RLServiceRequestRivalutazione
Descrizione
Il profilo RLServiceRequestRivalutazione è stato strutturato a partire dalla risorsa generica FHIR ServiceRequest ed è volto a notificare la necessità di una rivalutazione di un paziente attualmente in ricovero domiciliare.
Di seguito è presentato il contenuto del profilo in diversi formati. La corrispondente definizione è consultabile al seguente link: RLServiceRequestRivalutazione.
Snapshot View
ServiceRequest | I | ServiceRequest | There are no (further) constraints on this element Element IdServiceRequest A request for a service to be performed Alternate namesdiagnostic request, referral, referral request, transfer of care request DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
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id | Σ | 1..1 | System.String | Element IdServiceRequest.id UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto. DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | Σ | 1..1 | Meta | Element IdServiceRequest.meta Metadati della risorsa DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | Σ | 1..1 | id | Element IdServiceRequest.meta.versionId Versione della risorsa DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 1..1 | instant | Element IdServiceRequest.meta.lastUpdated Data e ora di ultimo aggiornamento della risorsa DefinitionFormato standard FHIR: YYY-MM-DDThh:mm:ss.sss+zz:zz This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
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profile | Σ | 1..1 | canonical(StructureDefinition)Fixed Value | Element IdServiceRequest.meta.profile Profilo al quale la risorsa si riferisce DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdServiceRequest.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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identifier | Σ | 1..1 | Identifier | Element IdServiceRequest.identifier Codice identificativo della richiesta di rivalutazione del paziente DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uriFixed Value | Element IdServiceRequest.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.siss.regione.lombardia.it/sid/identificativoRichiestaRivalutazionePaziente
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value | Σ | 1..1 | string | Element IdServiceRequest.identifier.value Codice identificativo della richiesta di rivalutazione del paziente Definition{codiceL2}{numeroPratica}_R{progressivo a 6 cifre es.000001} If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | There are no (further) constraints on this element Element IdServiceRequest.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Constraints
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element IdServiceRequest.instantiatesUri Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
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basedOn | Σ I | 1..1 | Reference(RLCarePlanProgettoIndividuale) | Element IdServiceRequest.basedOn Riferimento al progetto individuale nel quale è prevista l'erogazione della prestazione Alternate namesfulfills DefinitionReference al profilo RLCarePlanProgettoIndividuale contente il progetto individuale del paziente. UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(RLCarePlanProgettoIndividuale) Constraints
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replaces | Σ I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdServiceRequest.replaces What request replaces Alternate namessupersedes, prior, renewed order DefinitionThe request takes the place of the referenced completed or terminated request(s). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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requisition | Σ | 1..1 | Identifier | Element IdServiceRequest.requisition Numero pratica del ricovero domiciliare Alternate namesgrouperId, groupIdentifier DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes. 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.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uriFixed Value | Element IdServiceRequest.requisition.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.siss.regione.lombardia.it/sid/numeroPraticaRicoveroDomiciliare
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value | Σ | 1..1 | string | Element IdServiceRequest.requisition.value Numero pratica del ricovero domiciliare DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requisition.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requisition.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.status Stato del ricovero domiciliare DefinitionValore fisso su "active" The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. RequestStatus (required)Constraints
active
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intent | Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.intent Intento della richesta DefinitionValore fisso su "proposal" This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. RequestIntent (required)Constraints
proposal
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category | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.category Classification of service DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. ServiceRequestCategoryCodes (example)Constraints
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priority | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.priority routine | urgent | asap | stat DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. RequestPriority (required)Constraints
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doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.doNotPerform True if service/procedure should not be performed DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform"
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code | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.code What is being requested/ordered Alternate namesservice requested DefinitionA code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. 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. Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available [here](valueset-diagnostic-requests.html). ProcedureCodes(SNOMEDCT) (example)Constraints
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orderDetail | Σ I | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.orderDetail Additional order information Alternate namesdetailed instructions DefinitionAdditional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example)Constraints
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quantity[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.quantity[x] Service amount DefinitionAn amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction). When ordering a service the number of service items may need to be specified separately from the the service item.
