Release 4B Ballot #1

This page is part of the FHIR Specification v4.1.0: R4B Ballot. About the R4B version of FHIR. The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Patient Care Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the CommunicationRequest resource.

CommunicationRequest
Element IdCommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

Cardinality0..*
TypeDomainResource
Summaryfalse
CommunicationRequest.identifier
Element IdCommunicationRequest.identifier
Definition

Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Summarytrue
Comments

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.

CommunicationRequest.basedOn
Element IdCommunicationRequest.basedOn
Definition

A plan or proposal that is fulfilled in whole or in part by this request.

Cardinality0..*
TypeReference(Any)
Requirements

Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

Alternate Namesfulfills
Summarytrue
CommunicationRequest.replaces
Element IdCommunicationRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

Cardinality0..*
TypeReference(CommunicationRequest)
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Namessupersedes; prior
Summarytrue
Comments

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.

CommunicationRequest.groupIdentifier
Element IdCommunicationRequest.groupIdentifier
Definition

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

Cardinality0..1
TypeIdentifier
Alternate NamesgrouperId
Summarytrue
Comments

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

CommunicationRequest.status
Element IdCommunicationRequest.status
Definition

The status of the proposal or order.

Cardinality1..1
Terminology BindingRequestStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled 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.)
Summarytrue
CommunicationRequest.statusReason
Element IdCommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

Cardinality0..1
Terminology BindingCommunicationRequestStatusReason:
TypeCodeableConcept
Alternate NamesSuspended Reason; Cancelled Reason
Summaryfalse
Comments

This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].

CommunicationRequest.category
Element IdCommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

Cardinality0..*
Terminology BindingCommunicationCategory (Example)
TypeCodeableConcept
Summaryfalse
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

CommunicationRequest.priority
Element IdCommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Cardinality0..1
Terminology BindingRequestPriority (Required)
Typecode
Meaning if MissingIf missing, this task should be performed with normal priority
Summarytrue
CommunicationRequest.doNotPerform
Element IdCommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

Cardinality0..1
Typeboolean
Is Modifiertrue (Reason: If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.)
Meaning if MissingIf do not perform is not specified, the request is a positive request e.g. "do perform"
Alternate Namesprohibited
Summarytrue
Comments

The attributes provided with the request qualify what is not to be done.

CommunicationRequest.medium
Element IdCommunicationRequest.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Cardinality0..*
Terminology BindingParticipationMode (Example)
TypeCodeableConcept
Summaryfalse
CommunicationRequest.subject
Element IdCommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

Cardinality0..1
TypeReference(Patient | Group)
Alternate Namespatient
Summaryfalse
CommunicationRequest.about
Element IdCommunicationRequest.about
Definition

Other resources that pertain to this communication request and to which this communication request should be associated.

Cardinality0..*
TypeReference(Any)
Summaryfalse
Comments

Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.

CommunicationRequest.encounter
Element IdCommunicationRequest.encounter
Definition

The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

Cardinality0..1
TypeReference(Encounter)
Summarytrue
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

CommunicationRequest.payload
Element IdCommunicationRequest.payload
Definition

Text, attachment(s), or resource(s) to be communicated to the recipient.

Cardinality0..*
Summaryfalse
CommunicationRequest.payload.content[x]
Element IdCommunicationRequest.payload.content[x]
Definition

The communicated content (or for multi-part communications, one portion of the communication).

Cardinality1..1
Typestring|Attachment|Reference(Any)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
CommunicationRequest.occurrence[x]
Element IdCommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

Cardinality0..1
TypedateTime|Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Alternate Namestiming
Summarytrue
CommunicationRequest.authoredOn
Element IdCommunicationRequest.authoredOn
Definition

For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

Cardinality0..1
TypedateTime
Alternate NamescreatedOn
Summarytrue
CommunicationRequest.requester
Element IdCommunicationRequest.requester
Definition

The device, individual, or organization who initiated the request and has responsibility for its activation.

Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
Alternate Namesauthor
Summarytrue
CommunicationRequest.recipient
Element IdCommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

Cardinality0..*
TypeReference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)
Summaryfalse
CommunicationRequest.sender
Element IdCommunicationRequest.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

Cardinality0..1
TypeReference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)
Summarytrue
CommunicationRequest.reasonCode
Element IdCommunicationRequest.reasonCode
Definition

Describes why the request is being made in coded or textual form.

Cardinality0..*
Terminology Bindingv3 Code System ActReason (Example)
TypeCodeableConcept
Summarytrue
Comments

Textual reasons can be captured using reasonCode.text.

CommunicationRequest.reasonReference
Element IdCommunicationRequest.reasonReference
Definition

Indicates another resource whose existence justifies this request.

Cardinality0..*
TypeReference(Condition | Observation | DiagnosticReport | DocumentReference)
Summarytrue
CommunicationRequest.note
Element IdCommunicationRequest.note
Definition

Comments made about the request by the requester, sender, recipient, subject or other participants.

Cardinality0..*
TypeAnnotation
Summaryfalse