Extensions for Using Data Elements from FHIR R5 in FHIR R4
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Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R5_DeviceRequest_R4 - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-DeviceRequest resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. DeviceRequest
Definition

Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

ShortMedical device request
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. DeviceRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. DeviceRequest.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on DeviceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. DeviceRequest.extension:quantity
    Slice Namequantity
    Definition

    R5: DeviceRequest.quantity (new:integer)

    ShortR5: Quantity of devices to supply (new)
    Comments

    Element DeviceRequest.quantity has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.quantity has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Quantity of devices to supply (new)) (Extension Type: integer)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. DeviceRequest.extension:performer
    Slice Nameperformer
    Definition

    R5: DeviceRequest.performer additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Practitioner), CodeableReference(http://hl7.org/fhir/StructureDefinition/PractitionerRole), CodeableReference(http://hl7.org/fhir/StructureDefinition/Organization), CodeableReference(http://hl7.org/fhir/StructureDefinition/CareTeam), CodeableReference(http://hl7.org/fhir/StructureDefinition/HealthcareService), CodeableReference(http://hl7.org/fhir/StructureDefinition/Patient), CodeableReference(http://hl7.org/fhir/StructureDefinition/Device), CodeableReference(http://hl7.org/fhir/StructureDefinition/RelatedPerson))

    ShortR5: Requested Filler additional types
    Comments

    Element DeviceRequest.performer is mapped to FHIR R4 element DeviceRequest.performerType as SourceIsBroaderThanTarget. Element DeviceRequest.performer is mapped to FHIR R4 element DeviceRequest.performer as SourceIsBroaderThanTarget. The mappings for DeviceRequest.performer do not cover the following types: CodeableReference.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Requested Filler additional types) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. DeviceRequest.extension:reason
    Slice Namereason
    Definition

    R5: DeviceRequest.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))

    ShortR5: Coded/Linked Reason for request additional types
    Comments

    Element DeviceRequest.reason is mapped to FHIR R4 element DeviceRequest.reasonCode as SourceIsBroaderThanTarget. Element DeviceRequest.reason is mapped to FHIR R4 element DeviceRequest.reasonReference as SourceIsBroaderThanTarget. The mappings for DeviceRequest.reason do not cover the following types: CodeableReference.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Coded/Linked Reason for request additional types) (Complex Extension)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. DeviceRequest.extension:asNeeded
    Slice NameasNeeded
    Definition

    R5: DeviceRequest.asNeeded (new:boolean)

    ShortR5: PRN status of request (new)
    Comments

    Element DeviceRequest.asNeeded has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.asNeeded has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: PRN status of request (new)) (Extension Type: boolean)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. DeviceRequest.extension:asNeededFor
    Slice NameasNeededFor
    Definition

    R5: DeviceRequest.asNeededFor (new:CodeableConcept)

    ShortR5: Device usage reason (new)
    Comments

    Element DeviceRequest.asNeededFor has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.asNeededFor has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Device usage reason (new)) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. DeviceRequest.modifierExtension
    Definition

    An Extension


    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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensionExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. DeviceRequest.modifierExtension:doNotPerform
      Slice NamedoNotPerform
      Definition

      R5: DeviceRequest.doNotPerform (new:boolean)

      ShortR5: True if the request is to stop or not to start using the device (new)
      Comments

      Element DeviceRequest.doNotPerform has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.doNotPerform has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If do not perform is not specified, the request is a positive request e.g. "do perform". DeviceRequest.reasonCode includes the reason for marking the DeviceRequest as 'do not perform'.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(R5: True if the request is to stop or not to start using the device (new)) (Extension Type: boolean)
      Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc.)
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      20. DeviceRequest.status
      Definition

      The status of the request.

      Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
      Comments

      This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.

      Control0..1
      BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

      Codes representing the status of the request.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. DeviceRequest.intent
      Definition

      Whether the request is a proposal, plan, an original order or a reflex order.

      Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
      Control1..1
      BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

      The kind of diagnostic request.

      Typecode
      Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. DeviceRequest.code[x]
      Definition

      The details of the device to be used.

      ShortDevice requested
      Control1..1
      BindingFor example codes, see FHIRDeviceTypeshttp://hl7.org/fhir/ValueSet/device-kind|4.0.1
      (example to http://hl7.org/fhir/ValueSet/device-kind|4.0.1)

      Codes for devices that can be requested.

      TypeChoice of: Reference(Device), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. DeviceRequest.subject
      Definition

      The patient who will use the device.

      ShortFocus of request
      Control1..1
      TypeReference(Patient, Group, Location, Device)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be foundhere

      0. DeviceRequest
      2. DeviceRequest.extension
      Control0..*
      SlicingThis element introduces a set of slices on DeviceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 4. DeviceRequest.extension:quantity
        Slice Namequantity
        Definition

        R5: DeviceRequest.quantity (new:integer)

        ShortR5: Quantity of devices to supply (new)
        Comments

        Element DeviceRequest.quantity has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.quantity has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

        Control0..1
        TypeExtension(R5: Quantity of devices to supply (new)) (Extension Type: integer)
        6. DeviceRequest.extension:performer
        Slice Nameperformer
        Definition

        R5: DeviceRequest.performer additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Practitioner), CodeableReference(http://hl7.org/fhir/StructureDefinition/PractitionerRole), CodeableReference(http://hl7.org/fhir/StructureDefinition/Organization), CodeableReference(http://hl7.org/fhir/StructureDefinition/CareTeam), CodeableReference(http://hl7.org/fhir/StructureDefinition/HealthcareService), CodeableReference(http://hl7.org/fhir/StructureDefinition/Patient), CodeableReference(http://hl7.org/fhir/StructureDefinition/Device), CodeableReference(http://hl7.org/fhir/StructureDefinition/RelatedPerson))

        ShortR5: Requested Filler additional types
        Comments

        Element DeviceRequest.performer is mapped to FHIR R4 element DeviceRequest.performerType as SourceIsBroaderThanTarget. Element DeviceRequest.performer is mapped to FHIR R4 element DeviceRequest.performer as SourceIsBroaderThanTarget. The mappings for DeviceRequest.performer do not cover the following types: CodeableReference.

        Control0..1
        TypeExtension(R5: Requested Filler additional types) (Complex Extension)
        8. DeviceRequest.extension:reason
        Slice Namereason
        Definition

        R5: DeviceRequest.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))

        ShortR5: Coded/Linked Reason for request additional types
        Comments

        Element DeviceRequest.reason is mapped to FHIR R4 element DeviceRequest.reasonCode as SourceIsBroaderThanTarget. Element DeviceRequest.reason is mapped to FHIR R4 element DeviceRequest.reasonReference as SourceIsBroaderThanTarget. The mappings for DeviceRequest.reason do not cover the following types: CodeableReference.

        Control0..*
        TypeExtension(R5: Coded/Linked Reason for request additional types) (Complex Extension)
        10. DeviceRequest.extension:asNeeded
        Slice NameasNeeded
        Definition

        R5: DeviceRequest.asNeeded (new:boolean)

        ShortR5: PRN status of request (new)
        Comments

        Element DeviceRequest.asNeeded has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.asNeeded has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

        Control0..1
        TypeExtension(R5: PRN status of request (new)) (Extension Type: boolean)
        12. DeviceRequest.extension:asNeededFor
        Slice NameasNeededFor
        Definition

        R5: DeviceRequest.asNeededFor (new:CodeableConcept)

        ShortR5: Device usage reason (new)
        Comments

        Element DeviceRequest.asNeededFor has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.asNeededFor has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

        Control0..1
        TypeExtension(R5: Device usage reason (new)) (Extension Type: CodeableConcept)
        14. DeviceRequest.modifierExtension
        Control0..*
        SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. DeviceRequest.modifierExtension:doNotPerform
          Slice NamedoNotPerform
          Definition

          R5: DeviceRequest.doNotPerform (new:boolean)

          ShortR5: True if the request is to stop or not to start using the device (new)
          Comments

          Element DeviceRequest.doNotPerform has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.doNotPerform has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If do not perform is not specified, the request is a positive request e.g. "do perform". DeviceRequest.reasonCode includes the reason for marking the DeviceRequest as 'do not perform'.

          Control0..1
          TypeExtension(R5: True if the request is to stop or not to start using the device (new)) (Extension Type: boolean)
          18. DeviceRequest.priorRequest
          20. DeviceRequest.priorRequest.extension
          Control0..*
          SlicingThis element introduces a set of slices on DeviceRequest.priorRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 22. DeviceRequest.priorRequest.extension:replaces
            Slice Namereplaces
            Definition

            R5: DeviceRequest.replaces additional types from child elements (display, identifier, reference, type)

            ShortR5: replaces additional types
            Comments

            Element DeviceRequest.replaces is mapped to FHIR R4 element DeviceRequest.priorRequest as SourceIsBroaderThanTarget. The mappings for DeviceRequest.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 DeviceRequest.replaces with unmapped reference targets: DeviceRequest.

            Control0..*
            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))

            Guidance on how to interpret the contents of this table can be foundhere

            0. DeviceRequest
            Definition

            Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

            ShortMedical device request
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            2. DeviceRequest.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Is Modifierfalse
            Summarytrue
            4. DeviceRequest.meta
            Definition

            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. DeviceRequest.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

            ShortA set of rules under which this content was created
            Comments

            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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

            Control0..1
            Typeuri
            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            8. DeviceRequest.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            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).

            Control0..1
            BindingThe codes SHOULD be taken from CommonLanguages .
            (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            10. DeviceRequest.text
            Definition

            A human-readable narrative that contains a summary of the resource and can 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.

            ShortText summary of the resource, for human interpretation
            Comments

            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 information is added later.

            Control0..1
            TypeNarrative
            Is Modifierfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. DeviceRequest.contained
            Definition

            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.

            ShortContained, inline Resources
            Comments

            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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

            Control0..*
            TypeResource
            Is Modifierfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            14. DeviceRequest.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on DeviceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 16. DeviceRequest.extension:quantity
              Slice Namequantity
              Definition

              R5: DeviceRequest.quantity (new:integer)

              ShortR5: Quantity of devices to supply (new)
              Comments

              Element DeviceRequest.quantity has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.quantity has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Quantity of devices to supply (new)) (Extension Type: integer)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. DeviceRequest.extension:performer
              Slice Nameperformer
              Definition

              R5: DeviceRequest.performer additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/Practitioner), CodeableReference(http://hl7.org/fhir/StructureDefinition/PractitionerRole), CodeableReference(http://hl7.org/fhir/StructureDefinition/Organization), CodeableReference(http://hl7.org/fhir/StructureDefinition/CareTeam), CodeableReference(http://hl7.org/fhir/StructureDefinition/HealthcareService), CodeableReference(http://hl7.org/fhir/StructureDefinition/Patient), CodeableReference(http://hl7.org/fhir/StructureDefinition/Device), CodeableReference(http://hl7.org/fhir/StructureDefinition/RelatedPerson))

              ShortR5: Requested Filler additional types
              Comments

              Element DeviceRequest.performer is mapped to FHIR R4 element DeviceRequest.performerType as SourceIsBroaderThanTarget. Element DeviceRequest.performer is mapped to FHIR R4 element DeviceRequest.performer as SourceIsBroaderThanTarget. The mappings for DeviceRequest.performer do not cover the following types: CodeableReference.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Requested Filler additional types) (Complex Extension)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              20. DeviceRequest.extension:reason
              Slice Namereason
              Definition

              R5: DeviceRequest.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))

              ShortR5: Coded/Linked Reason for request additional types
              Comments

              Element DeviceRequest.reason is mapped to FHIR R4 element DeviceRequest.reasonCode as SourceIsBroaderThanTarget. Element DeviceRequest.reason is mapped to FHIR R4 element DeviceRequest.reasonReference as SourceIsBroaderThanTarget. The mappings for DeviceRequest.reason do not cover the following types: CodeableReference.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Coded/Linked Reason for request additional types) (Complex Extension)
              Is Modifierfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              22. DeviceRequest.extension:asNeeded
              Slice NameasNeeded
              Definition

              R5: DeviceRequest.asNeeded (new:boolean)

              ShortR5: PRN status of request (new)
              Comments

              Element DeviceRequest.asNeeded has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.asNeeded has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: PRN status of request (new)) (Extension Type: boolean)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              24. DeviceRequest.extension:asNeededFor
              Slice NameasNeededFor
              Definition

              R5: DeviceRequest.asNeededFor (new:CodeableConcept)

              ShortR5: Device usage reason (new)
              Comments

              Element DeviceRequest.asNeededFor has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.asNeededFor has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(R5: Device usage reason (new)) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              26. DeviceRequest.modifierExtension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on DeviceRequest.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 28. DeviceRequest.modifierExtension:doNotPerform
                Slice NamedoNotPerform
                Definition

                R5: DeviceRequest.doNotPerform (new:boolean)

                ShortR5: True if the request is to stop or not to start using the device (new)
                Comments

                Element DeviceRequest.doNotPerform has a context of DeviceRequest based on following the parent source element upwards and mapping to DeviceRequest. Element DeviceRequest.doNotPerform has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If do not perform is not specified, the request is a positive request e.g. "do perform". DeviceRequest.reasonCode includes the reason for marking the DeviceRequest as 'do not perform'.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(R5: True if the request is to stop or not to start using the device (new)) (Extension Type: boolean)
                Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc.)
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                30. DeviceRequest.identifier
                Definition

                Identifiers assigned to this order by the orderer or by the receiver.

                ShortExternal Request identifier
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. DeviceRequest.instantiatesCanonical
                Definition

                The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

                ShortInstantiates FHIR protocol or definition
                Comments

                Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                Control0..*
                Typecanonical(ActivityDefinition, PlanDefinition)
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. DeviceRequest.instantiatesUri
                Definition

                The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

                ShortInstantiates external protocol or definition
                Comments

                This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                Control0..*
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. DeviceRequest.basedOn
                Definition

                Plan/proposal/order fulfilled by this request.

                ShortWhat request fulfills
                Control0..*
                TypeReference(Resource)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. DeviceRequest.priorRequest
                Definition

                The request takes the place of the referenced completed or terminated request(s).

                ShortWhat request replaces
                Control0..*
                TypeReference(Resource)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. DeviceRequest.priorRequest.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                42. DeviceRequest.priorRequest.extension
                Definition

                An Extension

                ShortExtension
                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on DeviceRequest.priorRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 44. DeviceRequest.priorRequest.extension:replaces
                  Slice Namereplaces
                  Definition

                  R5: DeviceRequest.replaces additional types from child elements (display, identifier, reference, type)

                  ShortR5: replaces additional types
                  Comments

                  Element DeviceRequest.replaces is mapped to FHIR R4 element DeviceRequest.priorRequest as SourceIsBroaderThanTarget. The mappings for DeviceRequest.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 DeviceRequest.replaces with unmapped reference targets: DeviceRequest.

                  Control0..1
                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  46. DeviceRequest.priorRequest.reference
                  Definition

                  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.

                  ShortLiteral reference, Relative, internal or absolute URL
                  Comments

                  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.

                  Control0..1
                  This element is affected by the following invariants: ref-1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. DeviceRequest.priorRequest.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  ShortType the reference refers to (e.g. "Patient")
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from ResourceType .
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. DeviceRequest.priorRequest.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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.

                  ShortLogical reference, when literal reference is not known
                  Comments

                  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.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. DeviceRequest.priorRequest.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  ShortText alternative for the resource
                  Comments

                  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.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. DeviceRequest.groupIdentifier
                  Definition

                  Composite request this is part of.

                  ShortIdentifier of composite request
                  Control0..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. DeviceRequest.status
                  Definition

                  The status of the request.

                  Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
                  Comments

                  This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.

                  Control0..1
                  BindingThe codes SHALL be taken from RequestStatus
                  (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

                  Codes representing the status of the request.

                  Typecode
                  Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. DeviceRequest.intent
                  Definition

                  Whether the request is a proposal, plan, an original order or a reflex order.

                  Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
                  Control1..1
                  BindingThe codes SHALL be taken from RequestIntent
                  (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

                  The kind of diagnostic request.

                  Typecode
                  Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  60. DeviceRequest.priority
                  Definition

                  Indicates how quickly the {{title}} should be addressed with respect to other requests.

                  Shortroutine | urgent | asap | stat
                  Control0..1
                  BindingThe codes SHALL be taken from RequestPriority
                  (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

                  Identifies the level of importance to be assigned to actioning the request.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Meaning if MissingIf missing, normal priority
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  62. DeviceRequest.code[x]
                  Definition

                  The details of the device to be used.

                  ShortDevice requested
                  Control1..1
                  BindingFor example codes, see FHIRDeviceTypes
                  (example to http://hl7.org/fhir/ValueSet/device-kind|4.0.1)

                  Codes for devices that can be requested.

                  TypeChoice of: Reference(Device), CodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  64. DeviceRequest.parameter
                  Definition

                  Specific parameters for the ordered item. For example, the prism value for lenses.

                  ShortDevice details
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  66. DeviceRequest.parameter.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  68. DeviceRequest.parameter.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  70. DeviceRequest.parameter.modifierExtension
                  Definition

                  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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  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.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  72. DeviceRequest.parameter.code
                  Definition

                  A code or string that identifies the device detail being asserted.

                  ShortDevice detail
                  Control0..1
                  Binding

                  A code that identifies the device detail.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. DeviceRequest.parameter.value[x]
                  Definition

                  The value of the device detail.

                  ShortValue of detail
                  Comments

                  Range means device should have a value that falls somewhere within the specified range.

                  Control0..1
                  TypeChoice of: CodeableConcept, Quantity, Range, boolean
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. DeviceRequest.subject
                  Definition

                  The patient who will use the device.

                  ShortFocus of request
                  Control1..1
                  TypeReference(Patient, Group, Location, Device)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  78. DeviceRequest.encounter
                  Definition

                  An encounter that provides additional context in which this request is made.

                  ShortEncounter motivating request
                  Control0..1
                  TypeReference(Encounter)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  80. DeviceRequest.occurrence[x]
                  Definition

                  The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".

                  ShortDesired time or schedule for use
                  Control0..1
                  TypeChoice of: dateTime, Period, Timing
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  82. DeviceRequest.authoredOn
                  Definition

                  When the request transitioned to being actionable.

                  ShortWhen recorded
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  84. DeviceRequest.requester
                  Definition

                  The individual who initiated the request and has responsibility for its activation.

                  ShortWho/what is requesting diagnostics
                  Control0..1
                  TypeReference(Device, Practitioner, PractitionerRole, Organization)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. DeviceRequest.performerType
                  Definition

                  Desired type of performer for doing the diagnostic testing.

                  ShortFiller role
                  Control0..1
                  BindingFor example codes, see ParticipantRoles
                  (example to http://hl7.org/fhir/ValueSet/participant-role|4.0.1)

                  Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. DeviceRequest.performer
                  Definition

                  The desired performer for doing the diagnostic testing.

                  ShortRequested Filler
                  Control0..1
                  TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. DeviceRequest.reasonCode
                  Definition

                  Reason or justification for the use of this device.

                  ShortCoded Reason for request
                  Control0..*
                  BindingFor example codes, see Condition/Problem/DiagnosisCodes
                  (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                  Diagnosis or problem codes justifying the reason for requesting the device.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. DeviceRequest.reasonReference
                  Definition

                  Reason or justification for the use of this device.

                  ShortLinked Reason for request
                  Control0..*
                  TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. DeviceRequest.insurance
                  Definition

                  Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

                  ShortAssociated insurance coverage
                  Control0..*
                  TypeReference(Coverage, ClaimResponse)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. DeviceRequest.supportingInfo
                  Definition

                  Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site).

                  ShortAdditional clinical information
                  Control0..*
                  TypeReference(Resource)
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Knowing where the device is targeted is important for tracking if multiple sites are possible.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. DeviceRequest.note
                  Definition

                  Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

                  ShortNotes or comments
                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. DeviceRequest.relevantHistory
                  Definition

                  Key events in the history of the request.

                  ShortRequest provenance
                  Comments

                  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.

                  Control0..*
                  TypeReference(Provenance)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))