2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). 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: R3 R2

4.10 Resource ProcedureRequest - Content

This resource maintained by the Patient Care Work Group

A request for a procedure to be performed. May be a proposal or an order.

4.10.1 Scope and Usage

These resources have not yet undergone proper review by PC, CQI, CDS, and OO. At this time, they are to be considered only as draft resource proposals for potential submission.

A Procedure Request is a record of a request for a procedure to be performed. It can be used to represent a procedure that is planned, that is proposed, or that is ordered.

The procedure request may represent an order that is entered by a practitioner in a CPOE system as well as a proposal made by a clinical decision support system (CDSS) based on a patient's clinical record and context of care. Planned procedures may also be represented by this resource (though this use case is still being discussed and will need to be validated by Patient Care and Orders and Observation).

4.10.2 Boundaries and Relationships

Notes to reviewers:

Please note that the boundaries between a Diagnostic Order and a Procedure Request will need to be concretely defined by Patient Care.

4.10.3 Background and Context

The notion of a procedure request is of key importance to clinical decision support system which may recommend procedures based on a number of criteria evaluated on patient and other clinical information.

This resource is referenced by CarePlan2 and ClinicalAssessment

4.10.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ProcedureRequest DomainResourceProcedure Request
... identifier 0..*IdentifierIdentifier
... subject 1..1PatientSubject
... type 1..1CodeableConceptProcedure Type
... bodySite[x] Target body site
.... bodySiteCodeableConcept0..1CodeableConcept
.... bodySiteReference0..1BodySite
... indication 0..*CodeableConceptIndication
... timing[x] Timing
.... timingDateTime0..1dateTime
.... timingPeriod0..1Period
.... timingTiming0..1Timing
... encounter 0..1EncounterEncounter
... performer 0..1Practitioner | Organization | Patient | RelatedPersonPerformer
... status 0..1codeproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | aborted
ProcedureRequestStatus (Required)
... notes 0..*stringNotes
... asNeeded[x] PRN
.... asNeededBoolean0..1boolean
.... asNeededCodeableConcept0..1CodeableConcept
... orderedOn 0..1dateTimeWhen Requested
... orderer 0..1Practitioner | Patient | RelatedPerson | DeviceOrdering Party
... priority 0..1coderoutine | urgent | stat | asap
ProcedureRequestPriority (Required)

UML Diagram

ProcedureRequest (DomainResource)Identifiers assigned to this order by the order or by the receiveridentifier : Identifier 0..*The patient who will receive the proceduresubject : Reference(Patient) 1..1The specific procedure that is ordered. Use text if the exact nature of the procedure can't be codedtype : CodeableConcept 1..1Indicates the site on the subject's body where the procedure should be performed ( i.e. the target site)bodySite[x] : CodeableConcept|Reference(BodySite) 0..1The reason why the procedure is proposed or ordered. This procedure request may be motivated by a Condition for instanceindication : CodeableConcept 0..*The timing schedule for the proposed or ordered procedure. 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"timing[x] : dateTime|Period|Timing 0..1The encounter within which the procedure proposal or request was createdencounter : Reference(Encounter) 0..1E.g. surgeon, anaethetist, endoscopistperformer : Reference(Practitioner|Organization| Patient|RelatedPerson) 0..1The status of the orderstatus : code 0..1 « The status of the requestProcedureRequestStatus »Any other notes associated with this proposal or order - e.g., provider instructionsnotes : string 0..*If a CodeableConcept is present, it indicates the pre-condition for performing the procedureasNeeded[x] : boolean|CodeableConcept 0..1The time when the request was madeorderedOn : dateTime 0..1The healthcare professional responsible for proposing or ordering the procedureorderer : Reference(Practitioner|Patient| RelatedPerson|Device) 0..1The clinical priority associated with this orderpriority : code 0..1 « The priority of the requestProcedureRequestPriority »

