This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). 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
Example ServiceRequest/myringotomy (XML)
Raw XML (canonical form + also see XML Format Specification)
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An example of a Myringotomy referral request (id = "myringotomy")
<?xml version="1.0" encoding="UTF-8"?>
<ServiceRequest xmlns="http://hl7.org/fhir">
<id value="myringotomy"/>
<text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: ServiceRequest</b> <a name="myringotomy"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ServiceRequest "myringotomy" </p> </div> <p> <b> identifier</b> : id: ret4421</p> <p> <b> basedOn</b> : <span> : ServiceRequest for Myringotomy and insertion of tympanic ventilation tube</span> </p> <p> <b> replaces</b> : <span> : prior ServiceRequest</span> </p> <p> <b> requisition</b> : id: 1234</p> <p> <b> status</b> : active</p> <p> <b> intent</b> : order</p> <p> <b> category</b> : Patient referral to specialist <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #103696004)</span> </p> <p> <b> priority</b> : routine</p> <h3> Codes</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> Insertion of grommets <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #172676009 "Myringotomy and insertion of tympanic ventilation tube")</span> </td> </tr> </table> <p> <b> subject</b> : <a href="broken-link.html">https://fhir.orionhealth.com/blaze/fhir/Patient/77662: Beverly Weaver</a> </p> <p> <b> encounter</b> : <span> : Beverly Waver's encounter on 2014-02-14</span> </p> <p> <b> occurrence</b> : ?? --> 2014-03-14</p> <p> <b> authoredOn</b> : 2014-02-14</p> <p> <b> requester</b> : <a href="broken-link.html">https://fhir.orionhealth.com/blaze/fhir/Practitioner/77272: Serena Shrink</a> </p> <p> <b> performerType</b> : ENT <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (specialties#ent)</span> </p> <p> <b> performer</b> : <a href="broken-link.html">https://fhir.orionhealth.com/blaze/fhir/Practitioner/76597: Dr Dave</a> </p> <h3> Reasons</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> For consideration of Grommets <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </td> </tr> </table> <p> <b> note</b> : In the past 2 years Beverly has had 6 instances of rt-sided Otitis media. She
is falling behind her peers at school, and displaying some learning difficulties.
(By Serena Shrink @2014-02-14)</p> </div> </text> <identifier>
<system value="http://orionhealth.com/fhir/apps/referralids"/>
<value value="ret4421"/>
</identifier>
<basedOn>
<display value="ServiceRequest for Myringotomy and insertion of tympanic ventilation tube"/>
</basedOn>
<replaces>
<display value="prior ServiceRequest"/>
</replaces>
<requisition>
<value value="1234"/>
</requisition>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="103696004"/>
<display value="Patient referral to specialist"/>
</coding>
</category>
<priority value="routine"/>
<code>
<concept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="172676009"/>
<display value="Myringotomy and insertion of tympanic ventilation tube"/>
</coding>
<text value="Insertion of grommets"/>
</concept>
</code>
<subject>
<reference value="https://fhir.orionhealth.com/blaze/fhir/Patient/77662"/>
<display value="Beverly Weaver"/>
</subject>
<encounter>
<display value="Beverly Waver's encounter on 2014-02-14"/>
</encounter>
<occurrencePeriod>
<end value="2014-03-14"/>
</occurrencePeriod>
<authoredOn value="2014-02-14"/>
<requester>
<reference value="https://fhir.orionhealth.com/blaze/fhir/Practitioner/77272"/>
<display value="Serena Shrink"/>
</requester>
<performerType>
<coding>
<system value="http://orionhealth.com/fhir/apps/specialties"/>
<code value="ent"/>
<display value="ENT"/>
</coding>
</performerType>
<performer>
<reference value="https://fhir.orionhealth.com/blaze/fhir/Practitioner/76597"/>
<display value="Dr Dave"/>
</performer>
<reason>
<concept>
<text value="For consideration of Grommets"/>
</concept>
</reason>
<note>
<authorString value="Serena Shrink"/>
<time value="2014-02-14"/>
<text value="In the past 2 years Beverly has had 6 instances of rt-sided Otitis media. She is
falling behind her peers at school, and displaying some learning difficulties."/>
</note>
</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.