CH eTOC (R4)
3.0.0-ballot - ballot Switzerland flag

This page is part of the CH eTOC (R4) (v3.0.0-ballot: STU 3 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: ChEtocServiceRequest - Detailed Descriptions

Active as of 2024-05-17

Definitions for the ch-etoc-servicerequest resource profile.

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

0. ServiceRequest
Definition

This IG adheres to the FHIR International Patient Summary (IPS) Implementation Guide. Clinical content uses mostly the same resources as the IPS; some minor differences are explained in comments to the resources affected. The resource definitions are however constrained from FHIR base definitions and Swiss Core definitions and NOT from UVIPS. This decision was made in order to minimize unexpected impact of future changes in IPS and for compatibility with Swiss Core. eTOC adds a ServiceRequest resource to the clinical content (according to the IPS) in order to depict the reason for a referral, the requested service and some additional information (e.g. coverage, room preferance etc.). Resources for such purpose are referenced by the ServiceRequest resource. Header information such as sender, receiver etc. are condsidered as Generic Elements (to all sorts of referral, orders etc.) and follow the definition in the ORF Implementation Guide.

This IG follows the Swiss eHealth Exchange Format Handbook Part I: Service Requests V 0.13. The Questionnaire resource gives gudiance for the implementaion of the user interface.

ShortCH eTOC Service Request
2. ServiceRequest.code
BindingFor example codes, see ProcedureCodes(SNOMEDCT)
(example to http://hl7.org/fhir/ValueSet/procedure-code)

Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.

Must Supporttrue
4. ServiceRequest.code.text
Must Supporttrue
6. ServiceRequest.reasonCode
Must Supporttrue
8. ServiceRequest.reasonCode.text
Must Supporttrue
10. ServiceRequest.reasonReference
ShortExplanation/Justification for service or service (primary diagnosis)
TypeReference(CH eTOC Primary Diagnosis Condition)
Must Supporttrue
12. ServiceRequest.supportingInfo
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • profile @ resolve()
  • 14. ServiceRequest.supportingInfo:secondarydiagnosis
    Slice Namesecondarydiagnosis
    ShortAdditional problem / secondary diagnosis
    Control0..*
    TypeReference(CH eTOC Secondary Diagnosis Condition)
    Must Supporttrue
    16. ServiceRequest.supportingInfo:bodyHeight
    Slice NamebodyHeight
    Control0..1
    TypeReference(CH eTOC Body Height Observation)
    Must Supporttrue
    18. ServiceRequest.supportingInfo:bodyWeight
    Slice NamebodyWeight
    Control0..1
    TypeReference(CH eTOC Body Weight Observation)
    Must Supporttrue
    20. ServiceRequest.supportingInfo:pregnancy
    Slice Namepregnancy
    Control0..1
    TypeReference(CH eTOC Pregnancy Status Observation)
    Must Supporttrue
    22. ServiceRequest.supportingInfo:historyofIllnesses
    Slice NamehistoryofIllnesses
    Control0..*
    TypeReference(CH eTOC Past History of Illnesses Condition)
    Must Supporttrue
    24. ServiceRequest.supportingInfo:historyofProcedures
    Slice NamehistoryofProcedures
    Control0..*
    TypeReference(CH eTOC Procedure)
    Must Supporttrue
    26. ServiceRequest.supportingInfo:devices
    Slice Namedevices
    Control0..*
    TypeReference(CH eTOC Device)
    Must Supporttrue
    28. ServiceRequest.supportingInfo:socialHistory
    Slice NamesocialHistory
    Control0..1
    TypeReference(CH eTOC Social History Condition)
    Must Supporttrue
    30. ServiceRequest.supportingInfo:functionalStatus
    Slice NamefunctionalStatus
    Control0..*
    TypeReference(CH eTOC Functional Status Condition)
    Must Supporttrue
    32. ServiceRequest.supportingInfo:medicationstatement
    Slice Namemedicationstatement
    ShortMedicationStatement contains one medication with dosage
    Control0..*
    TypeReference(CH Core MedicationStatement)
    Must Supporttrue
    34. ServiceRequest.supportingInfo:allergiesIntolerances
    Slice NameallergiesIntolerances
    Control0..*
    TypeReference(CH eTOC Allergy Intolerance)
    Must Supporttrue
    36. ServiceRequest.supportingInfo:immunizations
    Slice Nameimmunizations
    Control0..*
    TypeReference(CH eTOC immunizationstatus)
    Must Supporttrue
    38. ServiceRequest.supportingInfo:labresults
    Slice Namelabresults
    Control0..*
    TypeReference(CH eTOC Lab Observation)
    Must Supporttrue
    40. ServiceRequest.supportingInfo:pathologyresults
    Slice Namepathologyresults
    Control0..*
    TypeReference(CH eTOC Pathology Observation)
    Must Supporttrue
    42. ServiceRequest.supportingInfo:imagingresults
    Slice Nameimagingresults
    Control0..*
    TypeReference(CH eTOC Radiology Observation)
    Must Supporttrue
    44. ServiceRequest.supportingInfo:cardiologyresults
    Slice Namecardiologyresults
    Control0..*
    TypeReference(CH eTOC Cardiology Observation)
    Must Supporttrue
    46. ServiceRequest.supportingInfo:attachment
    Slice Nameattachment
    Control0..*

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

    0. ServiceRequest
    Definition

    This IG adheres to the FHIR International Patient Summary (IPS) Implementation Guide. Clinical content uses mostly the same resources as the IPS; some minor differences are explained in comments to the resources affected. The resource definitions are however constrained from FHIR base definitions and Swiss Core definitions and NOT from UVIPS. This decision was made in order to minimize unexpected impact of future changes in IPS and for compatibility with Swiss Core. eTOC adds a ServiceRequest resource to the clinical content (according to the IPS) in order to depict the reason for a referral, the requested service and some additional information (e.g. coverage, room preferance etc.). Resources for such purpose are referenced by the ServiceRequest resource. Header information such as sender, receiver etc. are condsidered as Generic Elements (to all sorts of referral, orders etc.) and follow the definition in the ORF Implementation Guide.

    This IG follows the Swiss eHealth Exchange Format Handbook Part I: Service Requests V 0.13. The Questionnaire resource gives gudiance for the implementaion of the user interface.


    A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

    ShortCH eTOC Service RequestA request for a service to be performed
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Alternate Namesdiagnostic request, referral, referral request, transfer of care request
    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())
    prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
    prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
    2. ServiceRequest.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()))
    4. ServiceRequest.extension:locationAndTime
    Slice NamelocationAndTime
    Definition

    Location and Time of ServiceRequest Fulfillment.

    ShortCH ORF Location and Time
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(CH ORF Location and Time) (Extension Type: Reference)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    6. ServiceRequest.extension:requestedEncounterDetails
    Slice NamerequestedEncounterDetails
    Definition

    Requested Encounter Details for ServiceRequest Fulfillment.

    ShortCH ORF Requested Encounter Details
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(CH ORF Requested Encounter Details) (Extension Type: Reference)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. ServiceRequest.modifierExtension
    Definition

    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).

    ShortExtensions 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())
    10. ServiceRequest.identifier
    Definition

    Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

    ShortIdentifiers assigned to this order
    Comments

    The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 12. ServiceRequest.identifier:placerOrderIdentifier
      Slice NameplacerOrderIdentifier
      Definition

      Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

      ShortPlacer Order IdentifierIdentifiers assigned to this order
      Comments

      The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Pattern Value{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PLAC"
          }]
        }
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. ServiceRequest.identifier:placerOrderIdentifier.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. ServiceRequest.identifier:placerOrderIdentifier.system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. ServiceRequest.identifier:placerOrderIdentifier.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Example<br/><b>General</b>:123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ServiceRequest.identifier:fillerOrderIdentifier
      Slice NamefillerOrderIdentifier
      Definition

      Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

      ShortFiller Order IdentifierIdentifiers assigned to this order
      Comments

      The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Pattern Value{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "FILL"
          }]
        }
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ServiceRequest.identifier:fillerOrderIdentifier.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. ServiceRequest.identifier:fillerOrderIdentifier.system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ServiceRequest.identifier:fillerOrderIdentifier.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Example<br/><b>General</b>:123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. ServiceRequest.status
      Definition

      The status of the order.

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

      The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.


      The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

      Control1..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)

      The status of a service order.

      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
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ServiceRequest.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
      Comments

      This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

      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 service 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
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. ServiceRequest.priority
      Definition

      Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

      ShortOrder priorityroutine | urgent | asap | stat
      Control0..1
      BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
      (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
      Must Supporttrue
      Summarytrue
      Meaning if MissingIf missing, this task should be performed with normal priority
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. ServiceRequest.doNotPerform
      Definition

      Set this to true if the record is saying that the service/procedure should NOT be performed.

      ShortTrue if service/procedure should not be performed
      Comments

      In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

      Control0..1
      Typeboolean
      Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

      Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. ServiceRequest.code
      Definition

      A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

      ShortWhat is being requested/ordered
      Comments

      Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

      Control0..1
      BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-code
      (example to http://hl7.org/fhir/ValueSet/procedure-code)

      Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.


      Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate Namesservice requested
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. ServiceRequest.code.text
      Definition

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. ServiceRequest.subject
      Definition

      The principle target of a particular form content is one patient (for obstetrical and neonatal use cases see...).


      On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

      ShortPatientIndividual or Entity the service is ordered for
      Control1..1
      TypeReference(CH Core Patient, Patient, Group, Location, Device)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. ServiceRequest.requester
      Definition

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

      ShortThe person/organization responsible for the form contentWho/what is requesting service
      Comments

      This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

      Control0..1
      TypeReference(CH Core PractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Alternate Namesauthor, orderer
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. ServiceRequest.reasonCode
      Definition

      An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

      ShortExplanation/Justification for procedure or service
      Comments

      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

      Control0..*
      BindingFor example codes, see ProcedureReasonCodeshttp://hl7.org/fhir/ValueSet/procedure-reason
      (example to http://hl7.org/fhir/ValueSet/procedure-reason)

      Diagnosis or problem codes justifying the reason for requesting the service investigation.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. ServiceRequest.reasonCode.text
      Definition

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. ServiceRequest.reasonReference
      Definition

      Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

      ShortExplanation/Justification for service or service (primary diagnosis)
      Comments

      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

      Control0..*
      TypeReference(CH eTOC Primary Diagnosis Condition, Condition, Observation, DiagnosticReport, DocumentReference)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. ServiceRequest.insurance
      Definition

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

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

      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

      ShortAdditional clinical information
      Comments

      To represent information about how the services are to be delivered use the instructions element.

      Control0..*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate NamesAsk at order entry question, AOE
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 54. ServiceRequest.supportingInfo:secondarydiagnosis
        Slice Namesecondarydiagnosis
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional problem / secondary diagnosisAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Secondary Diagnosis Condition, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. ServiceRequest.supportingInfo:bodyHeight
        Slice NamebodyHeight
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..1*
        TypeReference(CH eTOC Body Height Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. ServiceRequest.supportingInfo:bodyWeight
        Slice NamebodyWeight
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..1*
        TypeReference(CH eTOC Body Weight Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. ServiceRequest.supportingInfo:pregnancy
        Slice Namepregnancy
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..1*
        TypeReference(CH eTOC Pregnancy Status Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. ServiceRequest.supportingInfo:historyofIllnesses
        Slice NamehistoryofIllnesses
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Past History of Illnesses Condition, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. ServiceRequest.supportingInfo:historyofProcedures
        Slice NamehistoryofProcedures
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Procedure, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. ServiceRequest.supportingInfo:devices
        Slice Namedevices
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Device, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. ServiceRequest.supportingInfo:socialHistory
        Slice NamesocialHistory
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..1*
        TypeReference(CH eTOC Social History Condition, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. ServiceRequest.supportingInfo:functionalStatus
        Slice NamefunctionalStatus
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Functional Status Condition, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. ServiceRequest.supportingInfo:medicationstatement
        Slice Namemedicationstatement
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortMedicationStatement contains one medication with dosageAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH Core MedicationStatement, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. ServiceRequest.supportingInfo:allergiesIntolerances
        Slice NameallergiesIntolerances
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Allergy Intolerance, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. ServiceRequest.supportingInfo:immunizations
        Slice Nameimmunizations
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC immunizationstatus, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. ServiceRequest.supportingInfo:labresults
        Slice Namelabresults
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Lab Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. ServiceRequest.supportingInfo:pathologyresults
        Slice Namepathologyresults
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Pathology Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. ServiceRequest.supportingInfo:imagingresults
        Slice Nameimagingresults
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Radiology Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. ServiceRequest.supportingInfo:cardiologyresults
        Slice Namecardiologyresults
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(CH eTOC Cardiology Observation, Resource)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. ServiceRequest.supportingInfo:attachment
        Slice Nameattachment
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. ServiceRequest.note
        Definition

