STU 3 Ballot

This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

10.3.12.2.4 StructureDefinition: OrderForGenetics - Detailed Descriptions

Definitions for the orderforgenetics Profile.

DiagnosticRequest(OrderForGenetics)
Definition

A record of a request for a diagnostic investigation service to be performed.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (xpath: not(parent::f:contained and f:text))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (xpath: not(parent::f:contained and f:contained))
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (xpath: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))])))
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (xpath: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated)))
DiagnosticRequest.id
Definition

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

Control0..1
Typeid
Comments

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

DiagnosticRequest.meta
Definition

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

Control0..1
TypeMeta
DiagnosticRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.

DiagnosticRequest.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Typecode
Comments

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

DiagnosticRequest.text
Definition

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

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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

DiagnosticRequest.contained
Definition

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

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

DiagnosticRequest.extension (http://hl7.org/fhir/StructureDefinition/diagnosticrequest-geneticsItem)
Definition

The specific diagnostic investigations that are requested as part of this request. Sometimes, there can only be one item per request, but in most contexts, more than one investigation can be requested.

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (xpath: @value|f:*|h:div)
ext-1: Must have either extensions or value[x], not both (xpath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')]))
DiagnosticRequest.modifierExtension
Definition

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

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

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

DiagnosticRequest.identifier
Definition

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

Control0..*
TypeIdentifier
Comments

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

DiagnosticRequest.definition
Definition

Protocol or definition followed by this request.

Control0..*
TypeReference(Resource)
DiagnosticRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

Control0..*
TypeReference(Resource)
DiagnosticRequest.replaces
Definition

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

Control0..*
TypeReference(Resource)
DiagnosticRequest.requisition
Definition

Composite request this is part of.

Control0..1
TypeIdentifier
DiagnosticRequest.status
Definition

The status of the order.

Control0..1
BindingThe status of a diagnostic order.
The codes SHALL be taken from RequestStatus
Typecode
Is Modifiertrue
Comments

Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled.

DiagnosticRequest.stage
Definition

Whether the request is a proposal, plan, an original order or a reflex order.

Control1..1
BindingThe kind of diagnostic request
The codes SHALL be taken from DiagnosticRequestStage; other codes may be used where these codes are not suitable
TypeCodeableConcept
Is Modifiertrue
DiagnosticRequest.code
Definition

A code that identifies a particular diagnostic investigation, or panel of investigations, that have been requested.

Control1..1
BindingCodes for tests/services that can be performed by diagnostic services.
The codes SHOULD be taken from LOINC Diagnostic Request Codes
TypeCodeableConcept
Comments

Many laboratory tests and radiology tests embed the specimen/organ system in the test name, for example, serum or serum/plasma glucose, or a chest xray. The specimen may not be recorded separately from the test code.

DiagnosticRequest.subject
Definition

On whom or what the investigation is to be performed. This is usually a human patient, but diagnostic tests can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

Control1..1
TypeChoice of: Reference(Patient), Reference(Group), Reference(Location), Reference(Device)
DiagnosticRequest.context
Definition

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

Control0..1
TypeChoice of: Reference(Encounter), Reference(EpisodeOfCare)
DiagnosticRequest.occurrence[x]
Definition

The date/time at which the diagnostic testing should occur.

Control0..1
TypeChoice of: dateTime, Period, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
DiagnosticRequest.authored
Definition

When the request transitioned to being actionable.

Control0..1
TypedateTime
DiagnosticRequest.requester
Definition

Who/what is requesting diagnostics. The practitioner that holds legal responsibility for ordering the investigation.

Control0..1
TypeChoice of: Reference(Device), Reference(Practitioner), Reference(Organization)
Comments

This not the dispatcher, but rather who is authorizing.

DiagnosticRequest.performerType
Definition

Desired type of performer for doing the diagnostic testing. (.

Control0..1
BindingIndicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
For example codes, see Participant Roles
TypeCodeableConcept
Comments

this is a role, not aparticipation type. I.e. doesn’t describe the task, describes the capacity. Examples “compounding pharmacy” or “psychiatrist” or “internal referral”.

DiagnosticRequest.performer
Definition

The desired perfomer for doing the diagnostic testing.

Control0..1
TypeChoice of: Reference(Practitioner), Reference(Organization), Reference(Patient), Reference(Device), Reference(RelatedPerson)
Comments

Use an extension or listing alternative alternative performers and/or roles and/or preference.

DiagnosticRequest.reason
Definition

An explanation or justification for why this diagnostic investigation is being requested. This is often for billing purposes. May relate to the resources referred to in supportingInformation.

Control0..*
BindingDiagnosis or problem codes justifying the reason for requesting the diagnostic investigation.
For example codes, see Condition/Problem/Diagnosis Codes
TypeCodeableConcept
Comments

This may be used to decide how the diagnostic investigation will be performed, or even if it will be performed at all. Use CodeableConcept text element if the data is free (uncoded) text as shown in the CT Scan example.

DiagnosticRequest.supportingInformation
Definition

Additional clinical information about the patient or specimen that may influence test interpretations. This includes observations explicitly requested by the producer(filler) to provide context or supporting information needed to complete the order.

Control0..*
TypeReference(Resource)
Alternate NamesAsk at order entry question, AOE
Comments

This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". Examples include reporting the amount of inspired oxygen for blood gasses, the point in the menstrual cycle for cervical pap tests, and other conditions that influence test interpretations.

DiagnosticRequest.note
Definition

Any other notes and comments made about the service request. (e.g. "patient hates needles").

Control0..*
TypeAnnotation
DiagnosticRequest.relevantHistory
Definition

Key events in the history of the request.

Control0..*
TypeReference(Provenance)
Comments

This may 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.