0.3.0 - Second STU ballot

This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.3.0: STU 1 Ballot 2) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

## StructureDefinition: DeviceRequestR4 - Detailed Descriptions

Definitions for the profile-devicerequest-r4 Profile.

1. 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.
Control | 0..*
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.div.exists())
2. DeviceRequest.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. DeviceRequest.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
4. DeviceRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
5. DeviceRequest.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | A human language. The codes SHOULD be taken from CommonLanguages Max Binding: AllLanguages
Type | code
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
6. DeviceRequest.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
7. DeviceRequest.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
8. DeviceRequest.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
9. DeviceRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
10. DeviceRequest.identifier
Definition | Identifiers assigned to this order by the orderer or by the receiver.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Must Support | true
11. 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.
Control | 1..1
Type | canonical(ActivityDefinition | PlanDefinition)
Must Support | 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.
12. 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.
Control | 0..*
Type | uri
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
13. DeviceRequest.basedOn
Definition | Plan/proposal/order fulfilled by this request.
Control | 1..1
Type | Reference(Resource)
Must Support | true
14. DeviceRequest.priorRequest
Definition | The request takes the place of the referenced completed or terminated request(s).
Control | 0..*
Type | Reference(Resource)
15. DeviceRequest.groupIdentifier
Definition | Composite request this is part of.
Control | 0..1
Type | Identifier
Comments | potentially relevant for CRD in some situations.
16. DeviceRequest.status
Definition | The status of the request.
Control | 1..1
Binding | Codes representing the status of the request. The codes SHALL be taken from RequestStatus
Type | code
Is Modifier | true
Must Support | true
Comments | This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.
Fixed Value | draft
17. DeviceRequest.intent
Definition | Whether the request is a proposal, plan, an original order or a reflex order.
Control | 1..1
Binding | The kind of diagnostic request. The codes SHALL be taken from RequestIntent
Type | code
Is Modifier | true
Comments | potentially relevant for CRD in some situations.
18. DeviceRequest.priority
Definition | Indicates how quickly the should be addressed with respect to other requests.
Control | 0..1
Binding | Identifies the level of importance to be assigned to actioning the request. The codes SHALL be taken from RequestPriority
Type | code
Meaning if Missing | If missing, normal priority
19. DeviceRequest.code[x]
Definition | The details of the device to be used.
Control | 1..1
Binding | Codes for devices that can be requested. For example codes, see FHIRDeviceTypes
Type | Choice of: Reference(DeviceR4), CodeableConcept
[x] Note | See Choice of Data Types for further information about how to use [x]
Must Support | true
20. DeviceRequest.parameter
Definition | Specific parameters for the ordered item. For example, the prism value for lenses.
Control | 0..*
Type | BackboneElement
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. DeviceRequest.parameter.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
22. DeviceRequest.parameter.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
23. DeviceRequest.parameter.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
24. DeviceRequest.parameter.code
Definition | A code or string that identifies the device detail being asserted.
Control | 0..1
Binding | A code that identifies the device detail.
Type | CodeableConcept
25. DeviceRequest.parameter.value[x]
Definition | The value of the device detail.
Control | 0..1
Type | Choice of: CodeableConcept, Quantity, Range, boolean
[x] Note | See Choice of Data Types for further information about how to use [x]
Comments | Range means device should have a value that falls somewhere within the specified range.
26. DeviceRequest.subject
Definition | The patient who will use the device.
Control | 1..1
Type | Reference(PatientR4)
Must Support | true
27. DeviceRequest.encounter
Definition | An encounter that provides additional context in which this request is made.
Control | 0..1
Type | Reference(EncounterR4)
Comments | potentially relevant for CRD in some situations.
28. 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".
Control | 0..1
Type | Choice of: dateTime, Period, Timing
[x] Note | See Choice of Data Types for further information about how to use [x]
Must Support | true
29. DeviceRequest.authoredOn
Definition | When the request transitioned to being actionable.
Control | 1..1
Type | dateTime
Must Support | true
30. DeviceRequest.requester
Definition | The individual who initiated the request and has responsibility for its activation.
Control | 1..1
Type | Reference(PractitionerR4 | US Core PractitionerRole Profile)
Must Support | true
31. DeviceRequest.performerType
Definition | Desired type of performer for doing the diagnostic testing.
Control | 0..1
Binding | Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. For example codes, see ParticipantRoles
Type | CodeableConcept
Comments | potentially relevant for CRD in some situations.
32. DeviceRequest.performer
Definition | The desired performer for doing the diagnostic testing.
Control | 0..1
Type | Reference(PractitionerR4 | US Core PractitionerRole Profile)
Must Support | true
33. DeviceRequest.reasonCode
Definition | Reason or justification for the use of this device.
Control | 0..*
Binding | Diagnosis or problem codes justifying the reason for requesting the device. For example codes, see Condition/Problem/DiagnosisCodes
Type | CodeableConcept
Must Support | true
34. DeviceRequest.reasonReference
Definition | Reason or justification for the use of this device.
Control | 0..*
Type | Reference(US Core Condition Profile | US Core Result Observation)
Must Support | true
Comments | potentially relevant for CRD in some situations.
35. DeviceRequest.insurance
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
Control | 0..*
Type | Reference(CoverageR4)
Must Support | true
36. 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).
Control | 0..*
Type | Reference(Resource)
Requirements | Knowing where the device is targeted is important for tracking if multiple sites are possible.
Comments | potentially relevant for CRD in some situations.
37. 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.
Control | 0..*
Type | Annotation
Comments | potentially relevant for CRD in some situations.
38. DeviceRequest.relevantHistory
Definition | Key events in the history of the request.
Control | 0..*
Type | Reference(Provenance)
Comments | potentially relevant for CRD in some situations.