This page is part of the US Core (v6.0.0-ballot: STU6 Ballot 1) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions
Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest | Version: 6.0.0-ballot | |||
Active as of 2022-10-07 | Computable Name: USCoreServiceRequestProfile | |||
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License |
This profile sets minimum expectations for recording, searching, and fetching the ServiceRequest resource to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource when using this profile. It provides the floor for standards development for specific use cases.fhirVersion: 4.0.1
Example Usage Scenarios:
The following are example usage scenarios for this profile:
The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.
Each Service Request must have:
Each Service Request must support:
Additional USCDI Requirements
For ONC’s USCDI requirements, each ServiceRequest must support the following additional elements. These elements are included in the formal definition of the profile, and they are represented in the examples.
*see guidance below
Profile specific implementation guidance:
ServiceRequest.category
binding must support, at a minimum, the US Core ServiceRequest Category Codes. However, this valueset can be treated as extensible, and other category codes can be used instead.ServiceRequest.code
valueset is broad to accommodate a wide variety of use cases and should be constrained to a subset for a particular use case or domain. (for example, LOINC for laboratory orders.)ServiceRequest.reasonCodeableConcept
or a reference using ServiceRequest.reasonReference
.Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from ServiceRequest
Path | Conformance | ValueSet |
ServiceRequest.category:us-core | required | USCoreServiceRequestCategoryCodes |
ServiceRequest.code | extensible | USCoreProcedureCodes |
ServiceRequest.reasonCode | extensible | USCoreConditionCodes |
Path | Conformance | ValueSet |
ServiceRequest.status | required | RequestStatus |
ServiceRequest.intent | required | RequestIntent |
ServiceRequest.category | example | ServiceRequestCategoryCodes |
ServiceRequest.category:us-core | required | USCoreServiceRequestCategoryCodes |
ServiceRequest.code | extensible | USCoreProcedureCodes |
ServiceRequest.reasonCode | extensible | USCoreConditionCodes |
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
ServiceRequest | C | 0..* | ServiceRequest | A request for a service to be performed | ||||
id | Σ | 0..1 | id | Logical id of this artifact | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order | ||||
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition | ||||
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | ||||
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills | ||||
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces | ||||
requisition | Σ | 0..1 | Identifier | Composite Request ID | ||||
status | ?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. | ||||
intent | ?!SΣ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. | ||||
Slices for category | SΣ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service. | ||||
category:us-core | SΣ | 0..* | CodeableConcept | Classification of service Binding: US Core ServiceRequest Category Codes (required) | ||||
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | ||||
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed | ||||
code | SΣ | 1..1 | CodeableConcept | What is being requested/ordered Binding: US Core Procedure Codes (extensible) | ||||
orderDetail | ΣC | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context. | ||||
quantity[x] | Σ | 0..1 | Service amount | |||||
quantityQuantity | Quantity | |||||||
quantityRatio | Ratio | |||||||
quantityRange | Range | |||||||
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Individual or Entity the service is ordered for | ||||
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created | ||||
occurrence[x] | SΣ | 0..1 | When service should occur | |||||
occurrencePeriod | Period S | |||||||
occurrenceDateTime | dateTime | |||||||
occurrenceTiming | Timing | |||||||
asNeeded[x] | Σ | 0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | |||||
asNeededBoolean | boolean | |||||||
asNeededCodeableConcept | CodeableConcept | |||||||
authoredOn | SΣ | 0..1 | dateTime | Date request signed | ||||
requester | SΣ | 0..1 | Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device) | Who/what is requesting service | ||||
performerType | Σ | 0..1 | CodeableConcept | Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. | ||||
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested performer | ||||
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered. | ||||
locationReference | Σ | 0..* | Reference(Location) | Requested location | ||||
reasonCode | Σ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible) | ||||
reasonReference | Σ | 0..* | Reference(US Core Condition Encounter Diagnosis Profile | US Core Condition Problems and Health Concerns Profile | US Core DiagnosticReport Profile for Report and Note Exchange | US Core DiagnosticReport Profile for Laboratory Results Reporting | US Core DocumentReference Profile | US Core Laboratory Result Observation Profile | US Core Observation Pregnancy Status Profile | US Core Observation Pregnancy Intent Profile | US Core Observation Occupation Profile | US Core Respiratory Rate Profile | US Core Simple Observation Profile | US Core Heart Rate Profile | US Core Smoking Status Observation Profile | US Core Observation Screening Assessment Profile | US Core Observation Clinical Result Profile | US Core Vital Signs Profile) | Explanation/Justification for service or service | ||||
insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
supportingInfo | 0..* | Reference(Resource) | Additional clinical information | |||||
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples | ||||
bodySite | Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | ||||
note | 0..* | Annotation | Comments | |||||
patientInstruction | Σ | 0..1 | string | Patient or consumer-oriented instructions | ||||
relevantHistory | 0..* | Reference(Provenance) | Request provenance | |||||
Documentation for this format |
Path | Conformance | ValueSet | ||||
ServiceRequest.language | preferred | CommonLanguages
| ||||
ServiceRequest.status | required | RequestStatus | ||||
ServiceRequest.intent | required | RequestIntent | ||||
ServiceRequest.category | example | ServiceRequestCategoryCodes | ||||
ServiceRequest.category:us-core | required | USCoreServiceRequestCategoryCodes | ||||
ServiceRequest.priority | required | RequestPriority | ||||
ServiceRequest.code | extensible | USCoreProcedureCodes | ||||
ServiceRequest.orderDetail | example | ServiceRequestOrderDetailsCodes | ||||
ServiceRequest.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes | ||||
ServiceRequest.performerType | example | ParticipantRoles | ||||
ServiceRequest.locationCode | example | ServiceDeliveryLocationRoleType | ||||
ServiceRequest.reasonCode | extensible | USCoreConditionCodes | ||||
ServiceRequest.bodySite | example | SNOMEDCTBodyStructures |
This structure is derived from ServiceRequest
Summary
Mandatory: 1 element
Must-Support: 9 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from ServiceRequest
Path | Conformance | ValueSet |
ServiceRequest.category:us-core | required | USCoreServiceRequestCategoryCodes |
ServiceRequest.code | extensible | USCoreProcedureCodes |
ServiceRequest.reasonCode | extensible | USCoreConditionCodes |
Key Elements View
Path | Conformance | ValueSet |
ServiceRequest.status | required | RequestStatus |
ServiceRequest.intent | required | RequestIntent |
ServiceRequest.category | example | ServiceRequestCategoryCodes |
ServiceRequest.category:us-core | required | USCoreServiceRequestCategoryCodes |
ServiceRequest.code | extensible | USCoreProcedureCodes |
ServiceRequest.reasonCode | extensible | USCoreConditionCodes |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
ServiceRequest | C | 0..* | ServiceRequest | A request for a service to be performed | ||||
id | Σ | 0..1 | id | Logical id of this artifact | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order | ||||
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition | ||||
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | ||||
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills | ||||
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces | ||||
requisition | Σ | 0..1 | Identifier | Composite Request ID | ||||
status | ?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. | ||||
intent | ?!SΣ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. | ||||
Slices for category | SΣ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service. | ||||
category:us-core | SΣ | 0..* | CodeableConcept | Classification of service Binding: US Core ServiceRequest Category Codes (required) | ||||
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | ||||
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed | ||||
code | SΣ | 1..1 | CodeableConcept | What is being requested/ordered Binding: US Core Procedure Codes (extensible) | ||||
orderDetail | ΣC | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context. | ||||
quantity[x] | Σ | 0..1 | Service amount | |||||
quantityQuantity | Quantity | |||||||
quantityRatio | Ratio | |||||||
quantityRange | Range | |||||||
subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Individual or Entity the service is ordered for | ||||
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created | ||||
occurrence[x] | SΣ | 0..1 | When service should occur | |||||
occurrencePeriod | Period S | |||||||
occurrenceDateTime | dateTime | |||||||
occurrenceTiming | Timing | |||||||
asNeeded[x] | Σ | 0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | |||||
asNeededBoolean | boolean | |||||||
asNeededCodeableConcept | CodeableConcept | |||||||
authoredOn | SΣ | 0..1 | dateTime | Date request signed | ||||
requester | SΣ | 0..1 | Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device) | Who/what is requesting service | ||||
performerType | Σ | 0..1 | CodeableConcept | Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. | ||||
