QI-Core Implementation Guide
5.0.0 - STU5 United States of America flag

This page is part of the Quality Improvement Core Framework (v5.0.0: STU5 (v5.0.0)) based on FHIR R4. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Service Not Requested

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested Version: 5.0.0
Active as of 2018-08-22 Computable Name: QICoreServiceNotRequested

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

Contents:

Guidance

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

  • See the Social Determinants of Health (SDOH) Guidance Page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
  • The ServiceRequest.category binding must support at a minimum the US Core ServiceRequest Category Codes. However, this valueset can be treated as extensible and other category codes can be used instead.
  • The ServiceRequest.code.extension:notDoneValueSet valueset identifies a set of possible coded values representing activities that were not requested, ordered, or performed.
  • The ServiceRequest.subject is Must Support with Must Support reference to QI Core Patient

Usage

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

See the patterns page for implementation and usage patterns.

Examples

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

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

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

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

Usage:

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

Formal Views of Profile Content

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

This structure is derived from USCoreServiceRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*USCoreServiceRequestProfileA request for a service to be performed
snr-1: to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... approachBodyStructure 0..*Reference(BodyStructure)The access point or points used for this procedure
URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure
... appropriatenessScore 0..1code, decimalAppropriateness Score
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore
Binding: Appropriateness Score (required): The RAND scoring for appropriateness of the procedure.

... reasonRefused S1..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerformReason
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed

... status S1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
... doNotPerform S1..1booleanTrue if service/procedure should not be performed
Fixed Value: true
... code
.... notDoneValueSet SC0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject S1..1Reference(QICore Patient)Individual or Entity the service is ordered for
... encounter S0..1Reference(QICore Encounter)Encounter in which the request was created
... occurrence[x] S0..1When service should occur
.... occurrenceDateTimedateTime S
.... occurrencePeriodPeriod S
.... occurrenceTimingTiming S
... authoredOn S1..1dateTimeDate request signed
... requester 0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile)Who/what is requesting service
... performer 0..*Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore Device | US Core Implantable Device Profile | QICore RelatedPerson | HealthcareService)Requested performer
... reasonReference SΣ0..*Reference(QICore Condition Encounter Diagnosis S | QICore Condition Problems Health Concerns S)Explanation/Justification for service or service
... specimen Σ0..*Reference(QICore Specimen)Procedure Samples
... bodySite S0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (preferred): Anatomic location where the procedure should be performed. This is the target site


doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
ServiceRequest.extension:appropriatenessScore
[CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore]]		preferredAppropriatenessScore
ServiceRequest.bodySitepreferredSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
snr-1errorServiceRequestto indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*USCoreServiceRequestProfileA request for a service to be performed
snr-1: to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... approachBodyStructure 0..*Reference(BodyStructure)The access point or points used for this procedure
URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure
... appropriatenessScore 0..1code, decimalAppropriateness Score
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore
Binding: Appropriateness Score (required): The RAND scoring for appropriateness of the procedure.


... Slices for modifierExtension ?!0..*ExtensionExtension
Slice: Unordered, Open by value:url
... modifierExtension:isElective ?!S0..1QICoreIsElectiveExtension
... status ?!SΣ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category SΣ1..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core SΣ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required)
... doNotPerform ?!SΣ1..1booleanTrue if service/procedure should not be performed
Fixed Value: true
... code SΣ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... notDoneValueSet SC0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject SΣ1..1Reference(QICore Patient)Individual or Entity the service is ordered for
... encounter SΣ0..1Reference(QICore Encounter)Encounter in which the request was created
... occurrence[x] SΣ0..1When service should occur
.... occurrenceDateTimedateTime
.... occurrencePeriodPeriod
.... occurrenceTimingTiming
... authoredOn SΣ1..1dateTimeDate request signed
... requester SΣ0..1Reference(QICore PractitionerRole | QICore Patient | QICore RelatedPerson)Who/what is requesting service
... performer Σ0..*Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore Device | US Core Implantable Device Profile | QICore RelatedPerson | HealthcareService)Requested performer
... reasonReference SΣ0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns)Explanation/Justification for service or service
... specimen Σ0..*Reference(QICore Specimen)Procedure Samples
... bodySite SΣ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (preferred): Anatomic location where the procedure should be performed. This is the target site



doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.bodySitepreferredSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
snr-1errorServiceRequestto indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*USCoreServiceRequestProfileA request for a service to be performed
snr-1: to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... approachBodyStructure 0..*Reference(BodyStructure)The access point or points used for this procedure
URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure
... appropriatenessScore 0..1code, decimalAppropriateness Score
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore
Binding: Appropriateness Score (required): The RAND scoring for appropriateness of the procedure.


... reasonRefused S1..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerformReason
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed


... Slices for modifierExtension ?!0..*ExtensionExtension
Slice: Unordered, Open by value:url
... modifierExtension:isElective ?!S0..1QICoreIsElectiveExtension
... identifier Σ0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical Σ0..*canonical(ActivityDefinition | PlanDefinition)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | ServiceRequest | MedicationRequest)What request fulfills
... replaces Σ0..*Reference(ServiceRequest)What request replaces
... requisition Σ0..1IdentifierComposite Request ID
... status ?!SΣ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category SΣ1..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core SΣ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required)
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ1..1booleanTrue if service/procedure should not be performed
Fixed Value: true
... code SΣ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... notDoneValueSet SC0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... orderDetail ΣC0..*CodeableConceptAdditional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.


... quantity[x] Σ0..1Service amount
.... quantityQuantityQuantity
.... quantityRatioRatio
.... quantityRangeRange
... subject SΣ1..1Reference(QICore Patient)Individual or Entity the service is ordered for
... encounter SΣ0..1Reference(QICore Encounter)Encounter in which the request was created
... occurrence[x] SΣ0..1When service should occur
.... occurrenceDateTimedateTime S
.... occurrencePeriodPeriod S
.... occurrenceTimingTiming S
... asNeeded[x] Σ0..1Preconditions 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.

.... asNeededBooleanboolean
.... asNeededCodeableConceptCodeableConcept
... authoredOn SΣ1..1dateTimeDate request signed
... requester SΣ0..1Reference(QICore Practitioner | QICore PractitionerRole S | QICore Organization | QICore Patient S | QICore RelatedPerson S | QICore Device | US Core Implantable Device Profile)Who/what is requesting service
... performerType Σ0..1CodeableConceptPerformer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ0..*Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore Device | US Core Implantable Device Profile | QICore RelatedPerson | HealthcareService)Requested performer
... locationCode Σ0..*CodeableConceptRequested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


... locationReference Σ0..*Reference(Location)Requested location
... reasonCode Σ0..*CodeableConceptExplanation/Justification for procedure or service
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.


... reasonReference SΣ0..*Reference(QICore Condition Encounter Diagnosis S | QICore Condition Problems Health Concerns S)Explanation/Justification for service or service
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... supportingInfo 0..*Reference(Resource)Additional clinical information
... specimen Σ0..*Reference(QICore Specimen)Procedure Samples
... bodySite SΣ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (preferred): Anatomic location where the procedure should be performed. This is the target site


... note 0..*AnnotationComments
... patientInstruction Σ0..1stringPatient or consumer-oriented instructions
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.priorityrequiredRequestPriority
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerTypeexampleParticipantRoles
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeexampleProcedureReasonCodes
ServiceRequest.bodySitepreferredSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 3 elements
Must-Support: 11 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from USCoreServiceRequestProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*USCoreServiceRequestProfileA request for a service to be performed
snr-1: to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... approachBodyStructure 0..*Reference(BodyStructure)The access point or points used for this procedure
URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure
... appropriatenessScore 0..1code, decimalAppropriateness Score
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore
Binding: Appropriateness Score (required): The RAND scoring for appropriateness of the procedure.

... reasonRefused S1..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerformReason
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed

... status S1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
... doNotPerform S1..1booleanTrue if service/procedure should not be performed
Fixed Value: true
... code
.... notDoneValueSet SC0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject S1..1Reference(QICore Patient)Individual or Entity the service is ordered for
... encounter S0..1Reference(QICore Encounter)Encounter in which the request was created
... occurrence[x] S0..1When service should occur
.... occurrenceDateTimedateTime S
.... occurrencePeriodPeriod S
.... occurrenceTimingTiming S
... authoredOn S1..1dateTimeDate request signed
... requester 0..1Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile)Who/what is requesting service
... performer 0..*Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore Device | US Core Implantable Device Profile | QICore RelatedPerson | HealthcareService)Requested performer
... reasonReference SΣ0..*Reference(QICore Condition Encounter Diagnosis S | QICore Condition Problems Health Concerns S)Explanation/Justification for service or service
... specimen Σ0..*Reference(QICore Specimen)Procedure Samples
... bodySite S0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (preferred): Anatomic location where the procedure should be performed. This is the target site


doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
ServiceRequest.extension:appropriatenessScore
[CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore]]		preferredAppropriatenessScore
ServiceRequest.bodySitepreferredSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
snr-1errorServiceRequestto indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*USCoreServiceRequestProfileA request for a service to be performed
snr-1: to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... approachBodyStructure 0..*Reference(BodyStructure)The access point or points used for this procedure
URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure
... appropriatenessScore 0..1code, decimalAppropriateness Score
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore
Binding: Appropriateness Score (required): The RAND scoring for appropriateness of the procedure.


... Slices for modifierExtension ?!0..*ExtensionExtension
Slice: Unordered, Open by value:url
... modifierExtension:isElective ?!S0..1QICoreIsElectiveExtension
... status ?!SΣ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category SΣ1..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core SΣ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required)
... doNotPerform ?!SΣ1..1booleanTrue if service/procedure should not be performed
Fixed Value: true
... code SΣ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... notDoneValueSet SC0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... subject SΣ1..1Reference(QICore Patient)Individual or Entity the service is ordered for
... encounter SΣ0..1Reference(QICore Encounter)Encounter in which the request was created
... occurrence[x] SΣ0..1When service should occur
.... occurrenceDateTimedateTime
.... occurrencePeriodPeriod
.... occurrenceTimingTiming
... authoredOn SΣ1..1dateTimeDate request signed
... requester SΣ0..1Reference(QICore PractitionerRole | QICore Patient | QICore RelatedPerson)Who/what is requesting service
... performer Σ0..*Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore Device | US Core Implantable Device Profile | QICore RelatedPerson | HealthcareService)Requested performer
... reasonReference SΣ0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns)Explanation/Justification for service or service
... specimen Σ0..*Reference(QICore Specimen)Procedure Samples
... bodySite SΣ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (preferred): Anatomic location where the procedure should be performed. This is the target site



doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.bodySitepreferredSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorServiceRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorServiceRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorServiceRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceServiceRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
prr-1errorServiceRequestorderDetail SHALL only be present if code is present
: orderDetail.empty() or code.exists()
snr-1errorServiceRequestto indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
: code.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor code.coding.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequest C0..*USCoreServiceRequestProfileA request for a service to be performed
snr-1: to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... approachBodyStructure 0..*Reference(BodyStructure)The access point or points used for this procedure
URL: http://hl7.org/fhir/StructureDefinition/procedure-approachBodyStructure
... appropriatenessScore 0..1code, decimalAppropriateness Score
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest-appropriatenessScore
Binding: Appropriateness Score (required): The RAND scoring for appropriateness of the procedure.


... reasonRefused S1..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-doNotPerformReason
Binding: QICore Negation Reason Codes (extensible): The reason the event did not occur or was not performed


... Slices for modifierExtension ?!0..*ExtensionExtension
Slice: Unordered, Open by value:url
... modifierExtension:isElective ?!S0..1QICoreIsElectiveExtension
... identifier Σ0..*IdentifierIdentifiers assigned to this order
... instantiatesCanonical Σ0..*canonical(ActivityDefinition | PlanDefinition)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | ServiceRequest | MedicationRequest)What request fulfills
... replaces Σ0..*Reference(ServiceRequest)What request replaces
... requisition Σ0..1IdentifierComposite Request ID
... status ?!SΣ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent ?!SΣ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... Slices for category SΣ1..*CodeableConceptClassification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


.... category:us-core SΣ0..*CodeableConceptClassification of service
Binding: US Core ServiceRequest Category Codes (required)
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... doNotPerform ?!SΣ1..1booleanTrue if service/procedure should not be performed
Fixed Value: true
... code SΣ1..1CodeableConceptWhat is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... notDoneValueSet SC0..1canonical(ValueSet)What was not requested
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... orderDetail ΣC0..*CodeableConceptAdditional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.


... quantity[x] Σ0..1Service amount
.... quantityQuantityQuantity
.... quantityRatioRatio
.... quantityRangeRange
... subject SΣ1..1Reference(QICore Patient)Individual or Entity the service is ordered for
... encounter SΣ0..1Reference(QICore Encounter)Encounter in which the request was created
... occurrence[x] SΣ0..1When service should occur
.... occurrenceDateTimedateTime S
.... occurrencePeriodPeriod S
.... occurrenceTimingTiming S
... asNeeded[x] Σ0..1Preconditions 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.

.... asNeededBooleanboolean
.... asNeededCodeableConceptCodeableConcept
... authoredOn SΣ1..1dateTimeDate request signed
... requester SΣ0..1Reference(QICore Practitioner | QICore PractitionerRole S | QICore Organization | QICore Patient S | QICore RelatedPerson S | QICore Device | US Core Implantable Device Profile)Who/what is requesting service
... performerType Σ0..1CodeableConceptPerformer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ0..*Reference(QICore Practitioner | QICore Organization | QICore Patient | QICore Device | US Core Implantable Device Profile | QICore RelatedPerson | HealthcareService)Requested performer
... locationCode Σ0..*CodeableConceptRequested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.


... locationReference Σ0..*Reference(Location)Requested location
... reasonCode Σ0..*CodeableConceptExplanation/Justification for procedure or service
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.


... reasonReference SΣ0..*Reference(QICore Condition Encounter Diagnosis S | QICore Condition Problems Health Concerns S)Explanation/Justification for service or service
... insurance 0..*Reference(Coverage | ClaimResponse)Associated insurance coverage
... supportingInfo 0..*Reference(Resource)Additional clinical information
... specimen Σ0..*Reference(QICore Specimen)Procedure Samples
... bodySite SΣ0..*CodeableConceptLocation on Body
Binding: SNOMEDCTBodyStructures (preferred): Anatomic location where the procedure should be performed. This is the target site


... note 0..*AnnotationComments
... patientInstruction Σ0..1stringPatient or consumer-oriented instructions
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.category:us-corerequiredUSCoreServiceRequestCategoryCodes
ServiceRequest.priorityrequiredRequestPriority
ServiceRequest.codeextensibleUSCoreProcedureCodes
ServiceRequest.orderDetailexampleServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerTypeexampleParticipantRoles
ServiceRequest.locationCodeexampleServiceDeliveryLocationRoleType
ServiceRequest.reasonCodeexampleProcedureReasonCodes
ServiceRequest.bodySitepreferredSNOMEDCTBodyStructures

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 3 elements
Must-Support: 11 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron