2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

5.20 Resource CommunicationRequest - Content

A request to convey information. E.g., the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

5.20.1 Scope and Usage

These resources have not yet undergone proper review by PC, CQI, CDS, and OO. At this time, they are to be considered only as draft resource proposals for potential submission.

This resource is a record of a request for a communication to be performed. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, and devices. Uses of communication request include

  • A computer-based decision-support system requesting a reminder or alert be delivered to a responsible provider
  • A physician requesting notification from the nurse if a patient's temperature exceeds a value
  • A monitoring system or a provider requesting a staff member or department to notify a public health agency of a patient presenting with a reportable communicable disease public health agency
    • As indicated above the request, may represent an order that entered by a practitioner in a CPOE system as well as a proposal made by a clinical decision support system (CDSS) based on a patient's clinical record and context of care.

    5.20.2 Boundaries and Relationships

    This resource is a record of a request. It does not represent the actual flow of communication. The use of CommunicationRequest. excludes requests for referrals which are covered by the ReferralRequest resource. The resource also excludes the types of communications supported by the Alert resource (need to better describe this overlap). Communication of orders and the ensuing responses are described by Order and OrderResponse resources.

    This resource is referenced by [CarePlan2]

    5.20.3 Resource Content

    Structure

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CommunicationRequest DomainResourceCommunication Request
    ... identifier 0..*IdentifierUnique identifier
    ... category 0..1CodeableConceptMessage category
    ... sender 0..1Patient | Practitioner | Device | RelatedPerson | OrganizationMessage sender
    ... recipient 0..*Patient | Device | RelatedPerson | PractitionerMessage recipient
    ... payload 0..*ElementMessage payload
    .... content[x] Message part content
    ..... contentString1..1string
    ..... contentAttachment1..1Attachment
    ..... contentReference1..1Any
    ... medium 0..*CodeableConceptCommunication medium
    ... requester 0..1Practitioner | Patient | RelatedPersonRequester of communication
    ... status M0..1codeproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
    CommunicationRequestStatus (Required)
    ... encounter 0..1EncounterEncounter leading to message
    ... scheduledTime 0..1dateTimeWhen scheduled
    ... reason 0..*CodeableConceptIndication for message
    ... orderedOn 0..1dateTimeWhen ordered or proposed
    ... subject 0..1PatientFocus of message
    ... priority 0..1CodeableConceptMessage urgency

    UML Diagram

    CommunicationRequest (DomainResource)A unique ID of this request for reference purposes. It must be provided if user wants it returned as part of any output, otherwise it will be auto-generated, if needed, by CDS system. Does not need to be the actual ID of the source systemidentifier : Identifier 0..*The type of message such as alert, notification, reminder, instruction, etccategory : CodeableConcept 0..1The entity (e.g., person, organization, clinical information system, or device) which is the source of the communicationsender : Reference(Patient|Practitioner|Device| RelatedPerson|Organization) 0..1The entity (e.g., person, organization, clinical information system, or device) which is the intended target of the communicationrecipient : Reference(Patient|Device|RelatedPerson| Practitioner) 0..*The communication medium, e.g., email, faxmedium : CodeableConcept 0..*The responsible person who authorizes this order, e.g., physician. This may be different than the author of the order statement, e.g., clerk, who may have entered the statement into the order entry applicationrequester : Reference(Practitioner|Patient| RelatedPerson) 0..1The status of the proposal or order (this element modifies the meaning of other elements)status : code 0..1 « The status of the communicationCommunicationRequestStatus »The encounter within which the communication request was createdencounter : Reference(Encounter) 0..1The time when this communication is to occurscheduledTime : dateTime 0..1The reason or justification for the communication requestreason : CodeableConcept 0..*The time when the request was madeorderedOn : dateTime 0..1The patient who is the focus of this communication requestsubject : Reference(Patient) 0..1Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routinepriority : CodeableConcept 0..1PayloadAn individual message part for multi-part messagescontent[x] : string|Attachment|Reference(Any) 1..1Text, attachment(s), or resource(s) to be communicated to the recipientpayload0..*

    XML Template

    <CommunicationRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <category><!-- 0..1 CodeableConcept Message category --></category>
 <sender><!-- 0..1 Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) Message sender --></sender>
 <recipient><!-- 0..* Reference(Patient|Device|RelatedPerson|Practitioner) 
     Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <medium><!-- 0..* CodeableConcept Communication medium --></medium>
 <requester><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson) 
     Requester of communication --></requester>
 <status value="[code]"/><!-- 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed -->
 <encounter><!-- 0..1 Reference(Encounter) Encounter leading to message --></encounter>
 <scheduledTime value="[dateTime]"/><!-- 0..1 When scheduled -->
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <orderedOn value="[dateTime]"/><!-- 0..1 When ordered or proposed -->
 <subject><!-- 0..1 Reference(Patient) Focus of message --></subject>
 <priority><!-- 0..1 CodeableConcept Message urgency --></priority>
</CommunicationRequest>

    JSON Template

    {doco
  "resourceType" : "CommunicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "category" : { CodeableConcept }, // Message category
  "sender" : { Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) }, // Message sender
  "recipient" : [{ Reference(Patient|Device|RelatedPerson|Practitioner) }], // 
     Message recipient
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "medium" : [{ CodeableConcept }], // Communication medium
  "requester" : { Reference(Practitioner|Patient|RelatedPerson) }, // 
     Requester of communication
  "status" : "<code>", // proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
  "encounter" : { Reference(Encounter) }, // Encounter leading to message
  "scheduledTime" : "<dateTime>", // When scheduled
  "reason" : [{ CodeableConcept }], // Indication for message
  "orderedOn" : "<dateTime>", // When ordered or proposed
  "subject" : { Reference(Patient) }, // Focus of message
  "priority" : { CodeableConcept } // Message urgency
}

    Structure

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CommunicationRequest DomainResourceCommunication Request
    ... identifier 0..*IdentifierUnique identifier
    ... category 0..1CodeableConceptMessage category
    ... sender 0..1Patient | Practitioner | Device | RelatedPerson | OrganizationMessage sender
    ... recipient 0..*Patient | Device | RelatedPerson | PractitionerMessage recipient
    ... payload 0..*ElementMessage payload
    .... content[x] Message part content
    ..... contentString1..1string
    ..... contentAttachment1..1Attachment
    ..... contentReference1..1Any
    ... medium 0..*CodeableConceptCommunication medium
    ... requester 0..1Practitioner | Patient | RelatedPersonRequester of communication
    ... status M0..1codeproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
    CommunicationRequestStatus (Required)
    ... encounter 0..1EncounterEncounter leading to message
    ... scheduledTime 0..1dateTimeWhen scheduled
    ... reason 0..*CodeableConceptIndication for message
    ... orderedOn 0..1dateTimeWhen ordered or proposed
    ... subject 0..1PatientFocus of message
    ... priority 0..1CodeableConceptMessage urgency

    UML Diagram

    CommunicationRequest (DomainResource)A unique ID of this request for reference purposes. It must be provided if user wants it returned as part of any output, otherwise it will be auto-generated, if needed, by CDS system. Does not need to be the actual ID of the source systemidentifier : Identifier 0..*The type of message such as alert, notification, reminder, instruction, etccategory : CodeableConcept 0..1The entity (e.g., person, organization, clinical information system, or device) which is the source of the communicationsender : Reference(Patient|Practitioner|Device| RelatedPerson|Organization) 0..1The entity (e.g., person, organization, clinical information system, or device) which is the intended target of the communicationrecipient : Reference(Patient|Device|RelatedPerson| Practitioner) 0..*The communication medium, e.g., email, faxmedium : CodeableConcept 0..*The responsible person who authorizes this order, e.g., physician. This may be different than the author of the order statement, e.g., clerk, who may have entered the statement into the order entry applicationrequester : Reference(Practitioner|Patient| RelatedPerson) 0..1The status of the proposal or order (this element modifies the meaning of other elements)status : code 0..1 « The status of the communicationCommunicationRequestStatus »The encounter within which the communication request was createdencounter : Reference(Encounter) 0..1The time when this communication is to occurscheduledTime : dateTime 0..1The reason or justification for the communication requestreason : CodeableConcept 0..*The time when the request was madeorderedOn : dateTime 0..1The patient who is the focus of this communication requestsubject : Reference(Patient) 0..1Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routinepriority : CodeableConcept 0..1PayloadAn individual message part for multi-part messagescontent[x] : string|Attachment|Reference(Any) 1..1Text, attachment(s), or resource(s) to be communicated to the recipientpayload0..*

    XML Template

    <CommunicationRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <category><!-- 0..1 CodeableConcept Message category --></category>
 <sender><!-- 0..1 Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) Message sender --></sender>
 <recipient><!-- 0..* Reference(Patient|Device|RelatedPerson|Practitioner) 
     Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <medium><!-- 0..* CodeableConcept Communication medium --></medium>
 <requester><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson) 
     Requester of communication --></requester>
 <status value="[code]"/><!-- 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed -->
 <encounter><!-- 0..1 Reference(Encounter) Encounter leading to message --></encounter>
 <scheduledTime value="[dateTime]"/><!-- 0..1 When scheduled -->
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <orderedOn value="[dateTime]"/><!-- 0..1 When ordered or proposed -->
 <subject><!-- 0..1 Reference(Patient) Focus of message --></subject>
 <priority><!-- 0..1 CodeableConcept Message urgency --></priority>
</CommunicationRequest>

    JSON Template

    {doco
  "resourceType" : "CommunicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "category" : { CodeableConcept }, // Message category
  "sender" : { Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) }, // Message sender
  "recipient" : [{ Reference(Patient|Device|RelatedPerson|Practitioner) }], // 
     Message recipient
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "medium" : [{ CodeableConcept }], // Communication medium
  "requester" : { Reference(Practitioner|Patient|RelatedPerson) }, // 
     Requester of communication
  "status" : "<code>", // proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
  "encounter" : { Reference(Encounter) }, // Encounter leading to message
  "scheduledTime" : "<dateTime>", // When scheduled
  "reason" : [{ CodeableConcept }], // Indication for message
  "orderedOn" : "<dateTime>", // When ordered or proposed
  "subject" : { Reference(Patient) }, // Focus of message
  "priority" : { CodeableConcept } // Message urgency
}

     

    Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

    5.20.3.1 Terminology Bindings

    PathDefinitionTypeReference
    CommunicationRequest.status The status of the communicationFixedhttp://hl7.org/fhir/communication-request-status

    Notes to reviewers:

    At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

    5.20.4 Search Parameters

    Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

    NameTypeDescriptionPaths
    categorytokenMessage categoryCommunicationRequest.category
    encounterreferenceEncounter leading to messageCommunicationRequest.encounter
    (Encounter)
    identifiertokenUnique identifierCommunicationRequest.identifier
    mediumtokenCommunication mediumCommunicationRequest.medium
    ordereddateWhen ordered or proposedCommunicationRequest.orderedOn
    patientreferenceFocus of messageCommunicationRequest.subject
    (Patient)
    prioritytokenMessage urgencyCommunicationRequest.priority
    recipientreferenceMessage recipientCommunicationRequest.recipient
    (Device, Patient, Practitioner, RelatedPerson)
    requesterreferenceRequester of communicationCommunicationRequest.requester
    (Patient, Practitioner, RelatedPerson)
    senderreferenceMessage senderCommunicationRequest.sender
    (Device, Organization, Patient, Practitioner, RelatedPerson)
    statustokenproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failedCommunicationRequest.status
    subjectreferenceFocus of messageCommunicationRequest.subject
    (Patient)
    timedateWhen scheduledCommunicationRequest.scheduledTime