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested performer | ||||
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered. | ||||
locationReference | Σ | 0..* | Reference(Location) | Requested location | ||||
reasonCode | Σ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible) | ||||
reasonReference | Σ | 0..* | Reference(US Core Condition Encounter Diagnosis Profile | US Core Condition Problems and Health Concerns Profile | US Core DiagnosticReport Profile for Report and Note Exchange | US Core DiagnosticReport Profile for Laboratory Results Reporting | US Core DocumentReference Profile | US Core Laboratory Result Observation Profile | US Core Observation Pregnancy Status Profile | US Core Observation Pregnancy Intent Profile | US Core Observation Occupation Profile | US Core Respiratory Rate Profile | US Core Simple Observation Profile | US Core Heart Rate Profile | US Core Smoking Status Observation Profile | US Core Observation Screening Assessment Profile | US Core Observation Clinical Result Profile | US Core Vital Signs Profile) | Explanation/Justification for service or service | ||||
insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
supportingInfo | 0..* | Reference(Resource) | Additional clinical information | |||||
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples | ||||
bodySite | Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | ||||
note | 0..* | Annotation | Comments | |||||
patientInstruction | Σ | 0..1 | string | Patient or consumer-oriented instructions | ||||
relevantHistory | 0..* | Reference(Provenance) | Request provenance | |||||
Documentation for this format |
Path | Conformance | ValueSet | ||||
ServiceRequest.language | preferred | CommonLanguages
| ||||
ServiceRequest.status | required | RequestStatus | ||||
ServiceRequest.intent | required | RequestIntent | ||||
ServiceRequest.category | example | ServiceRequestCategoryCodes | ||||
ServiceRequest.category:us-core | required | USCoreServiceRequestCategoryCodes | ||||
ServiceRequest.priority | required | RequestPriority | ||||
ServiceRequest.code | extensible | USCoreProcedureCodes | ||||
ServiceRequest.orderDetail | example | ServiceRequestOrderDetailsCodes | ||||
ServiceRequest.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes | ||||
ServiceRequest.performerType | example | ParticipantRoles | ||||
ServiceRequest.locationCode | example | ServiceDeliveryLocationRoleType | ||||
ServiceRequest.reasonCode | extensible | USCoreConditionCodes | ||||
ServiceRequest.bodySite | example | SNOMEDCTBodyStructures |
This structure is derived from ServiceRequest
Summary
Mandatory: 1 element
Must-Support: 9 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron
Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.
The following search parameters and search parameter combinations SHALL be supported:
SHALL support searching for all servicerequests for a patient using the patient
search parameter:
GET [base]/ServiceRequest?patient={Type/}[id]
Example:
Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient (how to search by reference)
SHALL support fetching a ServiceRequest using the _id
search parameter:
GET [base]/ServiceRequest/[id]
Example:
Implementation Notes: (how to search by the logical id of the resource)
SHALL support searching using the combination of the patient
and category
search parameters:
GET [base]/ServiceRequest?patient={Type/}[id]&category={system|}[code]
Example:
Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and a category code (how to search by reference and how to search by token)
patient
and code
search parameters:
code
(e.g.code={system|}[code],{system|}[code],...
)GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}
Example:
Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and report code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token)
patient
and category
and authored
search parameters:
authored
comparators: gt,lt,ge,le
authored
(e.g.authored=[date]&authored=[date]]&...
)GET [base]/ServiceRequest?patient={Type/}[id]&category={system|}[code]&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}
Example:
Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and date and a category code (how to search by reference and how to search by token and how to search by date)
The following search parameter combinations SHOULD be supported:
patient
and status
search parameters:
status
(e.g.status={system|}[code],{system|}[code],...
)GET [base]/ServiceRequest?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}
Example:
Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and status (how to search by reference and how to search by token)
patient
and code
and authored
search parameters:
code
(e.g.code={system|}[code],{system|}[code],...
)authored
comparators: gt,lt,ge,le
authored
(e.g.authored=[date]&authored=[date]]&...
)GET [base]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&authored={gt|lt|ge|le}[date]{&authored={gt|lt|ge|le}[date]&...}
Example:
Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and date and service code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token and how to search by date)