        Any other notes and comments made about the service request. For example, internal billing notes.

        ShortComments
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. ServiceRequest.note.text
        Definition

        The text of the annotation in markdown format.

        ShortThe annotation - text content (as markdown)
        Control1..1
        Typemarkdown
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-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 found here

        0. ServiceRequest
        Definition

        This IG adheres to the FHIR International Patient Summary (IPS) Implementation Guide. Clinical content uses mostly the same resources as the IPS; some minor differences are explained in comments to the resources affected. The resource definitions are however constrained from FHIR base definitions and Swiss Core definitions and NOT from UVIPS. This decision was made in order to minimize unexpected impact of future changes in IPS and for compatibility with Swiss Core. eTOC adds a ServiceRequest resource to the clinical content (according to the IPS) in order to depict the reason for a referral, the requested service and some additional information (e.g. coverage, room preferance etc.). Resources for such purpose are referenced by the ServiceRequest resource. Header information such as sender, receiver etc. are condsidered as Generic Elements (to all sorts of referral, orders etc.) and follow the definition in the ORF Implementation Guide.

        This IG follows the Swiss eHealth Exchange Format Handbook Part I: Service Requests V 0.13. The Questionnaire resource gives gudiance for the implementaion of the user interface.

        ShortCH eTOC Service Request
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Alternate Namesdiagnostic request, referral, referral request, transfer of care request
        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())
        prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
        2. ServiceRequest.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. ServiceRequest.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. ServiceRequest.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. ServiceRequest.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)

        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. ServiceRequest.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. ServiceRequest.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. ServiceRequest.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 ServiceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. ServiceRequest.extension:locationAndTime
          Slice NamelocationAndTime
          Definition

          Location and Time of ServiceRequest Fulfillment.

          ShortCH ORF Location and Time
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(CH ORF Location and Time) (Extension Type: Reference)
          Is Modifierfalse
          Must Supporttrue
          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. ServiceRequest.extension:requestedEncounterDetails
          Slice NamerequestedEncounterDetails
          Definition

          Requested Encounter Details for ServiceRequest Fulfillment.

          ShortCH ORF Requested Encounter Details
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(CH ORF Requested Encounter Details) (Extension Type: Reference)
          Is Modifierfalse
          Must Supporttrue
          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. ServiceRequest.modifierExtension
          Definition

          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).

          ShortExtensions 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())
          22. ServiceRequest.identifier
          Definition

          Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

          ShortIdentifiers assigned to this order
          Comments

          The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ $this
          • 24. ServiceRequest.identifier:placerOrderIdentifier
            Slice NameplacerOrderIdentifier
            Definition

            Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

            ShortPlacer Order Identifier
            Comments

            The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..1
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Pattern Value{
              "type" : {
                "coding" : [{
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PLAC"
                }]
              }
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. ServiceRequest.identifier:placerOrderIdentifier.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
            28. ServiceRequest.identifier:placerOrderIdentifier.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())
            SlicingThis element introduces a set of slices on ServiceRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 30. ServiceRequest.identifier:placerOrderIdentifier.use
              Definition

              The purpose of this identifier.

              Shortusual | official | temp | secondary | old (If known)
              Comments

              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

              Control0..1
              BindingThe codes SHALL be taken from IdentifierUse
              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

              Identifies the purpose for this identifier, if known .

