QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Service Not Requested

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested Version: 7.0.0-ballot
Active as of 2018-08-22 Computable Name: QICoreServiceNotRequested

Negation profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Contents:

Must Have:
  • status: (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
  • intent: (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  • code: What is being requested/ordered
  • subject: (QI) Individual or Entity the service is ordered for
  • authoredOn: (QI) Date request signed
QI Elements:
  • reasonRefused: (QI) Extension
  • doNotPerform: (QI) True if service/procedure should not be performed
  • notDoneValueSet: (QI) What was not requested
  • occurrence[x]: (QI) When service should occur
  • reasonCode: (QI) Explanation/Justification for procedure or service
  • reasonReference: (QI) Explanation/Justification for service or service
Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Guidance

Reference Guidance for use of the Service Not Requested profile can be found here.

  • See the Social Determinants of Health (SDOH) Guidance Page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
  • The 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.
  • The ServiceRequest.code.extension:notDoneValueSet valueset identifies a set of possible coded values representing activities that were not requested, ordered, or performed.
  • The ServiceRequest.subject is Must Support with Must Support reference to QI-Core Patient

Usage

The ServiceRequest and ServiceNotRequested profiles represent the positive and negative statements for a service request.

See the patterns page for implementation and usage patterns.

Examples

Negation Example with valuesetService discontinued; indicates that none of the services in the given not done value set were requested.
Negation Example with codeService discontinued; indicates that the given service, by code, was not requested.

Both of these example instances meet measure intent for exclusion as defined in the following example CQL: 

define "Intermittent Pneumatic Compression Devices Not Ordered":
  ["ServiceNotRequested": "Application of intermittent pneumatic compression devices (IPC)"] DeviceNotOrdered
    where (DeviceNotOrdered.reasonRefused in "Medical Reason"
      or DeviceNotOrdered.reasonRefused in "Patient Refusal")
      and DeviceNotOrdered.status in { 'active', 'completed', 'on-hold' }

For a more complete discussion of representation of negation within QI-Core and quality improvement artifacts, see the Negation in QI-Core topic.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreServiceRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile A request for a service to be performed
snr-1: To indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... status 1..1 code (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent 1..1 code (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
... code
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not requested
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... encounter 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn 1..1 dateTime (QI) Date request signed
... requester 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) Who/what is requesting service
... reasonCode 0..* CodeableConcept (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Required
... reasonReference 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
Additional Bindings Purpose
QICore Negation Reason Codes Required
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code

Constraints

IdGradePath(s)DetailsRequirements
snr-1errorServiceRequestTo indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile A request for a service to be performed
prr-1: orderDetail SHALL only be present if code is present
snr-1: To indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... 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): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... 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)
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not requested
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... subject SΣ 1..1 Reference(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrencePeriod Period
... authoredOn SΣ 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) Who/what is requesting service
... reasonCode Σ 0..* CodeableConcept (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Required

... reasonReference Σ 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
ServiceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
ServiceRequest.intentrequiredRequestIntent
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
ServiceRequest.categoryexampleServiceRequestCategoryCodes
http://hl7.org/fhir/ValueSet/servicerequest-category
from the FHIR Standard
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.codeextensibleUSCoreProcedureCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
Additional Bindings Purpose
QICore Negation Reason Codes Required
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
snr-1errorServiceRequestTo indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile A request for a service to be performed
prr-1: orderDetail SHALL only be present if code is present
snr-1: To indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... 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.

Additional BindingsPurpose
AllLanguages Max Binding
... 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 (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ 1..1 code (QI) 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): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... 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)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not requested
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... 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 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) 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 (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Required

... reasonReference Σ 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
ServiceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
ServiceRequest.intentrequiredRequestIntent
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
ServiceRequest.categoryexampleServiceRequestCategoryCodes
http://hl7.org/fhir/ValueSet/servicerequest-category
from the FHIR Standard
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
ServiceRequest.codeextensibleUSCoreProcedureCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
http://hl7.org/fhir/ValueSet/servicerequest-orderdetail
from the FHIR Standard
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
ServiceRequest.performerTypeexampleParticipantRoles
http://hl7.org/fhir/ValueSet/participant-role
from the FHIR Standard
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
Additional Bindings Purpose
QICore Negation Reason Codes Required
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
snr-1errorServiceRequestTo indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from USCoreServiceRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile A request for a service to be performed
snr-1: To indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... status 1..1 code (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent 1..1 code (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
... code
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not requested
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... encounter 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn 1..1 dateTime (QI) Date request signed
... requester 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) Who/what is requesting service
... reasonCode 0..* CodeableConcept (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Required
... reasonReference 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
Additional Bindings Purpose
QICore Negation Reason Codes Required
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code

Constraints

IdGradePath(s)DetailsRequirements
snr-1errorServiceRequestTo indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile A request for a service to be performed
prr-1: orderDetail SHALL only be present if code is present
snr-1: To indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... 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): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... 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)
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not requested
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
... subject SΣ 1..1 Reference(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrencePeriod Period
... authoredOn SΣ 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) Who/what is requesting service
... reasonCode Σ 0..* CodeableConcept (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Required

... reasonReference Σ 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
ServiceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
ServiceRequest.intentrequiredRequestIntent
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
ServiceRequest.categoryexampleServiceRequestCategoryCodes
http://hl7.org/fhir/ValueSet/servicerequest-category
from the FHIR Standard
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.codeextensibleUSCoreProcedureCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
Additional Bindings Purpose
QICore Negation Reason Codes Required
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
snr-1errorServiceRequestTo indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile A request for a service to be performed
prr-1: orderDetail SHALL only be present if code is present
snr-1: To indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... 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.

Additional BindingsPurpose
AllLanguages Max Binding
... 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 (QI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ 1..1 code (QI) 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): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


... 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)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... notDoneValueSet 0..1 canonical(ValueSet) (QI) What was not requested
URL: http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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(QICore Patient) (QI) Individual or Entity the service is ordered for
... encounter SΣ 0..1 Reference(QICore Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (QI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... 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 1..1 dateTime (QI) Date request signed
... requester SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) 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 (QI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
Additional BindingsPurpose
QICore Negation Reason Codes Required

... reasonReference Σ 0..* Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) (QI) 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
ServiceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
ServiceRequest.intentrequiredRequestIntent
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
ServiceRequest.categoryexampleServiceRequestCategoryCodes
http://hl7.org/fhir/ValueSet/servicerequest-category
from the FHIR Standard
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
ServiceRequest.codeextensibleUSCoreProcedureCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
http://hl7.org/fhir/ValueSet/servicerequest-orderdetail
from the FHIR Standard
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
http://hl7.org/fhir/ValueSet/medication-as-needed-reason
from the FHIR Standard
ServiceRequest.performerTypeexampleParticipantRoles
http://hl7.org/fhir/ValueSet/participant-role
from the FHIR Standard
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeextensibleUSCoreConditionCodes
Additional Bindings Purpose
QICore Negation Reason Codes Required
http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
ServiceRequest.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf 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-4errorServiceRequestIf 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-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
snr-1errorServiceRequestTo indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/StructureDefinition/cqf-notDoneValueSet').exists() xor code.coding.exists()

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron