This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR v3.5.0. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition: CRD CommunicationRequest - Detailed Descriptions

Definitions for the profile-communicationrequest-r4 Profile.

CommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

Control0..*
InvariantsDefined 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())
CommunicationRequest.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
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.

CommunicationRequest.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.

Control0..1
TypeMeta
CommunicationRequest.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.

Control0..1
Typeuri
Is Modifiertrue
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.

CommunicationRequest.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHOULD be taken from Common Languages
Typecode
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).

CommunicationRequest.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.

Control0..1
TypeNarrative
Alternate Namesnarrative, 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.

CommunicationRequest.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.

Control0..*
TypeResource
Alternate Namesinline 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.

CommunicationRequest.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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CommunicationRequest.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. 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).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

CommunicationRequest.identifier
Definition

Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Must Supporttrue
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Comments

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.

CommunicationRequest.basedOn
Definition

A plan or proposal that is fulfilled in whole or in part by this request.

Control1..1
TypeReference(Resource)
Must Supporttrue
Requirements

Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

Alternate Namesfulfills
CommunicationRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

Control0..*
TypeReference(CRD CommunicationRequest)
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Namessupersedes, prior
Comments

potentially relevant for CRD in some situations.

CommunicationRequest.groupIdentifier
Definition

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

Control0..1
TypeIdentifier
Alternate NamesgrouperId
Comments

potentially relevant for CRD in some situations.

CommunicationRequest.status
Definition

The status of the proposal or order.

Control1..1
BindingThe status of the communication request.
The codes SHALL be taken from RequestStatus
Typecode
Is Modifiertrue
Must Supporttrue
Fixed Valuedraft
CommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

Control0..1
BindingCodes identifying the reason for the current state of a request.
TypeCodeableConcept
Alternate NamesSuspended Reason, Cancelled Reason
Comments

potentially relevant for CRD in some situations.

CommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

Control0..*
BindingCodes for general categories of communications such as alerts, instruction, etc.
For example codes, see CommunicationCategory
TypeCodeableConcept
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

CommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Control0..1
BindingCodes indicating the relative importance of a communication request.
The codes SHALL be taken from RequestPriority
Typecode
Meaning if MissingIf missing, this task should be performed with normal priority
CommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

Control0..0
Typeboolean
Is Modifiertrue
Alternate Namesprohibited
Comments

The attributes provided with the request qualify what is not to be done.

Meaning if MissingIf do not perform is not specified, the request is a positive request e.g. "do perform"
CommunicationRequest.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Control0..*
BindingCodes for communication mediums such as phone, fax, email, in person, etc.
For example codes, see http://terminology.hl7.org/ValueSet/v3-ParticipationMode
TypeCodeableConcept
CommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

Control1..1
TypeReference(CRD Patient)
Must Supporttrue
Alternate Namespatient
CommunicationRequest.about
Definition

Other resources that pertain to this communication request and to which this communication request should be associated.

Control0..*
TypeReference(Resource)
Comments

potentially relevant for CRD in some situations.

CommunicationRequest.context
Definition

The encounter or episode of care within which the communication request was created.

Control0..1
TypeReference(CRD Encounter)
Alternate Namesencounter
Comments

potentially relevant for CRD in some situations.

CommunicationRequest.payload
Definition

Text, attachment(s), or resource(s) to be communicated to the recipient.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
CommunicationRequest.payload.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
CommunicationRequest.payload.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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CommunicationRequest.payload.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. 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).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

CommunicationRequest.payload.content[x]
Definition

The communicated content (or for multi-part communications, one portion of the communication).

Control1..1
TypeChoice of: string, Attachment, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
CommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

Control0..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Alternate Namestiming
CommunicationRequest.authoredOn
Definition

For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

Control1..1
TypedateTime
Must Supporttrue
Alternate NamescreatedOn
CommunicationRequest.requester
Definition

The device, individual, or organization who initiated the request and has responsibility for its activation.

Control1..1
TypeReference(CRD Practitioner | CRD PractitionerRole)
Must Supporttrue
Alternate Namesauthor
CommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

Control0..*
TypeReference(CRD Practitioner | CRD PractitionerRole)
Must Supporttrue
CommunicationRequest.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

Control0..1
TypeReference(CRD Practitioner | CRD PractitionerRole)
Must Supporttrue
CommunicationRequest.reasonCode
Definition

Describes why the request is being made in coded or textual form.

Control0..*
BindingCodes for describing reasons for the occurrence of a communication.
For example codes, see http://terminology.hl7.org/ValueSet/v3-ActReason
TypeCodeableConcept
Must Supporttrue
Comments

Textual reasons can be captured using reasonCode.text.

CommunicationRequest.reasonReference
Definition

Indicates another resource whose existence justifies this request.

Control0..*
TypeReference(CRD Condition | CRD Observation)
Must Supporttrue
Comments

potentially relevant for CRD in some situations.

CommunicationRequest.note
Definition

Comments made about the request by the requester, sender, recipient, subject or other participants.

Control0..*
TypeAnnotation
Comments

potentially relevant for CRD in some situations.