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. ServiceRequest.identifier:placerOrderIdentifier.type
              Definition

              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

              ShortDescription of identifier
              Comments

              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows users to make use of identifiers when the identifier system is not known.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. ServiceRequest.identifier:placerOrderIdentifier.system
              Definition

              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. ServiceRequest.identifier:placerOrderIdentifier.value
              Definition

              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

              ShortThe value that is unique
              Comments

              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

              Control1..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Example<br/><b>General</b>:123456
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. ServiceRequest.identifier:placerOrderIdentifier.period
              Definition

              Time period during which identifier is/was valid for use.

              ShortTime period when id is/was valid for use
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. ServiceRequest.identifier:placerOrderIdentifier.assigner
              Definition

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. ServiceRequest.identifier:fillerOrderIdentifier
              Slice NamefillerOrderIdentifier
              Definition

              Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

              ShortFiller Order Identifier
              Comments

              The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Pattern Value{
                "type" : {
                  "coding" : [{
                    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                    "code" : "FILL"
                  }]
                }
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. ServiceRequest.identifier:fillerOrderIdentifier.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
              46. ServiceRequest.identifier:fillerOrderIdentifier.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())
              SlicingThis element introduces a set of slices on ServiceRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 48. ServiceRequest.identifier:fillerOrderIdentifier.use
                Definition

                The purpose of this identifier.

                Shortusual | official | temp | secondary | old (If known)
                Comments

                Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                Control0..1
                BindingThe codes SHALL be taken from IdentifierUse
                (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                Identifies the purpose for this identifier, if known .

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. ServiceRequest.identifier:fillerOrderIdentifier.type
                Definition

                A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                ShortDescription of identifier
                Comments

                This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows users to make use of identifiers when the identifier system is not known.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. ServiceRequest.identifier:fillerOrderIdentifier.system
                Definition

                Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                ShortThe namespace for the identifier value
                Comments

                Identifier.system is always case sensitive.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. ServiceRequest.identifier:fillerOrderIdentifier.value
                Definition

                The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                ShortThe value that is unique
                Comments

                If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                Control1..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Example<br/><b>General</b>:123456
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. ServiceRequest.identifier:fillerOrderIdentifier.period
                Definition

                Time period during which identifier is/was valid for use.

                ShortTime period when id is/was valid for use
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. ServiceRequest.identifier:fillerOrderIdentifier.assigner
                Definition

                Organization that issued/manages the identifier.

                ShortOrganization that issued id (may be just text)
                Comments

                The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                Control0..1
                TypeReference(Organization)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. ServiceRequest.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 ServiceRequest.

                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()))
                62. ServiceRequest.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 ServiceRequest.

                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()))
                64. ServiceRequest.basedOn
                Definition

                Plan/proposal/order fulfilled by this request.

                ShortWhat request fulfills
                Control0..*
                TypeReference(CarePlan, CH Core ServiceRequest, CH Core MedicationRequest)
                Is Modifierfalse
                Summarytrue
                Alternate Namesfulfills
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. ServiceRequest.replaces
                Definition

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

                ShortWhat request replaces
                Control0..*
                TypeReference(ServiceRequest)
                Is Modifierfalse
                Summarytrue
                Alternate Namessupersedes, prior, renewed order
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. ServiceRequest.requisition
                Definition

                A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.

                ShortComposite Request ID
                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.

                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Requirements

                Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

                Alternate NamesgrouperId, groupIdentifier
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                70. ServiceRequest.status
                Definition

                The status of the order.

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

                The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

                Control1..1
                BindingThe codes SHALL be taken from RequestStatus
                (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

                The status of a service order.

