Data Exchange For Quality Measures STU1 for FHIR STU3 Implementation Guide (Release 1.0.0)

This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions

Definitions for the StructureDefinition-devicerequest-deqm 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.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
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 (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
2. DeviceRequest.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.

3. DeviceRequest.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. DeviceRequest.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All 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).

6. DeviceRequest.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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 This element is affected by the following invariants: dom-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 in formation 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.

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.

8. DeviceRequest.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

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.

9. DeviceRequest.modifierExtension
Definition

An Extension

Control0..*
TypeExtension
Is Modifiertrue
SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
10. DeviceRequest.modifierExtension:doNotPerform
SliceNamedoNotPerform
Definition

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

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(DoNotPerform) (Extension Type: boolean)
Is Modifiertrue
Must Supporttrue
Comments

The reason this extension is a modifier is because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. DeviceRequest.identifier
Definition

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

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
12. DeviceRequest.definition
Definition

Protocol or definition followed by this request. For example: The proposed act must be performed if the indicated conditions occur, e.g.., shortness of breath, SpO2 less than x%.

Control0..*
TypeReference(ActivityDefinition | PlanDefinition)
13. DeviceRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

Control0..*
TypeReference(Resource)
14. DeviceRequest.priorRequest
Definition

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

Control0..*
TypeReference(Resource)
15. DeviceRequest.groupIdentifier
Definition

Composite request this is part of.

Control0..1
TypeIdentifier
16. DeviceRequest.status
Definition

The status of the request.

Control0..1
BindingCodes representing the status of the request.
The codes SHALL be taken from RequestStatus
Typecode
Is Modifiertrue
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.

17. DeviceRequest.intent
Definition

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

Control1..1
BindingThe kind of diagnostic request
The codes SHALL be taken from RequestIntent
TypeCodeableConcept
Is Modifiertrue
18. DeviceRequest.priority
Definition

Indicates how quickly the {{title}} should be addressed with respect to other requests.

Control0..1
BindingIdentifies the level of importance to be assigned to actioning the request
The codes SHALL be taken from RequestPriority
Typecode
Default ValueIf missing, normal priority
19. DeviceRequest.code[x]
Definition

The details of the device to be used.

Control1..1
BindingCodes for devices that can be requested
For example codes, see FHIR Device Types
TypeChoice of: Reference(Device), CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
20. DeviceRequest.subject
Definition

The patient who will use the device.

Control1..1
TypeReference(Patient | Group | Location | Device)
21. DeviceRequest.context
Definition

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

Control0..1
TypeReference(Encounter | EpisodeOfCare)
22. 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".

Control0..1
TypeChoice of: dateTime, Period, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
23. DeviceRequest.authoredOn
Definition

When the request transitioned to being actionable.

Control0..1
TypedateTime
24. DeviceRequest.requester
Definition

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

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
25. DeviceRequest.requester.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
26. DeviceRequest.requester.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

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.

27. DeviceRequest.requester.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

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.

28. DeviceRequest.requester.agent
Definition

The device, practitioner, etc. who initiated the request.

Control1..1
TypeReference(Device | Practitioner | Organization)
29. DeviceRequest.requester.onBehalfOf
Definition

The organization the device or practitioner was acting on behalf of.

Control0..1
TypeReference(Organization)
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.

30. DeviceRequest.performerType
Definition

Desired type of performer for doing the diagnostic testing.

Control0..1
BindingIndicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
For example codes, see Participant Roles
TypeCodeableConcept
31. DeviceRequest.performer
Definition

The desired perfomer for doing the diagnostic testing.

Control0..1
TypeReference(Practitioner | Organization | Patient | Device | RelatedPerson | HealthcareService)
32. DeviceRequest.reasonCode
Definition

Reason or justification for the use of this device.

Control0..*
BindingDiagnosis or problem codes justifying the reason for requesting the device.
For example codes, see Condition/Problem/Diagnosis Codes
TypeCodeableConcept
33. DeviceRequest.reasonReference
Definition

Reason or justification for the use of this device.

Control0..*
TypeReference(Resource)
34. DeviceRequest.supportingInfo
Definition

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

Control0..*
TypeReference(Resource)
Requirements

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

35. 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.

Control0..*
TypeAnnotation
36. DeviceRequest.relevantHistory
Definition

Key events in the history of the request.

Control0..*
TypeReference(Provenance)
Comments

This may 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.