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quantityQuantity | Quantity | There are no (further) constraints on this element Data Type | ||
quantityRatio | Ratio | There are no (further) constraints on this element Data Type | ||
quantityRange | Range | There are no (further) constraints on this element Data Type | ||
subject | Σ I | 1..1 | Reference(RLPatientCittadino) | Element IdServiceRequest.subject Paziente al quale deve essere erogata la prestazione DefinitionReference alla risorsa RLPatientCittadino contenente i dettagli anagrafici del paziente References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdServiceRequest.encounter Encounter in which the request was created Alternate namescontext DefinitionAn encounter that provides additional information about the healthcare context in which this request is made. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | Σ | 1..1 | Element IdServiceRequest.occurrence[x] Data (e ora, se disponibile) in cui è stata ichiesta la rivalutazione la rivalutazione del paziente Alternate namesschedule DefinitionFormato: YYYY-MM-DD secondo lo standard FHIR. Nel caso in cui fosse disponibile anche l'ora compilare con il formato: YYYY-MM-DDThh:mm:ss+zz:zz secondo lo standard FHIR
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occurrenceDateTime | dateTime | Data Type | ||
asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.asNeeded[x] Preconditions for service DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints
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asNeededBoolean | boolean | There are no (further) constraints on this element Data Type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
authoredOn | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdServiceRequest.authoredOn Date request signed Alternate namesorderedOn DefinitionWhen the request transitioned to being actionable.
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requester | Σ I | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element IdServiceRequest.requester Who/what is requesting service Alternate namesauthor, orderer DefinitionThe individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Constraints
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.performerType Performer role Alternate namesspecialty DefinitionDesired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example)Constraints
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performer | Σ I | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | There are no (further) constraints on this element Element IdServiceRequest.performer Requested performer Alternate namesrequest recipient DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Constraints
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locationCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.locationCode Requested location DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example)Constraints
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locationReference | Σ I | 0..* | Reference(Location) | There are no (further) constraints on this element Element IdServiceRequest.locationReference Requested location DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.reasonCode Explanation/Justification for procedure or service DefinitionAn explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes (example)Constraints
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdServiceRequest.reasonReference Explanation/Justification for service or service DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference(Condition | Observation | DiagnosticReport | DocumentReference) Constraints
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insurance | I | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element IdServiceRequest.insurance Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Coverage | ClaimResponse) Constraints
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supportingInfo | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo Additional clinical information Alternate namesAsk at order entry question, AOE DefinitionAdditional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdServiceRequest.specimen Procedure Samples DefinitionOne or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
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bodySite | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.bodySite Location on Body Alternate nameslocation DefinitionAnatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example)Constraints
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note | 0..1 | Annotation | Element IdServiceRequest.note Motivo della rivalutazione DefinitionStringa alfanumerica al più di 1000 caratteri 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).
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.patientInstruction Patient or consumer-oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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relevantHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdServiceRequest.relevantHistory Request provenance DefinitionKey events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Differential View
ServiceRequest | I | ServiceRequest | There are no (further) constraints on this element Element IdServiceRequest A request for a service to be performed Alternate namesdiagnostic request, referral, referral request, transfer of care request DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
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id | Σ | 1..1 | System.String | Element IdServiceRequest.id UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto. DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | Σ | 1..1 | Meta | Element IdServiceRequest.meta Metadati della risorsa DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | Σ | 1..1 | id | Element IdServiceRequest.meta.versionId Versione della risorsa DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 1..1 | instant | Element IdServiceRequest.meta.lastUpdated Data e ora di ultimo aggiornamento della risorsa DefinitionFormato standard FHIR: YYY-MM-DDThh:mm:ss.sss+zz:zz This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
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profile | Σ | 1..1 | canonical(StructureDefinition)Fixed Value | Element IdServiceRequest.meta.profile Profilo al quale la risorsa si riferisce DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdServiceRequest.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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identifier | Σ | 1..1 | Identifier | Element IdServiceRequest.identifier Codice identificativo della richiesta di rivalutazione del paziente DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uriFixed Value | Element IdServiceRequest.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.siss.regione.lombardia.it/sid/identificativoRichiestaRivalutazionePaziente
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value | Σ | 1..1 | string | Element IdServiceRequest.identifier.value Codice identificativo della richiesta di rivalutazione del paziente Definition{codiceL2}{numeroPratica}_R{progressivo a 6 cifre es.000001} If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | There are no (further) constraints on this element Element IdServiceRequest.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Constraints
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element IdServiceRequest.instantiatesUri Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
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basedOn | Σ I | 1..1 | Reference(RLCarePlanProgettoIndividuale) | Element IdServiceRequest.basedOn Riferimento al progetto individuale nel quale è prevista l'erogazione della prestazione Alternate namesfulfills DefinitionReference al profilo RLCarePlanProgettoIndividuale contente il progetto individuale del paziente. UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(RLCarePlanProgettoIndividuale) Constraints
