QI-Core Implementation Guide
4.1.1 - STU 4.1.1
US
This page is part of the Quality Improvement Core Framework (v4.1.1: STU 4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Draft as of 2019-07-11 |
Definitions for the qicore-devicenotrequested resource profile.
1. DeviceRequest | |
Definition | Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker. |
Control | 0..* |
Invariants | Defined on this element dnr-1: to indicate what device was not requested, either at least one coding in the code or a notDoneValueSet extension shall be provided (: code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists()) |
2. DeviceRequest.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Control | 0..1 |
Type | string |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
3. DeviceRequest.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Control | 0..1 |
Type | Meta |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
4. DeviceRequest.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
5. DeviceRequest.language | |
Definition | The base language in which the resource is written. |
Control | 0..1 |
Binding | The codes SHOULD be taken from CommonLanguages Max Binding: AllLanguages A human language. |
Type | code |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
6. DeviceRequest.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Control | 0..1 |
Type | Narrative |
Alternate Names | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
7. DeviceRequest.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Control | 0..* |
Type | Resource |
Alternate Names | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
8. DeviceRequest.extension | |
Definition | An Extension |
Control | 0..* |
Type | Extension |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on DeviceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
9. DeviceRequest.extension:doNotPerformReason | |
SliceName | doNotPerformReason |
Definition | Indicates the reason the event was not performed. |
Control | 1..1 This element is affected by the following invariants: ele-1 |
Type | Extension(QICoreDoNotPerformReason) (Extension Type: CodeableConcept) |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
10. DeviceRequest.modifierExtension | |
Definition | An Extension |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on DeviceRequest.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
11. DeviceRequest.modifierExtension:doNotPerform | |
SliceName | doNotPerform |
Definition | An Extension |
Control | 1..1 This element is affected by the following invariants: ele-1 |
Type | Extension(Extension-5.0-DeviceRequest.doNotPerform) (Extension Type: boolean) |
Is Modifier | true |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
12. DeviceRequest.modifierExtension:doNotPerform.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
13. DeviceRequest.modifierExtension:doNotPerform.extension | |
Definition | An Extension |
Control | 0..0 |
Type | Extension |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on DeviceRequest.modifierExtension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
14. DeviceRequest.modifierExtension:doNotPerform.url | |
Definition | Source of the definition for the extension code - a logical name or a URL. |
Control | 1..1 |
Type | uri |
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
Fixed Value | http://hl7.org/fhir/5.0/StructureDefinition/extension-DeviceRequest.doNotPerform |
15. DeviceRequest.modifierExtension:doNotPerform.value[x] | |
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
Control | 1..1 |
Type | boolean |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | true |
Fixed Value | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
16. DeviceRequest.identifier | |
Definition | Identifiers assigned to this order by the orderer or by the receiver. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
17. DeviceRequest.instantiatesCanonical | |
Definition | The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest. |
Control | 0..* |
Type | canonical(ActivityDefinition | PlanDefinition) |
Comments | Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
18. DeviceRequest.instantiatesUri | |
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest. |
Control | 0..* |
Type | uri |
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
19. DeviceRequest.basedOn | |
Definition | Plan/proposal/order fulfilled by this request. |
Control | 0..* |
Type | Reference(Resource) |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
20. DeviceRequest.priorRequest | |
Definition | The request takes the place of the referenced completed or terminated request(s). |
Control | 0..* |
Type | Reference(Resource) |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
21. DeviceRequest.groupIdentifier | |
Definition | Composite request this is part of. |
Control | 0..1 |
Type | Identifier |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
22. DeviceRequest.status | |
Definition | The status of the request. |
Control | 1..1 |
Binding | The codes SHALL be taken from RequestStatus Codes representing the status of the request. |
Type | code |
Is Modifier | true |
Must Support | true |
Comments | This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid. |
Fixed Value | completed |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
23. DeviceRequest.intent | |
Definition | Whether the request is a proposal, plan, an original order or a reflex order. |
Control | 1..1 |
Binding | The codes SHALL be taken from RequestIntent The kind of diagnostic request. |
Type | code |
Is Modifier | true |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
24. DeviceRequest.priority | |
Definition | Indicates how quickly the {{title}} should be addressed with respect to other requests. |
Control | 0..1 |
Binding | The codes SHALL be taken from RequestPriority Identifies the level of importance to be assigned to actioning the request. |
Type | code |
Meaning if Missing | If missing, normal priority |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
25. DeviceRequest.code[x] | |
Definition | The details of the device to be used. |
Control | 1..1 This element is affected by the following invariants: dnr-1 |
