Release 5 Draft Ballot

This page is part of the FHIR Specification (v4.6.0: R5 Draft Ballot). 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

Servicerequest-example-pt.xml

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Raw XML (canonical form + also see XML Format Specification)

Jump past Narrative

Example of an order for an physical therapy evaluation procedure (id = "physical-therapy")

<?xml version="1.0" encoding="UTF-8"?>

<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="physical-therapy"/> 
  <!--    insert contents here    -->
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative</b> </p> <p> <b> status</b> : completed</p> <p> <b> intent</b> : order</p> <p> <b> category</b> : <span> Evaluation</span> </p> <p> <b> code</b> : <span> Assessment of passive range of motion</span> </p> <p> <b> subject</b> : <a> Generated Summary: Medical record number: 12345 (USUAL); active; Peter James Chalmers
           (OFFICIAL), Jim , Peter James Windsor (MAIDEN); , Phone: (03) 5555 6473, Phone: (03) 3410
           5613, Phone: (03) 5555 8834; gender: male; birthDate: 1974-12-25; </a> </p> <p> <b> occurrence</b> : 2016-09-27</p> <p> <b> authoredOn</b> : 2016-09-20</p> <p> <b> requester</b> : <span> Ollie Ortho, MD</span> </p> <p> <b> performer</b> : <span> Paul Therapist, PT</span> </p> <h3> Reasons</h3> <table> <tr> <td> -</td> </tr> <tr> <td> *</td> </tr> </table> <p> <b> bodySite</b> : <span> Both knees</span> </p> </div> </text> <status value="completed"/> 
  <intent value="order"/> 
  <category> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="386053000"/> 
      <display value="Evaluation procedure (procedure)"/> 
    </coding> 
    <text value="Evaluation"/> 
  </category> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="710830005"/> 
      <display value="Assessment of passive range of motion (procedure)"/> 
    </coding> 
    <text value="Assessment of passive range of motion"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
  </subject> 
  <occurrenceDateTime value="2016-09-27"/> 
  <authoredOn value="2016-09-20"/> 
  <requester> 
      <display value="Ollie Ortho, MD"/> 
  </requester> 
  <performer> 
    <display value="Paul Therapist, PT"/> 
  </performer> 
   <reason> 
    <concept> 
        <text value="assessment of mobility limitations due to osteoarthritis"/> 
    </concept> 
  </reason> 
  <bodySite> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="36701003"/> 
      <display value="Both knees (body structure)"/> 
    </coding> 
    <text value="Both knees"/> 
  </bodySite> 
</ServiceRequest> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.