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
Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest | Version: 4.1.1 | |||
Draft as of 2018-08-22 | Computable Name: QICoreServiceRequest |
Profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
To create an expression specifically requesting information that a ServiceRequest intentionally did not occur for a medical, patient or system reason, use the profile QICore-Servicenotrequested.
The ServiceRequest and ServiceNotRequested profiles represent the positive and negative statements for a service request. To ensure instances retrieved meet positive intent, applications should check the status and doNotPerform elements as illustrated in this example:
define ServiceRequest:
[ServiceRequest] SR
where SR.status in { 'draft', 'active', 'on-hold', 'completed' }
and SR.doNotPerform is not true
The following example illustrates the use of the ServiceRequest profile:
define "Intervention Comfort Measures":
(["ServiceRequest": "Comfort Measures"] P
where P.intent = 'order'
and P.doNotPerform is not true
)
union (["Procedure": "Comfort Measures"] InterventionPerformed
where InterventionPerformed.status in {'completed', 'in-progress'}
)
Request for Appendectomy Example |
Referral for Procedure Example |
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from ServiceRequest
Summary
Must-Support: 11 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
This structure is derived from ServiceRequest
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ServiceRequest | I | 0..* | ServiceRequest | A request for a service to be performed |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
request-statusReason | 0..1 | CodeableConcept | Reason for current status URL: http://hl7.org/fhir/StructureDefinition/request-statusReason Binding: (unbound) (example): Codes identifying the reason for the current state of an event. | |
procedure-approachBodyStructure | 0..* | Reference(BodyStructure) | The access point or points used for this procedure URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure | |
qicore-servicerequest-appropriatenessScore | 0..1 | code, decimal | Appropriateness Score URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore Binding: RAND Appropriateness Scores (required): The RAND scoring for appropriateness of the procedure. | |
Slices for modifierExtension | ?! | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension:isElective | ?!S | 0..1 | QICoreIsElective | Extension |
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order |
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills |
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces |
requisition | Σ | 0..1 | Identifier | Composite Request ID |
status | ?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. |
intent | ?!SΣ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. |
category | Σ | 0..* | CodeableConcept | Classification of service Binding: ServiceRequestCategoryCodes (example): Classification of the requested service. |
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. |
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed |
code | SΣ | 0..1 | CodeableConcept | What is being requested/ordered Binding: US Core Procedure Codes (preferred): Codes describing the Procedure Type |
orderDetail | ΣI | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context. |
quantity[x] | Σ | 0..1 | Service amount | |
quantityQuantity | Quantity | |||
quantityRatio | Ratio | |||
quantityRange | Range | |||
subject | SΣ | 1..1 | Reference(QICorePatient) | Individual or Entity the service is ordered for |
encounter | SΣ | 0..1 | Reference(Encounter) | Encounter in which the request was created |
occurrence[x] | SΣ | 0..1 | When service should occur | |
occurrenceDateTime | dateTime | |||
occurrencePeriod | Period | |||
occurrenceTiming | Timing | |||
asNeeded[x] | SΣ | 0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | |
asNeededBoolean | boolean | |||
asNeededCodeableConcept | CodeableConcept | |||
authoredOn | SΣ | 0..1 | dateTime | Date request signed |
requester | Σ | 0..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization | QICorePatient | QICoreRelatedPerson | QICoreDevice) | Who/what is requesting service |
performerType | Σ | 0..1 | CodeableConcept | Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. |
performer | Σ | 0..* | Reference(QICorePractitioner | QICoreOrganization | QICorePatient | QICoreDevice | QICoreRelatedPerson | HealthcareService) | Requested performer |
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered. |
locationReference | Σ | 0..* | Reference(Location) | Requested location |
reasonCode | SΣ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. |
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service |
insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |
supportingInfo | 0..* | Reference(Resource) | Additional clinical information | |
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples |
bodySite | SΣ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
note | 0..* | Annotation | Comments | |
patientInstruction | Σ | 0..1 | string | Patient or consumer-oriented instructions |
relevantHistory | 0..* | Reference(Provenance) | Request provenance | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ServiceRequest | I | 0..* | ServiceRequest | A request for a service to be performed |
modifierExtension:isElective | ?! | 0..1 | QICoreIsElective | Extension |
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. |
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. |
code | Σ | 0..1 | CodeableConcept | What is being requested/ordered Binding: US Core Procedure Codes (preferred): Codes describing the Procedure Type |
subject | Σ | 1..1 | Reference(QICorePatient) | Individual or Entity the service is ordered for |
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created |
occurrence[x] | Σ | 0..1 | When service should occur | |
occurrenceDateTime | dateTime | |||
occurrencePeriod | Period | |||
occurrenceTiming | Timing | |||
asNeeded[x] | Σ | 0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | |
asNeededBoolean | boolean | |||
asNeededCodeableConcept | CodeableConcept | |||
authoredOn | Σ | 0..1 | dateTime | Date request signed |
reasonCode | Σ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. |
bodySite | Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
Documentation for this format |
This structure is derived from ServiceRequest
Summary
Must-Support: 11 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from ServiceRequest
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ServiceRequest | I | 0..* | ServiceRequest | A request for a service to be performed |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
request-statusReason | 0..1 | CodeableConcept | Reason for current status URL: http://hl7.org/fhir/StructureDefinition/request-statusReason Binding: (unbound) (example): Codes identifying the reason for the current state of an event. | |
procedure-approachBodyStructure | 0..* | Reference(BodyStructure) | The access point or points used for this procedure URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure | |
qicore-servicerequest-appropriatenessScore | 0..1 | code, decimal | Appropriateness Score URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore Binding: RAND Appropriateness Scores (required): The RAND scoring for appropriateness of the procedure. | |
Slices for modifierExtension | ?! | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension:isElective | ?!S | 0..1 | QICoreIsElective | Extension |
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order |
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills |
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces |
requisition | Σ | 0..1 | Identifier | Composite Request ID |
status | ?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. |
intent | ?!SΣ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. |
category | Σ | 0..* | CodeableConcept | Classification of service Binding: ServiceRequestCategoryCodes (example): Classification of the requested service. |
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. |
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed |
code | SΣ | 0..1 | CodeableConcept | What is being requested/ordered Binding: US Core Procedure Codes (preferred): Codes describing the Procedure Type |
orderDetail | ΣI | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context. |
quantity[x] | Σ | 0..1 | Service amount | |
quantityQuantity | Quantity | |||
quantityRatio | Ratio | |||
quantityRange | Range | |||
subject | SΣ | 1..1 | Reference(QICorePatient) | Individual or Entity the service is ordered for |
encounter | SΣ | 0..1 | Reference(Encounter) | Encounter in which the request was created |
occurrence[x] | SΣ | 0..1 | When service should occur | |
occurrenceDateTime | dateTime | |||
occurrencePeriod | Period | |||
occurrenceTiming | Timing | |||
asNeeded[x] | SΣ | 0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | |
asNeededBoolean | boolean | |||
asNeededCodeableConcept | CodeableConcept | |||
authoredOn | SΣ | 0..1 | dateTime | Date request signed |
requester | Σ | 0..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization | QICorePatient | QICoreRelatedPerson | QICoreDevice) | Who/what is requesting service |
performerType | Σ | 0..1 | CodeableConcept | Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. |
performer | Σ | 0..* | Reference(QICorePractitioner | QICoreOrganization | QICorePatient | QICoreDevice | QICoreRelatedPerson | HealthcareService) | Requested performer |
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered. |
locationReference | Σ | 0..* | Reference(Location) | Requested location |
reasonCode | SΣ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. |
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service |
insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |
supportingInfo | 0..* | Reference(Resource) | Additional clinical information | |
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples |
bodySite | SΣ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
note | 0..* | Annotation | Comments | |
patientInstruction | Σ | 0..1 | string | Patient or consumer-oriented instructions |
relevantHistory | 0..* | Reference(Provenance) | Request provenance | |
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet |
ServiceRequest.language | preferred | CommonLanguages Max Binding: AllLanguages |
ServiceRequest.status | required | RequestStatus |
ServiceRequest.intent | required | RequestIntent |
ServiceRequest.category | example | ServiceRequestCategoryCodes |
ServiceRequest.priority | required | RequestPriority |
ServiceRequest.code | preferred | USCoreProcedureCodes |
ServiceRequest.orderDetail | example | ServiceRequestOrderDetailsCodes |
ServiceRequest.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes |
ServiceRequest.performerType | example | ParticipantRoles |
ServiceRequest.locationCode | example | ServiceDeliveryLocationRoleType |
ServiceRequest.reasonCode | example | ProcedureReasonCodes |
ServiceRequest.bodySite | example | SNOMEDCTBodyStructures |
Id | Grade | Path | Details | Requirements |
dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | ServiceRequest | 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 | error | ServiceRequest | 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 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | Best Practice | ServiceRequest | A resource should have narrative for robust management : text.`div`.exists() | |
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists() | |
ele-1 | error | ServiceRequest.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ServiceRequest.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ServiceRequest.extension:statusReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ServiceRequest.extension:statusReason | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ServiceRequest.extension:approachBodyStructure | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ServiceRequest.extension:approachBodyStructure | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ServiceRequest.extension:appropriatenessScore | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ServiceRequest.extension:appropriatenessScore | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ServiceRequest.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ServiceRequest.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ServiceRequest.modifierExtension:isElective | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ServiceRequest.modifierExtension:isElective | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ServiceRequest.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.instantiatesCanonical | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.instantiatesUri | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.basedOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.replaces | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.requisition | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.intent | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.priority | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.doNotPerform | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.orderDetail | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.quantity[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.occurrence[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.asNeeded[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.authoredOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.requester | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.performerType | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.performer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.locationCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.locationReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.reasonCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.reasonReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.insurance | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.supportingInfo | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.specimen | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.bodySite | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.patientInstruction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ServiceRequest.relevantHistory | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |