Generated Narrative: StructureDefinition profile-ServiceRequest-for-ReferralRequest Name Flags Card. Type Description & Constraints ReferralRequest 0..* ReferralRequest A request for referral or transfer of care #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:instantiatesUri 0..* uri R5: Instantiates external protocol or definition (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.instantiatesUri #xD; extension:code 0..1 Reference(Cross-version Profile for R5.ActivityDefinition for use in FHIR STU3(0.1.0) | ActivityDefinition | Cross-version Profile for R5.PlanDefinition for use in FHIR STU3(0.1.0) | PlanDefinition) R5: What is being requested/ordered additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.code #xD; extension:quantity 0..1 Quantity, Ratio, Range R5: Service amount (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.quantity #xD; extension:focus 0..* Reference(Cross-version Profile for R5.Resource for use in FHIR STU3(0.1.0) | Resource) R5: What the service request is about, when it is not about the subject of record (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.focus #xD; extension:location 0..* (Complex) R5: Requested location (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.location #xD; extension:reason 0..* (Complex) R5: Explanation/Justification for procedure or service additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.reason #xD; extension:insurance 0..* Reference(Cross-version Profile for R5.Coverage for use in FHIR STU3(0.1.0) | Coverage | Cross-version Profile for R5.ClaimResponse for use in FHIR STU3(0.1.0) | ClaimResponse) R5: Associated insurance coverage (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.insurance #xD; extension:bodyStructure 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure]] R5: BodyStructure-based location on the body (new) URL: http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure #xD; extension:patientInstruction 0..* (Complex) R5: Patient or consumer-oriented instructions (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.patientInstruction #xD; definition #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:instantiatesCanonical 0..* uri R5: Instantiates FHIR protocol or definition additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.instantiatesCanonical #xD; basedOn #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:basedOn 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: What request fulfills URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; replaces #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:replaces 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: What request replaces additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; intent #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:intent 0..1 code R5: proposal | plan | directive | order + URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.intent Binding: RequestIntent (required): The kind of service request. #xD; serviceRequested #xD; Slices for extension 1..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:parameterFocus 0..1 (Complex) R5: The context of the order details by reference (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.orderDetail.parameterFocus #xD; extension:parameter 1..* (Complex) R5: The parameter details for the service being requested (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.orderDetail.parameter #xD; subject #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:subject 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Individual or Entity the service is ordered for URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; context #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:encounter 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Encounter in which the request was created additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; recipient #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:performer 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Requested performer URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; supportingInfo #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:supportingInfo 0..* CodeableConcept R5: Additional clinical information additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.supportingInfo #xD; relevantHistory #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:relevantHistory 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R5: Request provenance additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; Documentation for this format
Cross-version Profile for R5.ServiceRequest for use in FHIR STU3
This cross-version profile allows R5 ServiceRequest content to be represented via FHIR STU3 ReferralRequest resources.
A request for referral or transfer of care
Used to record and send details about a request for referral service or transfer of a patient to the care of another provider or provider organization.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL NOT contain any narrative
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
R5: Instantiates external protocol or definition (new)
R5: `ServiceRequest.instantiatesUri` (new:uri)
Element `ServiceRequest.instantiatesUri` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.instantiatesUri` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.instantiatesUri` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
R5: What is being requested/ordered additional types
R5: `ServiceRequest.code` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/ActivityDefinition), CodeableReference(http://hl7.org/fhir/StructureDefinition/PlanDefinition)) additional types from child elements (reference)
Element `ServiceRequest.code` is mapped to FHIR STU3 element `ProcedureRequest.code` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.code` is mapped to FHIR STU3 element `ReferralRequest.type` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.code` is mapped to FHIR STU3 element `ReferralRequest.serviceRequested` as `RelatedTo`. The mappings for `ServiceRequest.code` do not cover the following types: CodeableReference. The mappings for `ServiceRequest.code` do not cover the following types based on type expansion: reference. Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.
R5: `ServiceRequest.quantity[x]` (new:Quantity, Range, Ratio)
Element `ServiceRequest.quantity[x]` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.quantity[x]` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.quantity[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
R5: What the service request is about, when it is not about the subject of record (new)
R5: `ServiceRequest.focus` (new:Reference(Resource))
Element `ServiceRequest.focus` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.focus` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.focus` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
R5: `ServiceRequest.location` (new:CodeableReference(Location))
Element `ServiceRequest.location` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.location` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.location` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
R5: Explanation/Justification for procedure or service additional types
R5: `ServiceRequest.reason` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Condition), CodeableReference(http://hl7.org/fhir/StructureDefinition/Observation), CodeableReference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport), CodeableReference(http://hl7.org/fhir/StructureDefinition/DocumentReference), CodeableReference(http://hl7.org/fhir/StructureDefinition/DetectedIssue))
Element `ServiceRequest.reason` is mapped to FHIR STU3 element `ProcedureRequest.reasonCode` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.reason` is mapped to FHIR STU3 element `ProcedureRequest.reasonReference` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.reason` is mapped to FHIR STU3 element `ReferralRequest.reasonCode` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.reason` is mapped to FHIR STU3 element `ReferralRequest.reasonReference` as `SourceIsBroaderThanTarget`. The mappings for `ServiceRequest.reason` do not cover the following types: CodeableReference. This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to *Observation* or *Condition* should be used if available. Otherwise, use `concept.text` element if the data is free (uncoded) text as shown in the [CT Scan example](https://hl7.org/fhir/servicerequest-example-di.html).
R5: `ServiceRequest.insurance` (new:Reference(Coverage,ClaimResponse))
Element `ServiceRequest.insurance` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.insurance` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.insurance` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
R5: BodyStructure-based location on the body (new)
R5: `ServiceRequest.bodyStructure` (new:Reference(BodyStructure))
Element `ServiceRequest.bodyStructure` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.bodyStructure` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.bodyStructure` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). An externally-defined extension that has been mapped as the representation of FHIR R5 element `ServiceRequest.bodyStructure`: `http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure`.
R5: Patient or consumer-oriented instructions (new)
R5: `ServiceRequest.patientInstruction` (new:BackboneElement)
Element `ServiceRequest.patientInstruction` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.patientInstruction` has a context of ReferralRequest based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.patientInstruction` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Business identifier that uniquely identifies the referral/care transfer request instance.
A protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request.
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
R5: Instantiates FHIR protocol or definition additional types
R5: `ServiceRequest.instantiatesCanonical` additional types (canonical(http://hl7.org/fhir/StructureDefinition/ActivityDefinition), canonical(http://hl7.org/fhir/StructureDefinition/PlanDefinition)) additional types from child elements (value)
Element `ServiceRequest.instantiatesCanonical` is mapped to FHIR STU3 element `ProcedureRequest.definition` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.instantiatesCanonical` is mapped to FHIR STU3 element `ReferralRequest.definition` as `SourceIsBroaderThanTarget`. The mappings for `ServiceRequest.instantiatesCanonical` do not cover the following types: canonical. The mappings for `ServiceRequest.instantiatesCanonical` do not cover the following types based on type expansion: value. The PlanDefinition resource is used to describe series, sequences, or groups of actions to be taken, while the ActivityDefinition resource is used to define each specific step or activity to be performed. More information can be found in the [Boundaries and Relationships](https://hl7.org/fhir/plandefi.html#12.23.2) section for PlanDefinition.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Logical reference, when literal reference is not known
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Indicates any plans, proposals or orders that this request is intended to satisfy - in whole or in part.
Element `ServiceRequest.basedOn` is mapped to FHIR STU3 element `ProcedureRequest.basedOn` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.basedOn` is mapped to FHIR STU3 element `ReferralRequest.basedOn` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ServiceRequest.basedOn` with unmapped reference targets: CarePlan, MedicationRequest, ServiceRequest.
Completed or terminated request(s) whose function is taken by this new request.
The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.
Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.
R5: What request replaces additional types
R5: `ServiceRequest.replaces` additional types from child elements (display, identifier, reference, type)
Element `ServiceRequest.replaces` is mapped to FHIR STU3 element `ProcedureRequest.replaces` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.replaces` is mapped to FHIR STU3 element `ReferralRequest.replaces` as `SourceIsBroaderThanTarget`. The mappings for `ServiceRequest.replaces` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ServiceRequest.replaces` with unmapped reference targets: ServiceRequest.
The business identifier of the logical "grouping" request/order that this referral is a part of.
Allows multiple orders to be collected as part of a single requisition.
draft | active | suspended | cancelled | completed | entered-in-error | unknown
The status of the authorization/intention reflected by the referral request record.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Workflow status is handled by the Task resource.
Distinguishes the "level" of authorization/demand implicit in this request.
The same resource structure is used when capturing proposals/recommendations, plans and actual requests.
Codes identifying the stage lifecycle stage of a request
unique id for the element within a resource (for internal references)
R5: proposal | plan | directive | order +
Element `ServiceRequest.intent` is mapped to FHIR STU3 element `ProcedureRequest.intent` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.intent` is mapped to FHIR STU3 element `ReferralRequest.intent` as `SourceIsBroaderThanTarget`. The target context `ProcedureRequest.intent` is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Referral/Transition of care request type
An indication of the type of referral (or where applicable the type of transfer of care) request.
Codes for types of referral; e.g. consult, transfer, temporary transfer.
Urgency of referral / transfer of care request
An indication of the urgency of referral (or where applicable the type of transfer of care) request.
Codes indicating the relative priority of the referral.
Actions requested as part of the referral
The service(s) that is/are requested to be provided to the patient. For example: cardiac pacemaker insertion.
Codes indicating the types of services that might be requested as part of a referral.
R5: The context of the order details by reference (new)
R5: `ServiceRequest.orderDetail.parameterFocus` (new:CodeableReference(Device,DeviceDefinition,DeviceRequest,SupplyRequest,Medication,MedicationRequest,BiologicallyDerivedProduct,Substance))
Element `ServiceRequest.orderDetail.parameterFocus` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.orderDetail.parameterFocus` has a context of ReferralRequest.serviceRequested based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.orderDetail.parameterFocus` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
R5: The parameter details for the service being requested (new)
R5: `ServiceRequest.orderDetail.parameter` (new:BackboneElement)
Element `ServiceRequest.orderDetail.parameter` has a context of ProcedureRequest based on following the parent source element upwards and mapping to `ProcedureRequest`. Element `ServiceRequest.orderDetail.parameter` has a context of ReferralRequest.serviceRequested based on following the parent source element upwards and mapping to `ReferralRequest`. Element `ServiceRequest.orderDetail.parameter` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
The patient who is the subject of a referral or transfer of care request.
Referral of family, group or community is to be catered for by profiles.
R5: Individual or Entity the service is ordered for
Element `ServiceRequest.subject` is mapped to FHIR STU3 element `ProcedureRequest.subject` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.subject` is mapped to FHIR STU3 element `ReferralRequest.subject` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ServiceRequest.subject` with unmapped reference targets: Device, Group, Location, Patient.
The encounter at which the request for referral or transfer of care is initiated.
R5: Encounter in which the request was created additional types
R5: `ServiceRequest.encounter` additional types from child elements (display, identifier, reference, type)
Element `ServiceRequest.encounter` is mapped to FHIR STU3 element `ProcedureRequest.context` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.encounter` is mapped to FHIR STU3 element `ReferralRequest.context` as `SourceIsBroaderThanTarget`. The mappings for `ServiceRequest.encounter` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ServiceRequest.encounter` with unmapped reference targets: Encounter.
When the service(s) requested in the referral should occur
The period of time within which the services identified in the referral/transfer of care is specified or required to occur.
When the occurrenceDateTime is used, then it is indicating that the requested service must happen before the specified date.
Use cases: (1) to indicate that the requested service is not to happen before a specified date, and saving the start date in Period.start; (2) to indicate that the requested service must happen before a specified date, and saving the end date in Period.end; (3) to indicate that the requested service must happen during the specified dates ("start" and "end" values).
Date/DateTime of creation for draft requests and date of activation for active requests.
The individual who initiated the request and has responsibility for its activation.
onBehalfOf can only be specified if agent is practitioner or device
(agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()
contains(f:agent/f:reference/@value, '/Practitioner/') or contains(f:agent/f:reference/@value, '/Device/') or not(exists(f:onBehalfOf))
Additional Content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
The device, practitioner, etc. who initiated the request.
The organization the device or practitioner was acting on behalf of.
Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.
The clinical specialty (discipline) that the referral is requested for
Indication of the clinical domain or discipline to which the referral or transfer of care request is sent. For example: Cardiology Gastroenterology Diabetology.
Codes indicating the types of capability the referred to service provider must have.
Receiver of referral / transfer of care request
The healthcare provider(s) or provider organization(s) who/which is to receive the referral/transfer of care request.
There will be a primary receiver. But the request can be received by any number of "copied to" providers or organizations.
Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
Element `ServiceRequest.performer` is mapped to FHIR STU3 element `ProcedureRequest.performer` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.performer` is mapped to FHIR STU3 element `ReferralRequest.recipient` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ServiceRequest.performer` with unmapped reference targets: CareTeam, Device, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson. If multiple performers are present, it is interpreted as a list of *alternative* performers without any preference regardless of order. If order of preference is needed use the [http://hl7.org/fhir/StructureDefinition/request-performerOrder](http://hl7.org/fhir/extensions/StructureDefinition-request-performerOrder.html). Use CareTeam to represent a group of performers (for example, Practitioner A *and* Practitioner B).
Reason for referral / transfer of care request
Description of clinical condition indicating why referral/transfer of care is requested. For example: Pathological Anomalies, Disabled (physical or mental), Behavioral Management.
Codes indicating why the referral is being requested.
Indicates another resource whose existence justifies this request.
The reason element gives a short description of why the referral is being made, the description expands on this to support a more complete clinical summary.
Additonal information to support referral or transfer of care request
Any additional (administrative, financial or clinical) information required to support request for referral or transfer of care. For example: Presenting problems/chief complaints Medical History Family History Alerts Allergy/Intolerance and Adverse Reactions Medications Observations/Assessments (may include cognitive and fundtional assessments) Diagnostic Reports Care Plan.
R5: Additional clinical information additional types
R5: `ServiceRequest.supportingInfo` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Resource)) additional types from child elements (concept)
Element `ServiceRequest.supportingInfo` is mapped to FHIR STU3 element `ProcedureRequest.supportingInfo` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.supportingInfo` is mapped to FHIR STU3 element `ReferralRequest.supportingInfo` as `SourceIsBroaderThanTarget`. The mappings for `ServiceRequest.supportingInfo` do not cover the following types: CodeableReference. The mappings for `ServiceRequest.supportingInfo` do not cover the following types based on type expansion: concept. To represent information about how the services are to be delivered use the `instructions` element.
Comments made about the referral request by any of the participants.
Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.
This element does not point to the Provenance associated with the *current* version of the resource - as it would be created after this version existed. The Provenance for the current version can be retrieved with a _revinclude.
.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
R5: `ServiceRequest.relevantHistory` additional types from child elements (display, identifier, reference, type)
Element `ServiceRequest.relevantHistory` is mapped to FHIR STU3 element `ProcedureRequest.relevantHistory` as `SourceIsBroaderThanTarget`. Element `ServiceRequest.relevantHistory` is mapped to FHIR STU3 element `ReferralRequest.relevantHistory` as `SourceIsBroaderThanTarget`. The mappings for `ServiceRequest.relevantHistory` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `ServiceRequest.relevantHistory` with unmapped reference targets: Provenance. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.