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replaces | Σ I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdServiceRequest.replaces What request replaces Alternate namessupersedes, prior, renewed order DefinitionThe request takes the place of the referenced completed or terminated request(s). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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requisition | Σ | 1..1 | Identifier | Element IdServiceRequest.requisition Numero pratica del ricovero domiciliare Alternate namesgrouperId, groupIdentifier DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes. 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.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uriFixed Value | Element IdServiceRequest.requisition.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.siss.regione.lombardia.it/sid/numeroPraticaRicoveroDomiciliare
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value | Σ | 1..1 | string | Element IdServiceRequest.requisition.value Numero pratica del ricovero domiciliare DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requisition.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requisition.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.status Stato del ricovero domiciliare DefinitionValore fisso su "active" The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. RequestStatus (required)Constraints
active
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intent | Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.intent Intento della richesta DefinitionValore fisso su "proposal" This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. RequestIntent (required)Constraints
proposal
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category | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.category Classification of service DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. ServiceRequestCategoryCodes (example)Constraints
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priority | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.priority routine | urgent | asap | stat DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. RequestPriority (required)Constraints
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doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.doNotPerform True if service/procedure should not be performed DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform"
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code | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.code What is being requested/ordered Alternate namesservice requested DefinitionA code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. 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. Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available [here](valueset-diagnostic-requests.html). ProcedureCodes(SNOMEDCT) (example)Constraints
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orderDetail | Σ I | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.orderDetail Additional order information Alternate namesdetailed instructions DefinitionAdditional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example)Constraints
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quantity[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.quantity[x] Service amount DefinitionAn amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction). When ordering a service the number of service items may need to be specified separately from the the service item.
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quantityQuantity | Quantity | There are no (further) constraints on this element Data Type | ||
quantityRatio | Ratio | There are no (further) constraints on this element Data Type | ||
quantityRange | Range | There are no (further) constraints on this element Data Type | ||
subject | Σ I | 1..1 | Reference(RLPatientCittadino) | Element IdServiceRequest.subject Paziente al quale deve essere erogata la prestazione DefinitionReference alla risorsa RLPatientCittadino contenente i dettagli anagrafici del paziente References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdServiceRequest.encounter Encounter in which the request was created Alternate namescontext DefinitionAn encounter that provides additional information about the healthcare context in which this request is made. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | Σ | 1..1 | Element IdServiceRequest.occurrence[x] Data (e ora, se disponibile) in cui è stata ichiesta la rivalutazione la rivalutazione del paziente Alternate namesschedule DefinitionFormato: YYYY-MM-DD secondo lo standard FHIR. Nel caso in cui fosse disponibile anche l'ora compilare con il formato: YYYY-MM-DDThh:mm:ss+zz:zz secondo lo standard FHIR
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occurrenceDateTime | dateTime | Data Type | ||
asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.asNeeded[x] Preconditions for service DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints
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asNeededBoolean | boolean | There are no (further) constraints on this element Data Type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
authoredOn | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdServiceRequest.authoredOn Date request signed Alternate namesorderedOn DefinitionWhen the request transitioned to being actionable.
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requester | Σ I | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element IdServiceRequest.requester Who/what is requesting service Alternate namesauthor, orderer DefinitionThe individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Constraints
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.performerType Performer role Alternate namesspecialty DefinitionDesired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example)Constraints
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performer | Σ I | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | There are no (further) constraints on this element Element IdServiceRequest.performer Requested performer Alternate namesrequest recipient DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Constraints
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locationCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.locationCode Requested location DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example)Constraints
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locationReference | Σ I | 0..* | Reference(Location) | There are no (further) constraints on this element Element IdServiceRequest.locationReference Requested location DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.reasonCode Explanation/Justification for procedure or service DefinitionAn explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes (example)Constraints
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdServiceRequest.reasonReference Explanation/Justification for service or service DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference(Condition | Observation | DiagnosticReport | DocumentReference) Constraints
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insurance | I | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element IdServiceRequest.insurance Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Coverage | ClaimResponse) Constraints
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supportingInfo | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo Additional clinical information Alternate namesAsk at order entry question, AOE DefinitionAdditional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdServiceRequest.specimen Procedure Samples DefinitionOne or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
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bodySite | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.bodySite Location on Body Alternate nameslocation DefinitionAnatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example)Constraints
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note | 0..1 | Annotation | Element IdServiceRequest.note Motivo della rivalutazione DefinitionStringa alfanumerica al più di 1000 caratteri 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).
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.patientInstruction Patient or consumer-oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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relevantHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdServiceRequest.relevantHistory Request provenance DefinitionKey events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Hybrid View
ServiceRequest | I | ServiceRequest | There are no (further) constraints on this element Element IdServiceRequest A request for a service to be performed Alternate namesdiagnostic request, referral, referral request, transfer of care request DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
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id | Σ | 1..1 | System.String | Element IdServiceRequest.id UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto. DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | Σ | 1..1 | Meta | Element IdServiceRequest.meta Metadati della risorsa DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | Σ | 1..1 | id | Element IdServiceRequest.meta.versionId Versione della risorsa DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
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lastUpdated | Σ | 1..1 | instant | Element IdServiceRequest.meta.lastUpdated Data e ora di ultimo aggiornamento della risorsa DefinitionFormato standard FHIR: YYY-MM-DDThh:mm:ss.sss+zz:zz This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
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source | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdServiceRequest.meta.source Identifies where the resource comes from DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
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profile | Σ | 1..1 | canonical(StructureDefinition)Fixed Value | Element IdServiceRequest.meta.profile Profilo al quale la risorsa si riferisce DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) Constraints
https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdServiceRequest.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdServiceRequest.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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identifier | Σ | 1..1 | Identifier | Element IdServiceRequest.identifier Codice identificativo della richiesta di rivalutazione del paziente DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uriFixed Value | Element IdServiceRequest.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.siss.regione.lombardia.it/sid/identificativoRichiestaRivalutazionePaziente
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value | Σ | 1..1 | string | Element IdServiceRequest.identifier.value Codice identificativo della richiesta di rivalutazione del paziente Definition{codiceL2}{numeroPratica}_R{progressivo a 6 cifre es.000001} If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | There are no (further) constraints on this element Element IdServiceRequest.instantiatesCanonical Instantiates FHIR protocol or definition DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Constraints
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instantiatesUri | Σ | 0..* | uri | There are no (further) constraints on this element Element IdServiceRequest.instantiatesUri Instantiates external protocol or definition DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
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basedOn | Σ I | 1..1 | Reference(RLCarePlanProgettoIndividuale) | Element IdServiceRequest.basedOn Riferimento al progetto individuale nel quale è prevista l'erogazione della prestazione Alternate namesfulfills DefinitionReference al profilo RLCarePlanProgettoIndividuale contente il progetto individuale del paziente. UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(RLCarePlanProgettoIndividuale) Constraints
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replaces | Σ I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdServiceRequest.replaces What request replaces Alternate namessupersedes, prior, renewed order DefinitionThe request takes the place of the referenced completed or terminated request(s). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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requisition | Σ | 1..1 | Identifier | Element IdServiceRequest.requisition Numero pratica del ricovero domiciliare Alternate namesgrouperId, groupIdentifier DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes. 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.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdServiceRequest.requisition.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | Σ | 1..1 | uriFixed Value | Element IdServiceRequest.requisition.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
https://fhir.siss.regione.lombardia.it/sid/numeroPraticaRicoveroDomiciliare
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value | Σ | 1..1 | string | Element IdServiceRequest.requisition.value Numero pratica del ricovero domiciliare DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdServiceRequest.requisition.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdServiceRequest.requisition.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.status Stato del ricovero domiciliare DefinitionValore fisso su "active" The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. RequestStatus (required)Constraints
active
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intent | Σ ?! | 1..1 | codeBindingFixed Value | Element IdServiceRequest.intent Intento della richesta DefinitionValore fisso su "proposal" This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. RequestIntent (required)Constraints
proposal
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category | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.category Classification of service DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. ServiceRequestCategoryCodes (example)Constraints
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priority | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdServiceRequest.priority routine | urgent | asap | stat DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests. Note that FHIR strings SHALL NOT exceed 1MB in size If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. RequestPriority (required)Constraints
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doNotPerform | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdServiceRequest.doNotPerform True if service/procedure should not be performed DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform"
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code | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.code What is being requested/ordered Alternate namesservice requested DefinitionA code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. 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. Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available [here](valueset-diagnostic-requests.html). ProcedureCodes(SNOMEDCT) (example)Constraints
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orderDetail | Σ I | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.orderDetail Additional order information Alternate namesdetailed instructions DefinitionAdditional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. ServiceRequestOrderDetailsCodes (example)Constraints
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quantity[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.quantity[x] Service amount DefinitionAn amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction). When ordering a service the number of service items may need to be specified separately from the the service item.
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quantityQuantity | Quantity | There are no (further) constraints on this element Data Type | ||
quantityRatio | Ratio | There are no (further) constraints on this element Data Type | ||
quantityRange | Range | There are no (further) constraints on this element Data Type | ||
subject | Σ I | 1..1 | Reference(RLPatientCittadino) | Element IdServiceRequest.subject Paziente al quale deve essere erogata la prestazione DefinitionReference alla risorsa RLPatientCittadino contenente i dettagli anagrafici del paziente References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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encounter | Σ I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdServiceRequest.encounter Encounter in which the request was created Alternate namescontext DefinitionAn encounter that provides additional information about the healthcare context in which this request is made. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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occurrence[x] | Σ | 1..1 | Element IdServiceRequest.occurrence[x] Data (e ora, se disponibile) in cui è stata ichiesta la rivalutazione la rivalutazione del paziente Alternate namesschedule DefinitionFormato: YYYY-MM-DD secondo lo standard FHIR. Nel caso in cui fosse disponibile anche l'ora compilare con il formato: YYYY-MM-DDThh:mm:ss+zz:zz secondo lo standard FHIR
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occurrenceDateTime | dateTime | Data Type | ||
asNeeded[x] | Σ | 0..1 | There are no (further) constraints on this element Element IdServiceRequest.asNeeded[x] Preconditions for service DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes (example)Constraints
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asNeededBoolean | boolean | There are no (further) constraints on this element Data Type | ||
asNeededCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
authoredOn | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdServiceRequest.authoredOn Date request signed Alternate namesorderedOn DefinitionWhen the request transitioned to being actionable.
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requester | Σ I | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | There are no (further) constraints on this element Element IdServiceRequest.requester Who/what is requesting service Alternate namesauthor, orderer DefinitionThe individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) Constraints
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performerType | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.performerType Performer role Alternate namesspecialty DefinitionDesired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. ParticipantRoles (example)Constraints
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performer | Σ I | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | There are no (further) constraints on this element Element IdServiceRequest.performer Requested performer Alternate namesrequest recipient DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B). Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Constraints
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locationCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.locationCode Requested location DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A location type where services are delivered. v3.ServiceDeliveryLocationRoleType (example)Constraints
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locationReference | Σ I | 0..* | Reference(Location) | There are no (further) constraints on this element Element IdServiceRequest.locationReference Requested location DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reasonCode | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.reasonCode Explanation/Justification for procedure or service DefinitionAn explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes (example)Constraints
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reasonReference | Σ I | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | There are no (further) constraints on this element Element IdServiceRequest.reasonReference Explanation/Justification for service or service DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference(Condition | Observation | DiagnosticReport | DocumentReference) Constraints
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insurance | I | 0..* | Reference(Coverage | ClaimResponse) | There are no (further) constraints on this element Element IdServiceRequest.insurance Associated insurance coverage DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Coverage | ClaimResponse) Constraints
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supportingInfo | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdServiceRequest.supportingInfo Additional clinical information Alternate namesAsk at order entry question, AOE DefinitionAdditional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the
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specimen | Σ I | 0..* | Reference(Specimen) | There are no (further) constraints on this element Element IdServiceRequest.specimen Procedure Samples DefinitionOne or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.
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bodySite | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdServiceRequest.bodySite Location on Body Alternate nameslocation DefinitionAnatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures (example)Constraints
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note | 0..1 | Annotation | Element IdServiceRequest.note Motivo della rivalutazione DefinitionStringa alfanumerica al più di 1000 caratteri 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).
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patientInstruction | Σ | 0..1 | string | There are no (further) constraints on this element Element IdServiceRequest.patientInstruction Patient or consumer-oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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relevantHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdServiceRequest.relevantHistory Request provenance DefinitionKey events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Table View
ServiceRequest | .. | |
ServiceRequest.id | 1.. | |
ServiceRequest.meta | 1.. | |
ServiceRequest.meta.versionId | 1.. | |
ServiceRequest.meta.lastUpdated | 1.. | |
ServiceRequest.meta.profile | 1..1 | |
ServiceRequest.identifier | 1..1 | |
ServiceRequest.identifier.system | 1.. | |
ServiceRequest.identifier.value | 1.. | |
ServiceRequest.basedOn | Reference(RLCarePlanProgettoIndividuale) | 1..1 |
ServiceRequest.requisition | 1.. | |
ServiceRequest.requisition.system | 1.. | |
ServiceRequest.requisition.value | 1.. | |
ServiceRequest.status | .. | |
ServiceRequest.intent | .. | |
ServiceRequest.subject | Reference(RLPatientCittadino) | .. |
ServiceRequest.occurrence[x] | dateTime | 1.. |
ServiceRequest.note | ..1 |
XML View
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="UUID" /> <url value="https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione" /> <name value="RLServiceRequestRivalutazione" /> <status value="active" /> <description value="Profilo volto a notificare la necessità di una rivalutazione di un paziente in ricovero domiciliare" /> <keyword> <system value="https://fhir.siss.regione.lombardia.it/CodeSystem/Tag" /> <code value="C-DOM" /> </keyword> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="ServiceRequest" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" /> <derivation value="constraint" /> <differential> <element id="ServiceRequest.id"> <path value="ServiceRequest.id" /> <short value="UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto." /> <min value="1" /> </element> <element id="ServiceRequest.meta"> <path value="ServiceRequest.meta" /> <short value="Metadati della risorsa" /> <min value="1" /> </element> <element id="ServiceRequest.meta.versionId"> <path value="ServiceRequest.meta.versionId" /> <short value="Versione della risorsa" /> <min value="1" /> </element> <element id="ServiceRequest.meta.lastUpdated"> <path value="ServiceRequest.meta.lastUpdated" /> <short value="Data e ora di ultimo aggiornamento della risorsa" /> <definition value="Formato standard FHIR: YYY-MM-DDThh:mm:ss.sss+zz:zz" /> <min value="1" /> </element> <element id="ServiceRequest.meta.profile"> <path value="ServiceRequest.meta.profile" /> <short value="Profilo al quale la risorsa si riferisce" /> <min value="1" /> <max value="1" /> <fixedCanonical value="https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione" /> </element> <element id="ServiceRequest.identifier"> <path value="ServiceRequest.identifier" /> <short value="Codice identificativo della richiesta di rivalutazione del paziente" /> <min value="1" /> <max value="1" /> </element> <element id="ServiceRequest.identifier.system"> <path value="ServiceRequest.identifier.system" /> <min value="1" /> <fixedUri value="https://fhir.siss.regione.lombardia.it/sid/identificativoRichiestaRivalutazionePaziente" /> </element> <element id="ServiceRequest.identifier.value"> <path value="ServiceRequest.identifier.value" /> <short value="Codice identificativo della richiesta di rivalutazione del paziente" /> <definition value="{codiceL2}{numeroPratica}_R{progressivo a 6 cifre es.000001}" /> <min value="1" /> </element> <element id="ServiceRequest.basedOn"> <path value="ServiceRequest.basedOn" /> <short value="Riferimento al progetto individuale nel quale è prevista l'erogazione della prestazione" /> <definition value="Reference al profilo RLCarePlanProgettoIndividuale contente il progetto individuale del paziente. UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto." /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.siss.regione.lombardia.it/StructureDefinition/RLCarePlanProgettoIndividuale" /> </type> </element> <element id="ServiceRequest.requisition"> <path value="ServiceRequest.requisition" /> <short value="Numero pratica del ricovero domiciliare" /> <min value="1" /> </element> <element id="ServiceRequest.requisition.system"> <path value="ServiceRequest.requisition.system" /> <min value="1" /> <fixedUri value="https://fhir.siss.regione.lombardia.it/sid/numeroPraticaRicoveroDomiciliare" /> </element> <element id="ServiceRequest.requisition.value"> <path value="ServiceRequest.requisition.value" /> <short value="Numero pratica del ricovero domiciliare" /> <min value="1" /> </element> <element id="ServiceRequest.status"> <path value="ServiceRequest.status" /> <short value="Stato del ricovero domiciliare" /> <definition value="Valore fisso su "active"" /> <fixedCode value="active" /> </element> <element id="ServiceRequest.intent"> <path value="ServiceRequest.intent" /> <short value="Intento della richesta" /> <definition value="Valore fisso su "proposal"" /> <fixedCode value="proposal" /> </element> <element id="ServiceRequest.subject"> <path value="ServiceRequest.subject" /> <short value="Paziente al quale deve essere erogata la prestazione" /> <definition value="Reference alla risorsa RLPatientCittadino contenente i dettagli anagrafici del paziente" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.siss.regione.lombardia.it/StructureDefinition/RLPatientCittadino" /> </type> </element> <element id="ServiceRequest.occurrence[x]"> <path value="ServiceRequest.occurrence[x]" /> <short value="Data (e ora, se disponibile) in cui è stata ichiesta la rivalutazione la rivalutazione del paziente" /> <definition value="Formato: YYYY-MM-DD secondo lo standard FHIR. \nNel caso in cui fosse disponibile anche l'ora compilare con il formato: YYYY-MM-DDThh:mm:ss+zz:zz secondo lo standard FHIR" /> <min value="1" /> <type> <code value="dateTime" /> </type> </element> <element id="ServiceRequest.note"> <path value="ServiceRequest.note" /> <short value="Motivo della rivalutazione" /> <definition value="Stringa alfanumerica al più di 1000 caratteri" /> <max value="1" /> </element> </differential> </StructureDefinition>
JSON View
{ "resourceType": "StructureDefinition", "id": "UUID", "url": "https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione", "name": "RLServiceRequestRivalutazione", "status": "active", "description": "Profilo volto a notificare la necessità di una rivalutazione di un paziente in ricovero domiciliare", "keyword": [ { "system": "https://fhir.siss.regione.lombardia.it/CodeSystem/Tag", "code": "C-DOM" } ], "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "ServiceRequest", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest", "derivation": "constraint", "differential": { "element": [ { "id": "ServiceRequest.id", "path": "ServiceRequest.id", "short": "UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto.", "min": 1 }, { "id": "ServiceRequest.meta", "path": "ServiceRequest.meta", "short": "Metadati della risorsa", "min": 1 }, { "id": "ServiceRequest.meta.versionId", "path": "ServiceRequest.meta.versionId", "short": "Versione della risorsa", "min": 1 }, { "id": "ServiceRequest.meta.lastUpdated", "path": "ServiceRequest.meta.lastUpdated", "short": "Data e ora di ultimo aggiornamento della risorsa", "definition": "Formato standard FHIR: YYY-MM-DDThh:mm:ss.sss+zz:zz", "min": 1 }, { "id": "ServiceRequest.meta.profile", "path": "ServiceRequest.meta.profile", "short": "Profilo al quale la risorsa si riferisce", "min": 1, "max": "1", "fixedCanonical": "https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione" }, { "id": "ServiceRequest.identifier", "path": "ServiceRequest.identifier", "short": "Codice identificativo della richiesta di rivalutazione del paziente", "min": 1, "max": "1" }, { "id": "ServiceRequest.identifier.system", "path": "ServiceRequest.identifier.system", "min": 1, "fixedUri": "https://fhir.siss.regione.lombardia.it/sid/identificativoRichiestaRivalutazionePaziente" }, { "id": "ServiceRequest.identifier.value", "path": "ServiceRequest.identifier.value", "short": "Codice identificativo della richiesta di rivalutazione del paziente", "definition": "{codiceL2}{numeroPratica}_R{progressivo a 6 cifre es.000001}", "min": 1 }, { "id": "ServiceRequest.basedOn", "path": "ServiceRequest.basedOn", "short": "Riferimento al progetto individuale nel quale è prevista l'erogazione della prestazione", "definition": "Reference al profilo RLCarePlanProgettoIndividuale contente il progetto individuale del paziente. UUID prodotto dal server FHIR (applicativo) che detiene la risorsa. Per maggiori informazioni su chi detiene la risorsa consultare il paragrafo API-Restful nella pagina di Contesto.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.siss.regione.lombardia.it/StructureDefinition/RLCarePlanProgettoIndividuale" ] } ] }, { "id": "ServiceRequest.requisition", "path": "ServiceRequest.requisition", "short": "Numero pratica del ricovero domiciliare", "min": 1 }, { "id": "ServiceRequest.requisition.system", "path": "ServiceRequest.requisition.system", "min": 1, "fixedUri": "https://fhir.siss.regione.lombardia.it/sid/numeroPraticaRicoveroDomiciliare" }, { "id": "ServiceRequest.requisition.value", "path": "ServiceRequest.requisition.value", "short": "Numero pratica del ricovero domiciliare", "min": 1 }, { "id": "ServiceRequest.status", "path": "ServiceRequest.status", "short": "Stato del ricovero domiciliare", "definition": "Valore fisso su \"active\"", "fixedCode": "active" }, { "id": "ServiceRequest.intent", "path": "ServiceRequest.intent", "short": "Intento della richesta", "definition": "Valore fisso su \"proposal\"", "fixedCode": "proposal" }, { "id": "ServiceRequest.subject", "path": "ServiceRequest.subject", "short": "Paziente al quale deve essere erogata la prestazione", "definition": "Reference alla risorsa RLPatientCittadino contenente i dettagli anagrafici del paziente", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.siss.regione.lombardia.it/StructureDefinition/RLPatientCittadino" ] } ] }, { "id": "ServiceRequest.occurrence[x]", "path": "ServiceRequest.occurrence[x]", "short": "Data (e ora, se disponibile) in cui è stata ichiesta la rivalutazione la rivalutazione del paziente", "definition": "Formato: YYYY-MM-DD secondo lo standard FHIR. \nNel caso in cui fosse disponibile anche l'ora compilare con il formato: YYYY-MM-DDThh:mm:ss+zz:zz secondo lo standard FHIR", "min": 1, "type": [ { "code": "dateTime" } ] }, { "id": "ServiceRequest.note", "path": "ServiceRequest.note", "short": "Motivo della rivalutazione", "definition": "Stringa alfanumerica al più di 1000 caratteri", "max": "1" } ] } }
Tipologie di ricerca
Dettagli della necessità di rivalutazione del paziente
Questa ricerca deve essere utilizzata da un’ASST nel momento in cui deve essere appurato se un paziente attualmente in ricovero domiciliare necessita di una rivalutazione. Mediante il numero pratica del servizio e cure domiciliari viene definita l’associazione della prestazione erogata con l’assistito.