Binding | For example codes, see FHIRDeviceTypes Codes for devices that can be requested. |
Type | CodeableConcept |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
26. DeviceRequest.code[x].id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
27. DeviceRequest.code[x].extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
Slicing | This element introduces a set of slices on DeviceRequest.code[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
28. DeviceRequest.code[x].extension:doNotPerformValueSet | |
SliceName | doNotPerformValueSet |
Definition | Specifies the value set that characterizes the events or activities that did not occur or were not performed. |
Control | 0..1 This element is affected by the following invariants: dnr-1 |
Type | Extension(NotDoneValueSet) (Extension Type: canonical(ValueSet)) |
Must Support | true |
Requirements | Must be able to indicate the value set from which the expected event would be drawn, had it occurred. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
29. DeviceRequest.code[x].coding | |
Definition | A reference to a code defined by a terminology system. |
Control | 0..* |
Type | Coding |
Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
30. DeviceRequest.code[x].text | |
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
Control | 0..1 |
Type | string |
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
Comments | Very often the text is the same as a displayName of one of the codings. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
31. DeviceRequest.parameter | |
Definition | Specific parameters for the ordered item. For example, the prism value for lenses. |
Control | 0..* |
Type | BackboneElement |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
32. DeviceRequest.parameter.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Control | 0..1 |
Type | string |
33. DeviceRequest.parameter.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Control | 0..* |
Type | Extension |
Alternate Names | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
34. DeviceRequest.parameter.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Control | 0..* |
Type | Extension |
Is Modifier | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
35. DeviceRequest.parameter.code | |
Definition | A code or string that identifies the device detail being asserted. |
Control | 0..1 |
Binding | A code that identifies the device detail. |
Type | CodeableConcept |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
36. DeviceRequest.parameter.value[x] | |
Definition | The value of the device detail. |
Control | 0..1 |
Type | Choice of: CodeableConcept, Quantity, Range, boolean |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Comments | Range means device should have a value that falls somewhere within the specified range. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
37. DeviceRequest.subject | |
Definition | The patient who will use the device. |
Control | 1..1 |
Type | Reference(QICorePatient) |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
38. DeviceRequest.encounter | |
Definition | An encounter that provides additional context in which this request is made. |
Control | 0..1 |
Type | Reference(QICoreEncounter) |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
39. DeviceRequest.occurrence[x] | |
Definition | The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". |
Control | 0..1 |
Type | Choice of: dateTime, Period, Timing |
[x] Note | See Choice of Data Types for further information about how to use [x] |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
40. DeviceRequest.authoredOn | |
Definition | When the request transitioned to being actionable. |
Control | 1..1 |
Type | dateTime |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
41. DeviceRequest.requester | |
Definition | The individual who initiated the request and has responsibility for its activation. |
Control | 0..1 |
Type | Reference(Device | Practitioner | PractitionerRole | Organization) |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
42. DeviceRequest.performerType | |
Definition | Desired type of performer for doing the diagnostic testing. |
Control | 0..1 |
Binding | For example codes, see ParticipantRoles Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. |
Type | CodeableConcept |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
43. DeviceRequest.performer | |
Definition | The desired performer for doing the diagnostic testing. |
Control | 0..1 |
Type | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
44. DeviceRequest.reasonCode | |
Definition | Reason or justification for the use of this device. |
Control | 0..* |
Binding | For example codes, see Condition/Problem/DiagnosisCodes Diagnosis or problem codes justifying the reason for requesting the device. |
Type | CodeableConcept |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
45. DeviceRequest.reasonReference | |
Definition | Reason or justification for the use of this device. |
Control | 0..* |
Type | Reference(Condition | Observation | DiagnosticReport | DocumentReference) |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
46. DeviceRequest.insurance | |
Definition | Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. |
Control | 0..* |
Type | Reference(Coverage | ClaimResponse) |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
47. DeviceRequest.supportingInfo | |
Definition | Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site). |
Control | 0..* |
Type | Reference(Resource) |
Requirements | Knowing where the device is targeted is important for tracking if multiple sites are possible. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
48. DeviceRequest.note | |
Definition | Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement. |
Control | 0..* |
Type | Annotation |
Must Support | true |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
49. DeviceRequest.relevantHistory | |
Definition | Key events in the history of the request. |
Control | 0..* |
Type | Reference(Provenance) |
Comments | This might not include provenances for all versions of the request - only those deemed "relevant" or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject. |
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |