QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide - Downloaded Version 7.0.2 See the Directory of published versions

## Resource Profile: QICore ServiceRequested

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequested | Version: 7.0.2
Standards status: Trial-use | Maturity Level: 4 | Computable Name: QICoreServiceRequested

Positive profile of ServiceRequest for decision support/quality metrics. Indicates that a service is proposed, planned, or ordered.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
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
- 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
- authoredOn: (QI) Date request signed
- 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

### Guidance

Reference Guidance for use of the Service Request 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` valueset is broad to accommodate a wide variety of use cases and should be constrained to a subset for a particular use case or domain. (for example, LOINC for laboratory orders.)
- 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 ServiceNotRequested 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; to specifically request information that a ServiceRequest intentionally did not occur for a medical, patient or system reason, use the profile QICoreServiceProhibited.

The following example illustrates the use of the ServiceRequested profile:

    define "Intermittent Pneumatic Compression Devices Ordered":
      ["ServiceRequested": "Application of intermittent pneumatic compression devices (IPC)"] DeviceOrdered
        where DeviceOrdered.intent = 'order'

Note that the doNotPerform and statuses indicating positive intent are implied by the use of the ServiceRequested profile.

See the patterns page for implementation and usage patterns.

### Examples

ServiceRequested for Appendectomy Example
Request for Graduated compression elastic hosiery (specific code)
Request for Intermittent pneumatic compression devices (value set)

Usages:

- Examples for this Profile: ServiceRequest/proposal-example-code, ServiceRequest/proposal-example and ServiceRequest/servicerequested-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | QICoreServiceRequest | A request for a service to be performed Constraints: prr-1, srq-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | (QI) draft | active | on-hold | completed Binding: Positive Request Status (required)
intent | ?!S Σ | 1..1 | code | (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category | S Σ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 0..* | CodeableConcept | Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
doNotPerform | ?!Σ | 0..1 | boolean | (QI) True if service/procedure should not be performed Fixed Value: false
code | S Σ C | 1..1 | CodeableConcept | (QI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:codeOptions | C | 0..1 | canonical(ValueSet) | (QI) Url of a value set of candidate services URL: http://hl7.org/fhir/StructureDefinition/codeOptions
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) Individual or Entity the service is ordered for
encounter | S Σ | 0..1 | Reference(QICore Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | (QI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ | 0..1 | dateTime | (QI) Date request signed
requester | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) | Who/what is requesting service
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.status | Base | required | Positive Request Status | 📦7.0.2 | This IG
ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
ServiceRequest.category | Base | example | Service Request Category Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.category:us-core | Base | required | US Core ServiceRequest Category Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`
srq-1 | error | ServiceRequest | To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided | `code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()`

This structure is derived from QICoreServiceRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest |  | 0..* | QICoreServiceRequest | A request for a service to be performed
status |  | 1..1 | code | (QI) draft | active | on-hold | completed Binding: Positive Request Status (required)
doNotPerform |  | 0..1 | boolean | (QI) True if service/procedure should not be performed Fixed Value: false
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.status | Base | required | Positive Request Status | 📦7.0.2 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | QICoreServiceRequest | A request for a service to be performed Constraints: prr-1, srq-1
id | Σ | 0..1 | id | 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): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
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 | ?!S Σ | 1..1 | code | (QI) draft | active | on-hold | completed Binding: Positive Request Status (required)
intent | ?!S Σ | 1..1 | code | (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category | S Σ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 0..* | CodeableConcept | Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
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 | (QI) True if service/procedure should not be performed Fixed Value: false
code | S Σ C | 1..1 | CodeableConcept | (QI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:codeOptions | C | 0..1 | canonical(ValueSet) | (QI) Url of a value set of candidate services URL: http://hl7.org/fhir/StructureDefinition/codeOptions
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
orderDetail | Σ C | 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 | S Σ | 1..1 | Reference(QICore Patient) | (QI) Individual or Entity the service is ordered for
encounter | S Σ | 0..1 | Reference(QICore Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | (QI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
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 | S Σ | 0..1 | dateTime | (QI) Date request signed
requester | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) | 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(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | 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 | Σ | 0..* | CodeableConcept | (QI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) | (QI) 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 | Σ | 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

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
ServiceRequest.status | Base | required | Positive Request Status | 📦7.0.2 | This IG
ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
ServiceRequest.category | Base | example | Service Request Category Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.category:us-core | Base | required | US Core ServiceRequest Category Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.performerType | Base | example | Participant Roles | 📦4.0.1 | FHIR Std.
ServiceRequest.locationCode | Base | example | ServiceDeliveryLocationRoleType | 📦3.0.0 | THO v6.5
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`
srq-1 | error | ServiceRequest | To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided | `code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()`

This structure is derived from QICoreServiceRequest

Summary

Fixed: 1 element

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | QICoreServiceRequest | A request for a service to be performed Constraints: prr-1, srq-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | (QI) draft | active | on-hold | completed Binding: Positive Request Status (required)
intent | ?!S Σ | 1..1 | code | (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category | S Σ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 0..* | CodeableConcept | Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
doNotPerform | ?!Σ | 0..1 | boolean | (QI) True if service/procedure should not be performed Fixed Value: false
code | S Σ C | 1..1 | CodeableConcept | (QI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:codeOptions | C | 0..1 | canonical(ValueSet) | (QI) Url of a value set of candidate services URL: http://hl7.org/fhir/StructureDefinition/codeOptions
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) Individual or Entity the service is ordered for
encounter | S Σ | 0..1 | Reference(QICore Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | (QI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ | 0..1 | dateTime | (QI) Date request signed
requester | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) | Who/what is requesting service
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.status | Base | required | Positive Request Status | 📦7.0.2 | This IG
ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
ServiceRequest.category | Base | example | Service Request Category Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.category:us-core | Base | required | US Core ServiceRequest Category Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`
srq-1 | error | ServiceRequest | To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided | `code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()`

Differential View

This structure is derived from QICoreServiceRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest |  | 0..* | QICoreServiceRequest | A request for a service to be performed
status |  | 1..1 | code | (QI) draft | active | on-hold | completed Binding: Positive Request Status (required)
doNotPerform |  | 0..1 | boolean | (QI) True if service/procedure should not be performed Fixed Value: false
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.status | Base | required | Positive Request Status | 📦7.0.2 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | QICoreServiceRequest | A request for a service to be performed Constraints: prr-1, srq-1
id | Σ | 0..1 | id | 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): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
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 | ?!S Σ | 1..1 | code | (QI) draft | active | on-hold | completed Binding: Positive Request Status (required)
intent | ?!S Σ | 1..1 | code | (QI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category | S Σ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 0..* | CodeableConcept | Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
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 | (QI) True if service/procedure should not be performed Fixed Value: false
code | S Σ C | 1..1 | CodeableConcept | (QI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:codeOptions | C | 0..1 | canonical(ValueSet) | (QI) Url of a value set of candidate services URL: http://hl7.org/fhir/StructureDefinition/codeOptions
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
orderDetail | Σ C | 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 | S Σ | 1..1 | Reference(QICore Patient) | (QI) Individual or Entity the service is ordered for
encounter | S Σ | 0..1 | Reference(QICore Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | (QI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
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 | S Σ | 0..1 | dateTime | (QI) Date request signed
requester | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson | QICore Device | US Core Implantable Device Profile) | 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(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | 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 | Σ | 0..* | CodeableConcept | (QI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore DiagnosticReport Profile for Report and Note Exchange | US Core DocumentReference Profile | QICore Simple Observation) | (QI) 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 | Σ | 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

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
ServiceRequest.status | Base | required | Positive Request Status | 📦7.0.2 | This IG
ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
ServiceRequest.category | Base | example | Service Request Category Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.category:us-core | Base | required | US Core ServiceRequest Category Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.performerType | Base | example | Participant Roles | 📦4.0.1 | FHIR Std.
ServiceRequest.locationCode | Base | example | ServiceDeliveryLocationRoleType | 📦3.0.0 | THO v6.5
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`
srq-1 | error | ServiceRequest | To indicate what service, either at least one coding in the code or a codeOptions extension shall be provided | `code.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor code.coding.exists()`

This structure is derived from QICoreServiceRequest

Summary

Fixed: 1 element

Maturity: 4

Other representations of profile: CSV, Excel, Schematron