Il parametro da valorizzare obbligatoriamente per effettuare la ricerca sono:
- requisition: numero pratica del servizio di cure domiciliari.
Nella tabella di seguito vengono riportati i dettagli tecnici per l’implementazione della ricerca:
SCOPE | Dettagli della necessità di rivalutazione del paziente |
---|---|
VERB | GET |
BASE_APIMANAGER | https://api.servizirl.it/c/operatori.siss/fhir/v1.0.0/npri |
BASE_APISOURCE | https://<nome_host_Ente>/<contesto_FHIR>/<codiceCudesL1>/<versione>/erogazione-adi |
URL | ServiceRequest?_profile=https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione &requisition={numeroPratica} &based-on:CarePlan.activity-reference:ServiceRequest.performer:Organization.identifier={codiceLivello2} |
A titolo esemplificativo, la chiamate:
ServiceRequest?_profile=https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione&requisition=2022000001&based-on:CarePlan.activity-reference:ServiceRequest.performer:Organization.identifier=03014300
Restituirà, se presenti, tutte le rivalutazioni necessarie alla pratica numero "2022000001" afferente alla struttura "03014300".
Un esempio di Bundle di risposta può essere consultato qui: esempio-ricerca-rivalutazioni.
Poiché questa ricerca è di prassi utilizzata per ricavare anche i dettagli relativi alle sospensioni temporanee dei servizi di cure domiciliari del paziente, strutturati nel profilo RLServiceRequestSopensioneADI, vengono di seguito riportate le informazioni per effettuare la ricerca congiunta.
Il parametro da valorizzare obbligatoriamente per effettuare la ricerca per entrambi i profili interessati (RLServiceRequestSopensioneADI e RLServiceRequestRivalutazione) è:
- requisition: numero pratica del servizio di cure domiciliari.
Nella tabella di seguito vengono riportati i dettagli tecnici per l’implementazione della ricerca:
SCOPE | Dettagli della sospensione temporanea del ricovero domiciliare e necessità di rivalutazione del paziente |
---|---|
VERB | GET |
BASE_APIMANAGER | https://api.servizirl.it/c/operatori.siss/fhir/v1.0.0/npri |
BASE_APISOURCE | https://<nome_host_Ente>/<contesto_FHIR>/<codiceCudesL1>/<versione>/erogazione-adi |
URL | ServiceRequest?_profile=https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione, https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestSospensioneADI &requisition={numeroPratica} &based-on:CarePlan.activity-reference:ServiceRequest.performer:Organization.identifier={codiceLivello2} |
La chiamata:
ServiceRequest?_profile=https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestRivalutazione,https://fhir.siss.regione.lombardia.it/StructureDefinition/RLServiceRequestSospensioneADI&requisition=2022000001&based-on:CarePlan.activity-reference:ServiceRequest.performer:Organization.identifier=03014300
Restituirà, se presenti, tutte le sospensioni temporanee e rivalutazioni relative pratica numero "2022000001" afferente alla struttura "03014300".
Un esempio di Bundle di risposta può essere consultato qui: esempio-ricerca-rivalutazioni-sospensioni.
Criterio di ricerca applicato per le funzionalità descritte nei documenti:
- DC-COOP-FHIR#01 (Specifiche di cooperazione applicativa nell’ambito delle cure domiciliari).
Search parameter
Per questo profilo sono utilizzati i seguenti parametri di ricerca previsti dallo standard:
- _profile
- based-on
- requisition
ValueSet
Attualmente non sono definiti value set specifici per il profilo RLServiceRequestRivalutazione.