STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 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

8.21 Resource CommunicationRequest - Content

Patient Care Work GroupMaturity Level: 1Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

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.

8.21.1 Scope and Usage

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 communicable disease reportable to the public health agency
  • A computer-based decision-support system proposes to send educational material to a patient

8.21.2 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. It also excludes requests for therapy or counseling which would be handled by the ProcedureRequest resource. The performance of a CommunicationRequest may result in a Communication resource.

PLANNED CHANGE:

CommunicationRequest is one of the Request resources in the FHIR Workflow specification. As such, it is expected to be adjusted to align with the Request workflow pattern which will involve adding a number of additional data elements and potentially renaming a few elements. At present, the workgroup plans to incorporate all elements with the exception of supportingInfo and relevantHistory, which will be handled as extensions. Any concerns about performing such alignment are welcome as ballot comments and/or tracker items.

This resource is referenced by CarePlan, ClaimResponse and ProcessResponse

8.21.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest ΣDomainResourceA request for information to be sent to a receiver
... identifier Σ0..*IdentifierUnique identifier
... category Σ0..1CodeableConceptMessage category
... sender Σ0..1Reference(Device | Organization | Patient | Practitioner | RelatedPerson)Message sender
... recipient Σ0..*Reference(Device | Organization | Patient | Practitioner | RelatedPerson | Group | CareTeam)Message recipient
... payload Σ0..*BackboneElementMessage payload
.... content[x] Σ1..1Message part content
..... contentStringstring
..... contentAttachmentAttachment
..... contentReferenceReference(Any)
... medium Σ0..*CodeableConceptA channel of communication
v3 Code System ParticipationMode (Example)
... requester Σ0..1Reference(Practitioner | Patient | RelatedPerson)An individual who requested a communication
... status ?!Σ0..1codeproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
CommunicationRequestStatus (Required)
... topic Σ0..*Reference(Any)Focal resources
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter or episode leading to message
... scheduled[x] Σ0..1When scheduled
.... scheduledDateTimedateTime
.... scheduledPeriodPeriod
... reason Σ0..*CodeableConceptIndication for message
v3 Code System ActReason (Example)
... requestedOn Σ0..1dateTimeWhen ordered or proposed
... subject Σ0..1Reference(Patient)Focus of message
... priority Σ0..1CodeableConceptMessage urgency
RequestPriority (Example)

doco Documentation for this format

UML Diagram (Legend)

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 autogenerated, if needed, by CDS system. Does not need to be the actual ID of the source systemidentifier : Identifier [0..*]The type of message to be sent such as alert, notification, reminder, instruction, etccategory : CodeableConcept [0..1]The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communicationsender : Reference [0..1] « Device|Organization|Patient|Practitioner| RelatedPerson »The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communicationrecipient : Reference [0..*] « Device|Organization|Patient| Practitioner|RelatedPerson|Group|CareTeam »A channel that was used for this communication (e.g. email, fax)medium : CodeableConcept [0..*] « Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example)v3 Code System ParticipationM...?? »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 [0..1] « Practitioner|Patient|RelatedPerson »The status of the proposal or order (this element modifies the meaning of other elements)status : code [0..1] « The status of the communication. (Strength=Required)CommunicationRequestStatus! »The resources which were related to producing this communication requesttopic : Reference [0..*] « Any »The encounter or episode of care within which the communication request was createdcontext : Reference [0..1] « Encounter|EpisodeOfCare »The time when this communication is to occurscheduled[x] : Type [0..1] « dateTime|Period »The reason or justification for the communication requestreason : CodeableConcept [0..*] « Codes for describing reasons for the occurrence of a communication. (Strength=Example)v3 Code System ActReason?? »The time when the request was maderequestedOn : dateTime [0..1]The patient who is the focus of this communication requestsubject : Reference [0..1] « Patient »Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routinepriority : CodeableConcept [0..1] « Codes indicating the relative importance of a communication request. (Strength=Example)RequestPriority?? »PayloadThe communicated content (or for multi-part communications, one portion of the communication)content[x] : Type [1..1] « string|Attachment|Reference(Any) »Text, attachment(s), or resource(s) to be communicated to the recipientpayload[0..*]

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(Device|Organization|Patient|Practitioner|
   RelatedPerson) Message sender --></sender>
 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group|CareTeam) Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <medium><!-- 0..* CodeableConcept A channel of communication --></medium>
 <requester><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson) An individual who requested a communication --></requester>
 <status value="[code]"/><!-- 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed -->
 <topic><!-- 0..* Reference(Any) Focal resources --></topic>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter or episode leading to message --></context>
 <scheduled[x]><!-- 0..1 dateTime|Period When scheduled --></scheduled[x]>
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <requestedOn 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(Device|Organization|Patient|Practitioner|
   RelatedPerson) }, // Message sender
  "recipient" : [{ Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group|CareTeam) }], // Message recipient
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "medium" : [{ CodeableConcept }], // A channel of communication
  "requester" : { Reference(Practitioner|Patient|RelatedPerson) }, // An individual who requested a communication
  "status" : "<code>", // proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
  "topic" : [{ Reference(Any) }], // Focal resources
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter or episode leading to message
  // scheduled[x]: When scheduled. One of these 2:
  "scheduledDateTime" : "<dateTime>",
  "scheduledPeriod" : { Period },
  "reason" : [{ CodeableConcept }], // Indication for message
  "requestedOn" : "<dateTime>", // When ordered or proposed
  "subject" : { Reference(Patient) }, // Focus of message
  "priority" : { CodeableConcept } // Message urgency
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:CommunicationRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:CommunicationRequest.identifier [ Identifier ], ... ; # 0..* Unique identifier
  fhir:CommunicationRequest.category [ CodeableConcept ]; # 0..1 Message category
  fhir:CommunicationRequest.sender [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson) ]; # 0..1 Message sender
  fhir:CommunicationRequest.recipient [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson|Group|CareTeam) ], ... ; # 0..* Message recipient
  fhir:CommunicationRequest.payload [ # 0..* Message payload
    # CommunicationRequest.payload.content[x] : 1..1 Message part content. One of these 3
      fhir:CommunicationRequest.payload.contentString [ string ]
      fhir:CommunicationRequest.payload.contentAttachment [ Attachment ]
      fhir:CommunicationRequest.payload.contentReference [ Reference(Any) ]
  ], ...;
  fhir:CommunicationRequest.medium [ CodeableConcept ], ... ; # 0..* A channel of communication
  fhir:CommunicationRequest.requester [ Reference(Practitioner|Patient|RelatedPerson) ]; # 0..1 An individual who requested a communication
  fhir:CommunicationRequest.status [ code ]; # 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
  fhir:CommunicationRequest.topic [ Reference(Any) ], ... ; # 0..* Focal resources
  fhir:CommunicationRequest.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter or episode leading to message
  # CommunicationRequest.scheduled[x] : 0..1 When scheduled. One of these 2
    fhir:CommunicationRequest.scheduledDateTime [ dateTime ]
    fhir:CommunicationRequest.scheduledPeriod [ Period ]
  fhir:CommunicationRequest.reason [ CodeableConcept ], ... ; # 0..* Indication for message
  fhir:CommunicationRequest.requestedOn [ dateTime ]; # 0..1 When ordered or proposed
  fhir:CommunicationRequest.subject [ Reference(Patient) ]; # 0..1 Focus of message
  fhir:CommunicationRequest.priority [ CodeableConcept ]; # 0..1 Message urgency
]

Changes since DSTU2

CommunicationRequest
CommunicationRequest.recipient Add Reference(Group), Add Reference(CareTeam)
CommunicationRequest.topic added Element
CommunicationRequest.context added Element
CommunicationRequest.encounter deleted

See the Full Difference for further information

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest ΣDomainResourceA request for information to be sent to a receiver
... identifier Σ0..*IdentifierUnique identifier
... category Σ0..1CodeableConceptMessage category
... sender Σ0..1Reference(Device | Organization | Patient | Practitioner | RelatedPerson)Message sender
... recipient Σ0..*Reference(Device | Organization | Patient | Practitioner | RelatedPerson | Group | CareTeam)Message recipient
... payload Σ0..*BackboneElementMessage payload
.... content[x] Σ1..1Message part content
..... contentStringstring
..... contentAttachmentAttachment
..... contentReferenceReference(Any)
... medium Σ0..*CodeableConceptA channel of communication
v3 Code System ParticipationMode (Example)
... requester Σ0..1Reference(Practitioner | Patient | RelatedPerson)An individual who requested a communication
... status ?!Σ0..1codeproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
CommunicationRequestStatus (Required)
... topic Σ0..*Reference(Any)Focal resources
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter or episode leading to message
... scheduled[x] Σ0..1When scheduled
.... scheduledDateTimedateTime
.... scheduledPeriodPeriod
... reason Σ0..*CodeableConceptIndication for message
v3 Code System ActReason (Example)
... requestedOn Σ0..1dateTimeWhen ordered or proposed
... subject Σ0..1Reference(Patient)Focus of message
... priority Σ0..1CodeableConceptMessage urgency
RequestPriority (Example)

doco Documentation for this format

UML Diagram (Legend)

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 autogenerated, if needed, by CDS system. Does not need to be the actual ID of the source systemidentifier : Identifier [0..*]The type of message to be sent such as alert, notification, reminder, instruction, etccategory : CodeableConcept [0..1]The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communicationsender : Reference [0..1] « Device|Organization|Patient|Practitioner| RelatedPerson »The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communicationrecipient : Reference [0..*] « Device|Organization|Patient| Practitioner|RelatedPerson|Group|CareTeam »A channel that was used for this communication (e.g. email, fax)medium : CodeableConcept [0..*] « Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example)v3 Code System ParticipationM...?? »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 [0..1] « Practitioner|Patient|RelatedPerson »The status of the proposal or order (this element modifies the meaning of other elements)status : code [0..1] « The status of the communication. (Strength=Required)CommunicationRequestStatus! »The resources which were related to producing this communication requesttopic : Reference [0..*] « Any »The encounter or episode of care within which the communication request was createdcontext : Reference [0..1] « Encounter|EpisodeOfCare »The time when this communication is to occurscheduled[x] : Type [0..1] « dateTime|Period »The reason or justification for the communication requestreason : CodeableConcept [0..*] « Codes for describing reasons for the occurrence of a communication. (Strength=Example)v3 Code System ActReason?? »The time when the request was maderequestedOn : dateTime [0..1]The patient who is the focus of this communication requestsubject : Reference [0..1] « Patient »Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routinepriority : CodeableConcept [0..1] « Codes indicating the relative importance of a communication request. (Strength=Example)RequestPriority?? »PayloadThe communicated content (or for multi-part communications, one portion of the communication)content[x] : Type [1..1] « string|Attachment|Reference(Any) »Text, attachment(s), or resource(s) to be communicated to the recipientpayload[0..*]

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(Device|Organization|Patient|Practitioner|
   RelatedPerson) Message sender --></sender>
 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group|CareTeam) Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <medium><!-- 0..* CodeableConcept A channel of communication --></medium>
 <requester><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson) An individual who requested a communication --></requester>
 <status value="[code]"/><!-- 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed -->
 <topic><!-- 0..* Reference(Any) Focal resources --></topic>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter or episode leading to message --></context>
 <scheduled[x]><!-- 0..1 dateTime|Period When scheduled --></scheduled[x]>
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <requestedOn 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(Device|Organization|Patient|Practitioner|
   RelatedPerson) }, // Message sender
  "recipient" : [{ Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group|CareTeam) }], // Message recipient
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "medium" : [{ CodeableConcept }], // A channel of communication
  "requester" : { Reference(Practitioner|Patient|RelatedPerson) }, // An individual who requested a communication
  "status" : "<code>", // proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
  "topic" : [{ Reference(Any) }], // Focal resources
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter or episode leading to message
  // scheduled[x]: When scheduled. One of these 2:
  "scheduledDateTime" : "<dateTime>",
  "scheduledPeriod" : { Period },
  "reason" : [{ CodeableConcept }], // Indication for message
  "requestedOn" : "<dateTime>", // When ordered or proposed
  "subject" : { Reference(Patient) }, // Focus of message
  "priority" : { CodeableConcept } // Message urgency
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:CommunicationRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:CommunicationRequest.identifier [ Identifier ], ... ; # 0..* Unique identifier
  fhir:CommunicationRequest.category [ CodeableConcept ]; # 0..1 Message category
  fhir:CommunicationRequest.sender [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson) ]; # 0..1 Message sender
  fhir:CommunicationRequest.recipient [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson|Group|CareTeam) ], ... ; # 0..* Message recipient
  fhir:CommunicationRequest.payload [ # 0..* Message payload
    # CommunicationRequest.payload.content[x] : 1..1 Message part content. One of these 3
      fhir:CommunicationRequest.payload.contentString [ string ]
      fhir:CommunicationRequest.payload.contentAttachment [ Attachment ]
      fhir:CommunicationRequest.payload.contentReference [ Reference(Any) ]
  ], ...;
  fhir:CommunicationRequest.medium [ CodeableConcept ], ... ; # 0..* A channel of communication
  fhir:CommunicationRequest.requester [ Reference(Practitioner|Patient|RelatedPerson) ]; # 0..1 An individual who requested a communication
  fhir:CommunicationRequest.status [ code ]; # 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failed
  fhir:CommunicationRequest.topic [ Reference(Any) ], ... ; # 0..* Focal resources
  fhir:CommunicationRequest.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter or episode leading to message
  # CommunicationRequest.scheduled[x] : 0..1 When scheduled. One of these 2
    fhir:CommunicationRequest.scheduledDateTime [ dateTime ]
    fhir:CommunicationRequest.scheduledPeriod [ Period ]
  fhir:CommunicationRequest.reason [ CodeableConcept ], ... ; # 0..* Indication for message
  fhir:CommunicationRequest.requestedOn [ dateTime ]; # 0..1 When ordered or proposed
  fhir:CommunicationRequest.subject [ Reference(Patient) ]; # 0..1 Focus of message
  fhir:CommunicationRequest.priority [ CodeableConcept ]; # 0..1 Message urgency
]

