QI-Core Implementation Guide: STU 3.2 (v3.2.0 for FHIR 3.0.1)

This page is part of the Quality Improvement Core Framework (v3.2.0: STU 3) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

QICore-CommunicationRequest

Formats: Narrative, XML, JSON, Turtle

Raw xml


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="qicore-communicationrequest"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest" title="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.">CommunicationRequest</a><a name="CommunicationRequest"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: white; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.extension:orderedBy" title="Extension URL = http://hl7.org/fhir/StructureDefinition/communicationrequest-orderedBy">communicationrequest-orderedBy</a><a name="CommunicationRequest.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="http://hl7.org/fhir/STU3/practitioner.html">Practitioner</a> | <a href="http://hl7.org/fhir/STU3/organization.html">Organization</a> | <a href="http://hl7.org/fhir/STU3/device.html">Device</a> | <a href="http://hl7.org/fhir/STU3/patient.html">Patient</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Agent that ordered the communication<br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/STU3/extension-communicationrequest-orderedby.html">http://hl7.org/fhir/StructureDefinition/communicationrequest-orderedBy</a></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: white; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.extension:authorizedBy" title="Extension URL = http://hl7.org/fhir/StructureDefinition/procedurerequest-authorizedBy">procedurerequest-authorizedBy</a><a name="CommunicationRequest.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="http://hl7.org/fhir/STU3/practitioner.html">Practitioner</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Practitioner who authorized request<br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/STU3/extension-procedurerequest-authorizedby.html">http://hl7.org/fhir/StructureDefinition/procedurerequest-authorizedBy</a></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck14.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: white; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.extension:reasonRejected" title="Extension URL = http://hl7.org/fhir/StructureDefinition/communicationrequest-reasonRejected">communicationrequest-reasonRejected</a><a name="CommunicationRequest.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Reason why request was rejected<br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/STU3/extension-communicationrequest-reasonrejected.html">http://hl7.org/fhir/StructureDefinition/communicationrequest-reasonRejected</a><br/><span style="font-weight:bold">Binding: </span><a href="ValueSet-qicore-communication-reason-not-performed.html">Communication reason not performed codes</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The value set merely provides examples of the types of concepts intended to be included.">example</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.category" title="The type of message to be sent such as alert, notification, reminder, instruction, etc.">category</a><a name="CommunicationRequest.category"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Message category<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/STU3/valueset-communication-category.html">CommunicationCategory</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The value set merely provides examples of the types of concepts intended to be included.">example</a>)<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.sender" title="The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.">sender</a><a name="CommunicationRequest.sender"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Message sender</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.recipient" title="The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.">recipient</a><a name="CommunicationRequest.recipient"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson | <a href="http://hl7.org/fhir/STU3/group.html">Group</a> | <a href="http://hl7.org/fhir/STU3/careteam.html">CareTeam</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Message receipient<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.medium" title="A channel that was used for this communication (e.g. email, fax).">medium</a><a name="CommunicationRequest.medium"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">A channel of communication<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/STU3/v3/ParticipationMode/vs.html">ParticipationMode</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The value set merely provides examples of the types of concepts intended to be included.">example</a>)<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.requester" title="The individual who initiated the request and has responsibility for its activation.">requester</a><a name="CommunicationRequest.requester"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Who/what us requesting service</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.status" title="The status of the proposal or order.">status</a><a name="CommunicationRequest.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">draft | active | suspended | cancelled | completed | entered-in-error | unknown<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/STU3/valueset-request-status.html">RequestStatus</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">required</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.context" title="The encounter or episode of care within which the communication request was created.">context</a><a name="CommunicationRequest.context"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | <a href="http://hl7.org/fhir/STU3/episodeofcare.html">EpisodeOfCare</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Encounter or episode leading to message</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.subject" title="The encounter or episode of care within which the communication request was created.">subject</a><a name="CommunicationRequest.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Encounter or episode leading to message</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.reasonCode" title="Describes why the request is being made in coded or textual form.">reasonCode</a><a name="CommunicationRequest.reasonCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Why is communication needed?<br/><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/STU3/v3/ActReason/vs.html">ActReason</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The value set merely provides examples of the types of concepts intended to be included.">example</a>)<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-qicore-communicationrequest-definitions.html#CommunicationRequest.occurrence[x]" title="The time when this communication is to occur.">occurrence[x]</a><a name="CommunicationRequest.occurrence_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">When scheduled</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationrequest"/>
  <version value="3.2.0"/>
  <name value="QICore-CommunicationRequest"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2018-08-22T00:00:00+10:00"/>
  <publisher value="Health Level Seven, Inc. - CQI WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/special/committees/CQI"/>
    </telecom>
  </contact>
  <description
               value="Profile of CommunicationRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="us"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="qdm"/>
    <uri value="http://www.healthit.gov/quality-data-model"/>
    <name value="Quality Data Model"/>
  </mapping>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="CommunicationRequest"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="CommunicationRequest">
      <path value="CommunicationRequest"/>