XML Template

<ProcedureRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier --></identifier>
 <subject><!-- 1..1 Reference(Patient) Subject --></subject>
 <type><!-- 1..1 CodeableConcept Procedure Type --></type>
 <bodySite[x]><!-- 0..1 CodeableConcept|Reference(BodySite) Target body site --></bodySite[x]>
 <indication><!-- 0..* CodeableConcept Indication --></indication>
 <timing[x]><!-- 0..1 dateTime|Period|Timing Timing --></timing[x]>
 <encounter><!-- 0..1 Reference(Encounter) Encounter --></encounter>
 <performer><!-- 0..1 Reference(Practitioner|Organization|Patient|RelatedPerson) Performer --></performer>
 <status value="[code]"/><!-- 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | aborted -->
 <notes value="[string]"/><!-- 0..* Notes -->
 <asNeeded[x]><!-- 0..1 boolean|CodeableConcept PRN --></asNeeded[x]>
 <orderedOn value="[dateTime]"/><!-- 0..1 When Requested -->
 <orderer><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson|Device) Ordering Party --></orderer>
 <priority value="[code]"/><!-- 0..1 routine | urgent | stat | asap -->
</ProcedureRequest>

JSON Template

{doco
  "resourceType" : "ProcedureRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier
  "subject" : { Reference(Patient) }, // R! Subject
  "type" : { CodeableConcept }, // R! Procedure Type
  // bodySite[x]: Target body site. One of these 2:
  "bodySiteCodeableConcept" : { CodeableConcept },
  "bodySiteReference" : { Reference(BodySite) },
  "indication" : [{ CodeableConcept }], // Indication
  // timing[x]: Timing. One of these 3:
  "timingDateTime" : "<dateTime>",
  "timingPeriod" : { Period },
  "timingTiming" : { Timing },
  "encounter" : { Reference(Encounter) }, // Encounter
  "performer" : { Reference(Practitioner|Organization|Patient|RelatedPerson) }, // Performer
  "status" : "<code>", // proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | aborted
  "notes" : ["<string>"], // Notes
  // asNeeded[x]: PRN. One of these 2:
  "asNeededBoolean" : <boolean>,
  "asNeededCodeableConcept" : { CodeableConcept },
  "orderedOn" : "<dateTime>", // When Requested
  "orderer" : { Reference(Practitioner|Patient|RelatedPerson|Device) }, // Ordering Party
  "priority" : "<code>" // routine | urgent | stat | asap
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ProcedureRequest DomainResourceProcedure Request
... identifier 0..*IdentifierIdentifier
... subject 1..1PatientSubject
... type 1..1CodeableConceptProcedure Type
... bodySite[x] Target body site
.... bodySiteCodeableConcept0..1CodeableConcept
.... bodySiteReference0..1BodySite
... indication 0..*CodeableConceptIndication
... timing[x] Timing
.... timingDateTime0..1dateTime
.... timingPeriod0..1Period
.... timingTiming0..1Timing
... encounter 0..1EncounterEncounter
... performer 0..1Practitioner | Organization | Patient | RelatedPersonPerformer
... status 0..1codeproposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | aborted
ProcedureRequestStatus (Required)
... notes 0..*stringNotes
... asNeeded[x] PRN
.... asNeededBoolean0..1boolean
.... asNeededCodeableConcept0..1CodeableConcept
... orderedOn 0..1dateTimeWhen Requested
... orderer 0..1Practitioner | Patient | RelatedPerson | DeviceOrdering Party
... priority 0..1coderoutine | urgent | stat | asap
ProcedureRequestPriority (Required)

UML Diagram

ProcedureRequest (DomainResource)Identifiers assigned to this order by the order or by the receiveridentifier : Identifier 0..*The patient who will receive the proceduresubject : Reference(Patient) 1..1The specific procedure that is ordered. Use text if the exact nature of the procedure can't be codedtype : CodeableConcept 1..1Indicates the site on the subject's body where the procedure should be performed ( i.e. the target site)bodySite[x] : CodeableConcept|Reference(BodySite) 0..1The reason why the procedure is proposed or ordered. This procedure request may be motivated by a Condition for instanceindication : CodeableConcept 0..*The timing schedule for the proposed or ordered procedure. 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"timing[x] : dateTime|Period|Timing 0..1The encounter within which the procedure proposal or request was createdencounter : Reference(Encounter) 0..1E.g. surgeon, anaethetist, endoscopistperformer : Reference(Practitioner|Organization| Patient|RelatedPerson) 0..1The status of the orderstatus : code 0..1 « The status of the requestProcedureRequestStatus »Any other notes associated with this proposal or order - e.g., provider instructionsnotes : string 0..*If a CodeableConcept is present, it indicates the pre-condition for performing the procedureasNeeded[x] : boolean|CodeableConcept 0..1The time when the request was madeorderedOn : dateTime 0..1The healthcare professional responsible for proposing or ordering the procedureorderer : Reference(Practitioner|Patient| RelatedPerson|Device) 0..1The clinical priority associated with this orderpriority : code 0..1 « The priority of the requestProcedureRequestPriority »

XML Template

<ProcedureRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier --></identifier>
 <subject><!-- 1..1 Reference(Patient) Subject --></subject>
 <type><!-- 1..1 CodeableConcept Procedure Type --></type>
 <bodySite[x]><!-- 0..1 CodeableConcept|Reference(BodySite) Target body site --></bodySite[x]>
 <indication><!-- 0..* CodeableConcept Indication --></indication>
 <timing[x]><!-- 0..1 dateTime|Period|Timing Timing --></timing[x]>
 <encounter><!-- 0..1 Reference(Encounter) Encounter --></encounter>
 <performer><!-- 0..1 Reference(Practitioner|Organization|Patient|RelatedPerson) Performer --></performer>
 <status value="[code]"/><!-- 0..1 proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | aborted -->
 <notes value="[string]"/><!-- 0..* Notes -->
 <asNeeded[x]><!-- 0..1 boolean|CodeableConcept PRN --></asNeeded[x]>
 <orderedOn value="[dateTime]"/><!-- 0..1 When Requested -->
 <orderer><!-- 0..1 Reference(Practitioner|Patient|RelatedPerson|Device) Ordering Party --></orderer>
 <priority value="[code]"/><!-- 0..1 routine | urgent | stat | asap -->
</ProcedureRequest>

JSON Template

{doco
  "resourceType" : "ProcedureRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier
  "subject" : { Reference(Patient) }, // R! Subject
  "type" : { CodeableConcept }, // R! Procedure Type
  // bodySite[x]: Target body site. One of these 2:
  "bodySiteCodeableConcept" : { CodeableConcept },
  "bodySiteReference" : { Reference(BodySite) },
  "indication" : [{ CodeableConcept }], // Indication
  // timing[x]: Timing. One of these 3:
  "timingDateTime" : "<dateTime>",
  "timingPeriod" : { Period },
  "timingTiming" : { Timing },
  "encounter" : { Reference(Encounter) }, // Encounter
  "performer" : { Reference(Practitioner|Organization|Patient|RelatedPerson) }, // Performer
  "status" : "<code>", // proposed | planned | requested | received | accepted | in-progress | completed | suspended | rejected | aborted
  "notes" : ["<string>"], // Notes
  // asNeeded[x]: PRN. One of these 2:
  "asNeededBoolean" : <boolean>,
  "asNeededCodeableConcept" : { CodeableConcept },
  "orderedOn" : "<dateTime>", // When Requested
  "orderer" : { Reference(Practitioner|Patient|RelatedPerson|Device) }, // Ordering Party
  "priority" : "<code>" // routine | urgent | stat | asap
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

4.10.4.1 Terminology Bindings

PathDefinitionTypeReference
ProcedureRequest.status The status of the requestFixedhttp://hl7.org/fhir/procedure-request-status
ProcedureRequest.priority The priority of the requestFixedhttp://hl7.org/fhir/procedure-request-priority

Notes to reviewers:

At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

4.10.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
patientreferenceSearch by subject - a patientProcedureRequest.subject
(Patient)
subjectreferenceSearch by subjectProcedureRequest.subject
(Patient)