# QICore Service Prohibited - QI-Core Implementation Guide v7.0.2

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **QICore Service Prohibited**

## Resource Profile: QICore Service Prohibited 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-serviceprohibited | *Version*:7.0.2 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 4 | *Computable Name*:QICoreServiceProhibited |

 
Negation profile of ServiceRequest for decision support/quality metrics. Indicates a request not to provide a service 

"Must Have", "QI Elements" and "primary code path" are defined in the
[QI-Core Must Support section](index.md#mustsupport-flag).

**Must Have:**
* intent: (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
* code: (QI) What is being requested/ordered
* subject: (QI) Individual or Entity the service is ordered for
* authoredOn: (QI) Date request signed
* status: (QI) draft | active | on-hold | completed

**QI Elements:**
* code.extension(codeOptions): (QI) Url of a value set of candidate services
* reasonCode: (QI) Explanation/Justification for procedure or service
* occurrence[x]: (QI) When service should occur
* doNotPerform: (QI) True if service/procedure should not be performed
* reasonReference: (QI) Explanation/Justification for service or service

**Primary code path:**code

(PCPath) This element is the primary code path for this resource
[CQL Retrieve](https://cql.hl7.org/02-authorsguide.html#retrieve)

### Guidance

  Reference Guidance for use of the Service Prohibited profile can be found [here.](http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-servicerequest.html#mandatory-and-must-support-data-elements) 
* See the [Social Determinants of Health (SDOH)](https://hl7.org/fhir/us/core/sdoh.html) 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](http://hl7.org/fhir/us/core/STU7/ValueSet-us-core-servicerequest-category.html). However, this valueset can be treated as [extensible](http://hl7.org/fhir/R4/terminologies.html#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 profile defines the conformance expectations for a ServiceRequest, regardless of whether it is a positive or negative statement. The ServiceRequested and ServiceProhibited profiles represent the positive and negative statements for a service request. 

To create an expression indicating the existence of a service request, use the profile [QICoreServiceRequested](StructureDefinition-qicore-servicerequested.md); to specifically request information that a ServiceRequest intentionally did not occur for a medical, patient or system reason, use the profile [QICoreServiceProhibited](StructureDefinition-qicore-serviceprohibited.md).

The following expression retrieves instances that meet measure intent for exclusion: 

```
define "Intermittent Pneumatic Compression Devices Not Ordered":
  ["ServiceProhibited": "Application of intermittent pneumatic compression devices (IPC)"] DeviceProhibited
    where (DeviceProhibited.reasonRefused in "Medical Reason"
      or DeviceProhibited.reasonRefused in "Patient Refusal")
```

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

  See the [patterns](patterns.md) page for implementation and usage patterns.  

### Examples

 

| | |
| :--- | :--- |
| [Negation Example with valueset](ServiceRequest-negation-example.md) | Service discontinued; indicates that none of the services in the given `codeOptions` value set were requested. |
| [Negation Example with code](ServiceRequest-negation-example-code.md) | Service discontinued; indicates that the given service, by code, was not requested. |

 

**Usages:**

* Examples for this Profile: [ServiceRequest/negation-example-code](ServiceRequest-negation-example-code.md) and [ServiceRequest/negation-example](ServiceRequest-negation-example.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.qicore|current/StructureDefinition/qicore-serviceprohibited)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-qicore-serviceprohibited.csv), [Excel](StructureDefinition-qicore-serviceprohibited.xlsx), [Schematron](StructureDefinition-qicore-serviceprohibited.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "qicore-serviceprohibited",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-primaryCodePath",
    "valueString" : "code"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-isIncluded",
    "valueBoolean" : true
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-isRetrievable",
    "valueBoolean" : true
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-modelInfo-label",
    "valueString" : "ServiceProhibited"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cqi"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 4,
    "_valueInteger" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/qicore/ImplementationGuide/us-qicore"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/qicore/ImplementationGuide/us-qicore"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-serviceprohibited",
  "version" : "7.0.2",
  "name" : "QICoreServiceProhibited",
  "title" : "QICore Service Prohibited",
  "status" : "active",
  "experimental" : false,
  "date" : "2018-08-22",
  "publisher" : "HL7 International / Clinical Quality Information",
  "contact" : [{
    "name" : "Clinical Quality Information WG",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cqi"
    }]
  }],
  "description" : "Negation profile of ServiceRequest for decision support/quality metrics. Indicates a request not to provide a service",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "quick",
    "uri" : "http://siframework.org/cqf",
    "name" : "Quality Improvement and Clinical Knowledge (QUICK)"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "ServiceRequest",
  "baseDefinition" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "ServiceRequest",
      "path" : "ServiceRequest",
      "mustSupport" : false
    },
    {
      "id" : "ServiceRequest.status",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.status",
      "short" : "(QI) draft | active | on-hold | completed",
      "binding" : {
        "strength" : "required",
        "valueSet" : "http://hl7.org/fhir/us/qicore/ValueSet/qicore-positive-request-status"
      }
    },
    {
      "id" : "ServiceRequest.doNotPerform",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.doNotPerform",
      "short" : "(QI) True if service/procedure should not be performed",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "boolean"
      }],
      "fixedBoolean" : true
    },
    {
      "id" : "ServiceRequest.authoredOn",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.authoredOn",
      "short" : "(QI) Date request signed",
      "min" : 1,
      "max" : "1"
    },
    {
      "id" : "ServiceRequest.reasonCode",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-keyelement",
        "valueBoolean" : true
      }],
      "path" : "ServiceRequest.reasonCode",
      "short" : "(QI) Explanation/Justification for procedure or service",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "extension" : [{
            "url" : "key",
            "valueId" : "3fdfb5b5-0d5e-4b02-bda5-562629399813"
          },
          {
            "url" : "purpose",
            "valueCode" : "extensible"
          },
          {
            "url" : "valueSet",
            "valueCanonical" : "http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason"
          }],
          "url" : "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
        }],
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code"
      }
    }]
  }
}

```
