R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). 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

Servicerequest-example2.xml

Orders and Observations Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

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An example of an order for home physiotherapy (id = "physiotherapy")

<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="physiotherapy"/> 
  <!--    demonstrating in this example the reason reference element using contained resources
   for the purpose of this example only typically this would be a separate independent resource
     -->
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : physiotherapy</p> <p> <b> contained</b> : , </p> <p> <b> identifier</b> : Placer = 20170201-0001</p> <p> <b> basedOn</b> : <a> CarePlan/gpvisit</a> </p> <p> <b> status</b> : completed</p> <p> <b> intent</b> : order</p> <p> <b> code</b> : Physiotherapy of chest (regime/therapy)  <span> (Details : {SNOMED CT code '34431008' = 'Physiotherapy of chest', given as 'Physiotherapy
           of chest (regime/therapy) '})</span> </p> <p> <b> subject</b> : <a> Patient/example</a> </p> <p> <b> occurrence</b> : Duration 15days, Do 1-1 per 1 days</p> <p> <b> asNeeded</b> : as needed to clear mucus <span> (Details )</span> </p> <p> <b> authoredOn</b> : 01/02/2017 5:23:07 PM</p> <p> <b> requester</b> : <a> Dr Adam Careful</a> </p> <p> <b> reasonReference</b> : id: cystic-fibrosis; clinicalStatus: active; verificationStatus: confirmed; Problem
         List Item <span> (Details : {http://hl7.org/fhir/condition-category code 'problem-list-item' = 'Problem
           List Item', given as 'Problem List Item'})</span> ; Mild <span> (Details : {SNOMED CT code '255604002' = 'Mild', given as 'Mild'})</span> ; Cystic Fibrosis <span> (Details : {http://hl7.org/fhir/sid/icd-10-cm code 'E84.0' = 'E84.0', given as 'Cystic
           fibrosis with pulmonary manifestations'})</span> ; onset: 12/11/2012</p> <p> <b> relevantHistory</b> : Author's Signature. Generated Summary: id: signature; recorded: 01/02/2017 5:23:07 PM;
         </p> </div> </text> <contained> 
    <Provenance> 
      <id value="signature"/> 
      <target> 
        <reference value="ServiceRequest/physiotherapy/_history/1"/> 
      </target> 
      <recorded value="2017-02-01T17:23:07Z"/> 
      <agent> 
        <role> 
          <coding> 
            <system value="http://hl7.org/fhir/v3/ParticipationType"/> 
            <code value="AUT"/> 
          </coding> 
        </role> 
        <whoReference> 
          <reference value="Practitioner/example"/> 
          <display value="Dr Adam Careful"/> 
        </whoReference> 
      </agent> 
      <signature> 
        <type> 
          <system value="urn:iso-astm:E1762-95:2013"/> 
          <code value="1.2.840.10065.1.12.1.1"/> 
          <display value="Author's Signature"/> 
        </type> 
        <when value="2017-02-01T17:23:07Z"/> 
        <whoReference> 
          <reference value="Practitioner/example"/> 
          <display value="Dr Adam Careful"/> 
        </whoReference> 
        <targetFormat value="application/fhir+xml"/> 
        <sigFormat value="application/signature+xml"/> 
        <blob value="dGhpcyBibG9iIGlzIHNuaXBwZWQ="/> 
      </signature> 
    </Provenance> 
  </contained> 
  <contained> 
    <Condition> 
      <id value="cystic-fibrosis"/> 
      <clinicalStatus value="active"/> 
      <verificationStatus value="confirmed"/> 
      <category> 
        <coding> 
          <system value="http://hl7.org/fhir/condition-category"/> 
          <code value="problem-list-item"/> 
          <display value="Problem List Item"/> 
        </coding> 
      </category> 
      <severity> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="255604002"/> 
          <display value="Mild"/> 
        </coding> 
      </severity> 
      <code> 
        <coding> 
          <system value="http://hl7.org/fhir/sid/icd-10-cm"/> 
          <code value="E84.0"/> 
          <display value="Cystic fibrosis with pulmonary manifestations"/> 
        </coding> 
        <text value="Cystic Fibrosis"/> 
      </code> 
      <subject> 
        <reference value="Patient/example"/> 
      </subject> 
      <onsetDateTime value="2012-11-12"/> 
    </Condition> 
  </contained> 
  <identifier> 
    <type> 
      <coding> 
        <system value="http://hl7.org/fhir/identifier-type"/> 
        <code value="PLAC"/> 
        <display value="Placer Identifier"/> 
      </coding> 
      <text value="Placer"/> 
    </type> 
    <system value="http://goodhealth.org/placer-ids">
    </system> 
    <value value="20170201-0001"/> 
  </identifier> 
  <!--     example to show how a CarePlan can be referenced from a request    -->
  <basedOn> 
    <reference value="CarePlan/gpvisit"/> 
  </basedOn> 
  <status value="completed"/> 
  <intent value="order"/> 
  <!--    Physiotherapy or home excercises would be a common use case for as needed. E.g. exercises
   for cystic fibrosis - "Chest therapy 1-4 times per day as needed to clear mucus"    -->
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="34431008"/> 
      <display value="Physiotherapy of chest (regime/therapy) "/> 
    </coding> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
  </subject> 
  <occurrenceTiming> 
    <repeat> 
      <duration value="15"/> 
      <durationMax value="25"/> 
      <durationUnit value="min"/> 
      <frequency value="1"/> 
      <frequencyMax value="4"/> 
      <period value="1"/> 
      <periodUnit value="d"/> 
    </repeat> 
  </occurrenceTiming> 
  <asNeededCodeableConcept> 
    <text value="as needed to clear mucus"/> 
  </asNeededCodeableConcept> 
  <!--    TimeStamp when order authorized   -->
  <authoredOn value="2017-02-01T17:23:07Z"/> 
  <requester> 
      <reference value="Practitioner/example"/> 
      <display value="Dr Adam Careful"/> 
  </requester> 
  <!--    demonstrating in this example the reason reference element using a contained resource
   for the purpose of this example only typically would reference an external resource   -->
  <reasonReference> 
    <reference value="#cystic-fibrosis"/> 
  </reasonReference> 
  <!--    demonstrating in this example the relevant history element using a contained resource
   for the purpose of this example only typically would reference an external resource   -->
  <relevantHistory> 
    <reference value="#signature"/> 
    <display value="Author's Signature"/> 
  </relevantHistory> 
</ServiceRequest> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.