      <short value="A request for information to be sent to a receiver"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Request"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="workflow.order"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map
             value="“Note, there is no corresponding QDM concept to CommunicationRequest.”"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.id">
      <path value="CommunicationRequest.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="CommunicationRequest.meta">
      <path value="CommunicationRequest.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="CommunicationRequest.implicitRules">
      <path value="CommunicationRequest.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="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&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="CommunicationRequest.language">
      <path value="CommunicationRequest.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="CommunicationRequest.text">
      <path value="CommunicationRequest.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.contained">
      <path value="CommunicationRequest.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.extension">
      <path value="CommunicationRequest.extension"/>
      <slicing id="3">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element id="CommunicationRequest.extension:orderedBy">
      <path value="CommunicationRequest.extension"/>
      <sliceName value="orderedBy"/>
      <short value="Agent that ordered the communication"/>
      <definition value="Agent that ordered the communication."/>
      <comment value="This may need to be placed into the resource itself."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/communicationrequest-orderedBy"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])"/>
        <source value="Extension"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.extension:authorizedBy">
      <path value="CommunicationRequest.extension"/>
      <sliceName value="authorizedBy"/>
      <short value="Practitioner who authorized request"/>
      <definition
                  value="The practitioner who authorized the communication request, usually the same as the orderer when the orderer is a practitioner."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedurerequest-authorizedBy"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])"/>
        <source value="Extension"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.extension:reasonRejected">
      <path value="CommunicationRequest.extension"/>
      <sliceName value="reasonRejected"/>
      <short value="Reason why request was rejected"/>
      <definition
                  value="The reason associated with the rejection of this communication request by the receiver. Applicable only if the status is rejected."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/communicationrequest-reasonRejected"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &#39;value&#39;)])"/>
        <source value="Extension"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.modifierExtension">
      <path value="CommunicationRequest.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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. 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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.identifier">
      <path value="CommunicationRequest.identifier"/>
      <short value="Unique identifier"/>
      <definition
                  value="A unique ID of this request for reference purposes. It must be provided if user wants it returned as part of any output, otherwise it will be autogenerated, if needed, by CDS system. Does not need to be the actual ID of the source system."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.basedOn">
      <path value="CommunicationRequest.basedOn"/>
      <short value="Fulfills plan or proposal"/>
      <definition
                  value="A plan or proposal that is fulfilled in whole or in part by this request."/>
      <requirements
                    value="Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon."/>
      <alias value="fulfills"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.basedOn"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.replaces">
      <path value="CommunicationRequest.replaces"/>
      <short value="Request(s) replaced by this request"/>
      <definition
                  value="Completed or terminated request(s) whose function is taken by this new request."/>
      <comment
               value="The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing."/>
      <requirements
                    value="Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests."/>
      <alias value="supersedes"/>
      <alias value="prior"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.replaces"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.replaces"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=RPLC].target"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.groupIdentifier">
      <path value="CommunicationRequest.groupIdentifier"/>
      <short value="Composite request this is part of"/>
      <definition
                  value="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."/>
      <comment
               value="Requests are linked either by a &quot;basedOn&quot; relationship (i.e. one request is fulfilling another) or by having a common requisition.  Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation."/>
      <alias value="grouperId"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.groupIdentifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.groupIdentifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.status">
      <path value="CommunicationRequest.status"/>
      <short
             value="draft | active | suspended | cancelled | completed | entered-in-error | unknown"/>
      <definition value="The status of the proposal or order."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description
                     value="Codes identifying the stage lifecycle stage of a request"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/request-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.category">
      <path value="CommunicationRequest.category"/>
      <short value="Message category"/>
      <definition
                  value="The type of message to be sent such as alert, notification, reminder, instruction, etc."/>
      <comment
               value="There may be multiple axes of categorization and one communication request may serve multiple purposes."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Codes for general categories of communications such as alerts, instruction, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/communication-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.priority">
      <path value="CommunicationRequest.priority"/>
      <short value="Message urgency"/>
      <definition
                  value="Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.priority"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <meaningWhenMissing
                          value="If missing, this task should be performed with normal priority"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CommunicationPriority"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Codes indicating the relative importance of a communication request."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/request-priority"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.priority"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="grade"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.medium">
      <path value="CommunicationRequest.medium"/>
      <short value="A channel of communication"/>
      <definition
                  value="A channel that was used for this communication (e.g. email, fax)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.medium"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="A set of codes specifying the modality by which the Entity playing the Role is participating in the Act. Examples: Physically present, over the telephone, written communication. Rationale: Particularly for author (originator) participants this is used to specify whether the information represented by the act was initially provided verbally, (hand-)written, or electronically. Open Issue: There needs to be a reexamination of the hierarchies as there seems to be some muddling between ELECTRONIC and other concepts that involve electronic communication that are in other hierarchies."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ParticipationMode"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="CommunicationRequest.subject">
      <path value="CommunicationRequest.subject"/>
      <short value="Encounter or episode leading to message"/>
      <definition
                  value="The encounter or episode of care within which the communication request was created."/>
      <alias value="patient"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.recipient">
      <path value="CommunicationRequest.recipient"/>
      <short value="Message receipient"/>
      <definition
                  value="The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.recipient"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.performer"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.topic">
      <path value="CommunicationRequest.topic"/>
      <short value="Focal resources"/>
      <definition
                  value="The resources which were related to producing this communication request."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.topic"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.supportingInfo"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.context">
      <path value="CommunicationRequest.context"/>
      <short value="Encounter or episode leading to message"/>
      <definition
                  value="The encounter or episode of care within which the communication request was created."/>
      <alias value="encounter"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.context"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.payload">
      <path value="CommunicationRequest.payload"/>
      <short value="Message payload"/>
      <definition
                  value="Text, attachment(s), or resource(s) to be communicated to the recipient."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.payload"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
    </element>
    <element id="CommunicationRequest.payload.id">
      <path value="CommunicationRequest.payload.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.extension">
      <path value="CommunicationRequest.payload.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.modifierExtension">
      <path value="CommunicationRequest.payload.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.payload.content[x]">
      <path value="CommunicationRequest.payload.content[x]"/>
      <short value="Message part content"/>
      <definition
                  value="The communicated content (or for multi-part communications, one portion of the communication)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.payload.content[x]"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map
             value="Request.supportingInfo IF Reference, Request.note if string; No mapping if Attachment"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.occurrence[x]">
      <path value="CommunicationRequest.occurrence[x]"/>
      <short value="When scheduled"/>
      <definition value="The time when this communication is to occur."/>
      <alias value="timing"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.occurrence[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.occurrence"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.planned"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.authoredOn">
      <path value="CommunicationRequest.authoredOn"/>
      <short value="When request transitioned to being actionable"/>
      <definition
                  value="For draft requests, indicates the date of initial creation.  For requests with other statuses, indicates the date of activation."/>
      <alias value="createdOn"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.authoredOn"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.authoredOn"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.sender">
      <path value="CommunicationRequest.sender"/>
      <short value="Message sender"/>
      <definition
                  value="The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.sender"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.requester.agent"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.requester">
      <path value="CommunicationRequest.requester"/>
      <short value="Who/what us requesting service"/>
      <definition
                  value="The individual who initiated the request and has responsibility for its activation."/>
      <alias value="author"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.requester"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="cmr-1"/>
        <severity value="error"/>
        <human
               value="onBehalfOf can only be specified if agent is practitioner or device"/>
        <expression
                    value="(agent.resolve() is Practitioner) or (agent.resolve() is Device) or onBehalfOf.exists().not()"/>
        <xpath
               value="contains(f:agent/f:reference/@value, &#39;/Practitioner/&#39;) or contains(f:agent/f:reference/@value, &#39;/Device/&#39;) or not(exists(f:onBehalfOf))"/>
        <source value="CommunicationRequest.requester"/>
      </constraint>
      <mustSupport value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.requester"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.id">
      <path value="CommunicationRequest.requester.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.extension">
      <path value="CommunicationRequest.requester.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.modifierExtension">
      <path value="CommunicationRequest.requester.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.agent">
      <path value="CommunicationRequest.requester.agent"/>
      <short value="Individual making the request"/>
      <definition
                  value="The device, practitioner, etc. who initiated the request."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.requester.agent"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.requester.agent"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".player"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.requester.onBehalfOf">
      <path value="CommunicationRequest.requester.onBehalfOf"/>
      <short value="Organization agent is acting for"/>
      <definition
                  value="The organization the device or practitioner was acting on behalf of."/>
      <requirements
                    value="Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when authoring the request."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CommunicationRequest.requester.onBehalfOf"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <condition value="cmr-1"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.requester.onBehalfOf"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".scoper"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.reasonCode">
      <path value="CommunicationRequest.reasonCode"/>
      <short value="Why is communication needed?"/>
      <definition
                  value="Describes why the request is being made in coded or textual form."/>
      <comment value="Textual reasons can be caprued using reasonCode.text."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.reasonCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description
                     value="A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type &quot;has reason&quot; linking to another Act. Examples: Example reasons that might qualify for being coded in this field might be: &quot;routine requirement&quot;, &quot;infectious disease reporting requirement&quot;, &quot;on patient request&quot;, &quot;required by law&quot;."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.reasonCode"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.reasonReference">
      <path value="CommunicationRequest.reasonReference"/>
      <short value="Why is communication needed?"/>
      <definition
                  value="Indicates another resource whose existence justifies this request."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.reasonReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.reasonReference"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=RSON].target"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.note">
      <path value="CommunicationRequest.note"/>
      <short value="Comments made about communication request"/>
      <definition
                  value="Comments made about the request by the requester, sender, recipient, subject or other participants."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CommunicationRequest.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="Request.note"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="CommunicationRequest">
      <path value="CommunicationRequest"/>
      <definition
                  value="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."/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map
             value="“Note, there is no corresponding QDM concept to CommunicationRequest.”"/>
      </mapping>
    </element>
    <element id="CommunicationRequest.extension:orderedBy">
      <path value="CommunicationRequest.extension"/>
      <sliceName value="orderedBy"/>
      <short value="Agent that ordered the communication"/>
      <definition value="Agent that ordered the communication."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/communicationrequest-orderedBy"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.extension:authorizedBy">
      <path value="CommunicationRequest.extension"/>
      <sliceName value="authorizedBy"/>
      <short value="Practitioner who authorized request"/>
      <definition
                  value="The practitioner who authorized the communication request, usually the same as the orderer when the orderer is a practitioner."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedurerequest-authorizedBy"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.extension:reasonRejected">
      <path value="CommunicationRequest.extension"/>
      <sliceName value="reasonRejected"/>
      <short value="Reason why request was rejected"/>
      <definition
                  value="The reason associated with the rejection of this communication request by the receiver. Applicable only if the status is rejected."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/communicationrequest-reasonRejected"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <binding>
        <strength value="example"/>
        <description value="Reason communication request was not performed"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/qicore/ValueSet/qicore-communication-reason-not-performed"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="CommunicationRequest.status">
      <path value="CommunicationRequest.status"/>
      <short
             value="draft | active | suspended | cancelled | completed | entered-in-error | unknown"/>
      <definition value="The status of the proposal or order."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="required"/>
        <description
                     value="Codes identifying the stage lifecycle stage of a request"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/request-status"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="CommunicationRequest.category">
      <path value="CommunicationRequest.category"/>
      <short value="Message category"/>
      <definition
                  value="The type of message to be sent such as alert, notification, reminder, instruction, etc."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Codes for general categories of communications such as alerts, instruction, etc."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/communication-category"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="CommunicationRequest.medium">
      <path value="CommunicationRequest.medium"/>
      <short value="A channel of communication"/>
      <definition
                  value="A channel that was used for this communication (e.g. email, fax)."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="A set of codes specifying the modality by which the Entity playing the Role is participating in the Act. Examples: Physically present, over the telephone, written communication. Rationale: Particularly for author (originator) participants this is used to specify whether the information represented by the act was initially provided verbally, (hand-)written, or electronically. Open Issue: There needs to be a reexamination of the hierarchies as there seems to be some muddling between ELECTRONIC and other concepts that involve electronic communication that are in other hierarchies."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ParticipationMode"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="CommunicationRequest.subject">
      <path value="CommunicationRequest.subject"/>
      <short value="Encounter or episode leading to message"/>
      <definition
                  value="The encounter or episode of care within which the communication request was created."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.recipient">
      <path value="CommunicationRequest.recipient"/>
      <short value="Message receipient"/>
      <definition
                  value="The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.context">
      <path value="CommunicationRequest.context"/>
      <short value="Encounter or episode leading to message"/>
      <definition
                  value="The encounter or episode of care within which the communication request was created."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.occurrence[x]">
      <path value="CommunicationRequest.occurrence[x]"/>
      <short value="When scheduled"/>
      <definition value="The time when this communication is to occur."/>
      <min value="0"/>
      <max value="1"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.sender">
      <path value="CommunicationRequest.sender"/>
      <short value="Message sender"/>
      <definition
                  value="The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.requester">
      <path value="CommunicationRequest.requester"/>
      <short value="Who/what us requesting service"/>
      <definition
                  value="The individual who initiated the request and has responsibility for its activation."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="CommunicationRequest.reasonCode">
      <path value="CommunicationRequest.reasonCode"/>
      <short value="Why is communication needed?"/>
      <definition
                  value="Describes why the request is being made in coded or textual form."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type &quot;has reason&quot; linking to another Act. Examples: Example reasons that might qualify for being coded in this field might be: &quot;routine requirement&quot;, &quot;infectious disease reporting requirement&quot;, &quot;on patient request&quot;, &quot;required by law&quot;."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActReason"/>
        </valueSetReference>
      </binding>
    </element>
  </differential>
</StructureDefinition>