
                        ]
                    }
                }
            ],
            "authorReference": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/sds-user-id",
                    "value": "9999999999"
                },
                "display": "Dr. Gene Smith"
            },
            "text": "MALE"
        }
    ]