Changes since DSTU2

CommunicationRequest
CommunicationRequest.recipient Add Reference(Group), Add Reference(CareTeam)
CommunicationRequest.topic added Element
CommunicationRequest.context added Element
CommunicationRequest.encounter deleted

See the Full Difference for further information

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle), JSON-LD (for RDF as JSON-LD),

8.21.3.1 Terminology Bindings

PathDefinitionTypeReference
CommunicationRequest.category Codes for general categories of communications such as alerts, instruction, etc.UnknownNo details provided yet
CommunicationRequest.medium Codes for communication mediums such as phone, fax, email, in person, etc.Examplev3 Code System ParticipationMode
CommunicationRequest.status The status of the communication.RequiredCommunicationRequestStatus
CommunicationRequest.reason Codes for describing reasons for the occurrence of a communication.Examplev3 Code System ActReason
CommunicationRequest.priority Codes indicating the relative importance of a communication request.ExampleRequestPriority

Notes to reviewers:

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

8.21.3.2 CommunicationRequest.sender and CommunicationRequest.recepient

CommunicationRequest.sender and CommunicationRequest.recipient allow Patient|Practitioner|RelatedPerson - but it is not unusual to have a communication target - even a defined one - where it is unknown what kind of role the person is playing.

If the communication request is to or from an individual, whose role is not known (practitioner, patient or related person), - for example, only email address is captured in the system; then RelatedPerson should be used by default.

8.21.4 Search Parameters

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

NameTypeDescriptionPathsIn Common
categorytokenMessage categoryCommunicationRequest.category
contextreferenceEncounter or episode leading to messageCommunicationRequest.context
(EpisodeOfCare, Encounter)
identifiertokenUnique identifierCommunicationRequest.identifier
mediumtokenA channel of communicationCommunicationRequest.medium
patientreferenceFocus of messageCommunicationRequest.subject
(Patient)
prioritytokenMessage urgencyCommunicationRequest.priority
recipientreferenceMessage recipientCommunicationRequest.recipient
(Practitioner, Group, Organization, CareTeam, Device, Patient, RelatedPerson)
requesteddateWhen ordered or proposedCommunicationRequest.requestedOn
requesterreferenceAn individual who requested a communicationCommunicationRequest.requester
(Practitioner, Patient, RelatedPerson)
senderreferenceMessage senderCommunicationRequest.sender
(Practitioner, Organization, Device, Patient, RelatedPerson)
statustokenproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | failedCommunicationRequest.status
subjectreferenceFocus of messageCommunicationRequest.subject
(Patient)
timedateWhen scheduledCommunicationRequest.scheduledDateTime