R6 Ballot (2nd Draft)

Publish-box (todo)

Orders and Observations icon Work GroupMaturity Level: 1 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner

Detailed Descriptions for the elements in the DeviceRequest resource.

DeviceRequest
Element Id DeviceRequest
Definition

Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

Short Display Medical device request
Cardinality 0..*
Type DomainResource
Summary false
DeviceRequest.identifier
Element Id DeviceRequest.identifier
Definition

Identifiers assigned to this order by the orderer or by the receiver.

Short Display External Request identifier
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Summary true
DeviceRequest.instantiatesCanonical
Element Id DeviceRequest.instantiatesCanonical
Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

Short Display Instantiates FHIR protocol or definition
Cardinality 0..*
Type canonical(ActivityDefinition | PlanDefinition)
Summary true
Comments

Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

DeviceRequest.instantiatesUri
Element Id DeviceRequest.instantiatesUri
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

Short Display Instantiates external protocol or definition
Cardinality 0..*
Type uri
Summary true
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

DeviceRequest.basedOn
Element Id DeviceRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

Short Display What request fulfills
Cardinality 0..*
Type Reference(Any)
Summary true
DeviceRequest.replaces
Element Id DeviceRequest.replaces
Definition

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

Short Display What request replaces
Cardinality 0..*
Type Reference(DeviceRequest)
Summary true
DeviceRequest.groupIdentifier
Element Id DeviceRequest.groupIdentifier
Definition

A shared identifier common to multiple independent Request instances that were activated/authorized more or less simultaneously by a single author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or a prescription number shared by all meds ordered at one time.

Short Display Identifier of composite request
Cardinality 0..1
Type Identifier
Summary true
DeviceRequest.status
Element Id DeviceRequest.status
Definition

The status of the request.

Short Display draft | active | on-hold | revoked | completed | entered-in-error | unknown
Cardinality 0..1
Terminology Binding RequestStatus (Required)
Type code
Is Modifier true (Reason: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summary true
Comments

This element is labeled as a modifier because the status contains the codes revoked and entered-in-error that mark the request as not currently valid.

DeviceRequest.intent
Element Id DeviceRequest.intent
Definition

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

Short Display proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Cardinality 1..1
Terminology Binding RequestIntent (Required)
Type code
Is Modifier true (Reason: This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request)
Summary true
Comments

This element is immutable. It cannot be changed for the same resource instance.

DeviceRequest.priority
Element Id DeviceRequest.priority
Definition

Indicates how quickly the request should be addressed with respect to other requests.

Short Display routine | urgent | asap | stat
Cardinality 0..1
Terminology Binding RequestPriority (Required)
Type code
Meaning if Missing If missing, normal priority
Summary true
DeviceRequest.doNotPerform
Element Id DeviceRequest.doNotPerform
Definition

If true, indicates that the provider is asking for the patient to either stop using or to not start using the specified device or category of devices. For example, the patient has undergone surgery and the provider is indicating that the patient should not wear contact lenses.

Short Display True if the request is to stop or not to start using the device
Cardinality 0..1
Type boolean
Is Modifier true (Reason: This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc.))
Summary true
Comments

If do not perform is not specified, the request is a positive request e.g. "do perform". DeviceRequest.reasonCode includes the reason for marking the DeviceRequest as 'do not perform'.

DeviceRequest.code
Element Id DeviceRequest.code
Definition

The details of the device to be used.

Short Display Device requested
Cardinality 1..1
Terminology Binding Device Type (Example)
Type CodeableReference(Device | DeviceDefinition)
Summary true
DeviceRequest.quantity
Element Id DeviceRequest.quantity
Definition

The number of devices to be provided.

Short Display Quantity of devices to supply
Cardinality 0..1
Type integer
Summary false
DeviceRequest.parameter
Element Id DeviceRequest.parameter
Definition

Specific parameters for the ordered item. For example, the prism value for lenses.

Short Display Device details
Cardinality 0..*
Summary false
DeviceRequest.parameter.code
Element Id DeviceRequest.parameter.code
Definition

A code or string that identifies the device detail being asserted.

Short Display Device detail
Cardinality 0..1
Terminology Binding ParameterCode:
Type CodeableConcept
Summary false
DeviceRequest.parameter.value[x]
Element Id DeviceRequest.parameter.value[x]
Definition

The value of the device detail.

Short Display Value of detail
Cardinality 0..1
Type CodeableConcept|Quantity|Range|boolean
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary false
Comments

Range means device should have a value that falls somewhere within the specified range.

DeviceRequest.subject
Element Id DeviceRequest.subject
Definition

The patient who will use the device.

Short Display Focus of request
Cardinality 1..1
Type Reference(Patient | Group | Location | Device)
Summary true
DeviceRequest.encounter
Element Id DeviceRequest.encounter
Definition

An encounter that provides additional context in which this request is made.

Short Display Encounter motivating request
Cardinality 0..1
Type Reference(Encounter)
Summary true
DeviceRequest.occurrence[x]
Element Id DeviceRequest.occurrence[x]
Definition

The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".

Short Display Desired time or schedule for use
Cardinality 0..1
Type dateTime|Period|Timing
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary true
DeviceRequest.authoredOn
Element Id DeviceRequest.authoredOn
Definition

When the request transitioned to being actionable.

Short Display When recorded
Cardinality 0..1
Type dateTime
Summary true
DeviceRequest.requester
Element Id DeviceRequest.requester
Definition

The individual or entity who initiated the request and has responsibility for its activation.

Short Display Who/what submitted the device request
Cardinality 0..1
Type Reference(Device | Practitioner | PractitionerRole | Organization)
Summary true
DeviceRequest.performer
Element Id DeviceRequest.performer
Definition

The desired individual or entity to provide the device to the subject of the request (e.g., patient, location).

Short Display Requested Filler
Cardinality 0..1
Type CodeableReference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)
Summary true
DeviceRequest.reason
Element Id DeviceRequest.reason
Definition

Reason or justification for the use of this device.

Short Display Coded/Linked Reason for request
Cardinality 0..*
Terminology Binding Condition/Problem/Diagnosis Codes (Example)
Type CodeableReference(Condition | Observation | DiagnosticReport | DocumentReference)
Summary true
DeviceRequest.asNeeded
Element Id DeviceRequest.asNeeded
Definition

This status is to indicate whether the request is a PRN or may be given as needed.

Short Display PRN status of request
Cardinality 0..1
Type boolean
Summary false
DeviceRequest.asNeededFor
Element Id DeviceRequest.asNeededFor
Definition

The reason for using the device.

Short Display Device usage reason
Cardinality 0..1
Type CodeableConcept
Summary false
DeviceRequest.insurance
Element Id DeviceRequest.insurance
Definition

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

Short Display Associated insurance coverage
Cardinality 0..*
Type Reference(Coverage | ClaimResponse)
Summary false
DeviceRequest.supportingInfo
Element Id DeviceRequest.supportingInfo
Definition

Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site).

Short Display Additional clinical information
Cardinality 0..*
Type Reference(Any)
Requirements

Knowing where the device is targeted is important for tracking if multiple sites are possible.

Summary false
DeviceRequest.note
Element Id DeviceRequest.note
Definition

Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

Short Display Notes or comments
Cardinality 0..*
Type Annotation
Summary false
DeviceRequest.relevantHistory
Element Id DeviceRequest.relevantHistory
Definition

Key events in the history of the request.

Short Display Request provenance
Cardinality 0..*
Type Reference(Provenance)
Summary false
Comments

This might 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.