                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
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. ServiceRequest.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
                Comments

                This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                Control1..1
                BindingThe codes SHALL be taken from RequestIntent
                (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

                The kind of service 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
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. ServiceRequest.category
                Definition

                A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                ShortClassification of service
                Comments

                There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                Control0..*
                BindingFor example codes, see ServiceRequest Category
                (example to http://fhir.ch/ig/ch-term/ValueSet/servicerequest-category)
                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                Used for filtering what service request are retrieved and displayed.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. ServiceRequest.priority
                Definition

                Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

                ShortOrder priority
                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
                Must Supporttrue
                Summarytrue
                Meaning if MissingIf missing, this task should be performed with normal priority
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. ServiceRequest.doNotPerform
                Definition

                Set this to true if the record is saying that the service/procedure should NOT be performed.

                ShortTrue if service/procedure should not be performed
                Comments

                In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

                Control0..1
                Typeboolean
                Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

                Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                80. ServiceRequest.code
                Definition

                A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

                ShortWhat is being requested/ordered
                Comments

                Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

                Control0..1
                BindingFor example codes, see ProcedureCodes(SNOMEDCT)
                (example to http://hl7.org/fhir/ValueSet/procedure-code)

                Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Alternate Namesservice requested
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. ServiceRequest.code.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
                84. ServiceRequest.code.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())
                SlicingThis element introduces a set of slices on ServiceRequest.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 86. ServiceRequest.code.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. ServiceRequest.code.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. ServiceRequest.orderDetail
                  Definition

                  Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.

                  ShortAdditional order information
                  Comments

                  For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

                  Control0..*
                  This element is affected by the following invariants: prr-1
                  BindingFor example codes, see ServiceRequestOrderDetailsCodes
                  (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

                  Codified order entry details which are based on order context.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Alternate Namesdetailed instructions
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. ServiceRequest.quantity[x]
                  Definition

                  An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

                  ShortService amount
                  Control0..1
                  TypeChoice of: Quantity, Ratio, Range
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  When ordering a service the number of service items may need to be specified separately from the the service item.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. ServiceRequest.subject
                  Definition

                  The principle target of a particular form content is one patient (for obstetrical and neonatal use cases see...).

                  ShortPatient
                  Control1..1
                  TypeReference(CH Core Patient)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. ServiceRequest.encounter
                  Definition

                  An encounter that provides additional information about the healthcare context in which this request is made.

                  ShortEncounter in which the request was created
                  Control0..1
                  TypeReference(CH Core Encounter)
                  Is Modifierfalse
                  Summarytrue
                  Alternate Namescontext
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. ServiceRequest.occurrence[x]
                  Definition

                  The date/time at which the requested service should occur.

                  ShortWhen service should occur
                  Control0..1
                  TypeChoice of: dateTime, Period, Timing
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Alternate Namesschedule
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. ServiceRequest.asNeeded[x]
                  Definition

                  If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

                  ShortPreconditions for service
                  Control0..1
                  BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                  A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

                  TypeChoice of: boolean, CodeableConcept
                  [x] NoteSee Choice of Data Types for 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()))
                  102. ServiceRequest.authoredOn
                  Definition

                  When the request transitioned to being actionable.

                  ShortDate request signed
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Alternate NamesorderedOn
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  104. ServiceRequest.requester
                  Definition

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

                  ShortThe person/organization responsible for the form content
                  Comments

                  This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

                  Control0..1
                  TypeReference(CH Core PractitionerRole)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Alternate Namesauthor, orderer
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. ServiceRequest.performerType
                  Definition

                  Desired type of performer for doing the requested service.

                  ShortPerformer role
                  Comments

                  This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

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

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

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

                  The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

                  ShortRequested performer
                  Comments

                  If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

                  Control0..*
                  TypeReference(CH Core Practitioner, CH Core PractitionerRole, CH Core Organization, CareTeam, HealthcareService, CH Core Patient, Device, RelatedPerson)
                  Is Modifierfalse
                  Summarytrue
                  Alternate Namesrequest recipient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. ServiceRequest.locationCode
                  Definition

                  The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

                  ShortRequested location
                  Control0..*
                  BindingFor example codes, see ServiceDeliveryLocationRoleType
                  (example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

                  A location type where services are delivered.

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

                  A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

                  ShortRequested location
                  Control0..*
                  TypeReference(Location)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. ServiceRequest.reasonCode
                  Definition

                  An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

                  ShortExplanation/Justification for procedure or service
                  Comments

                  This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                  Control0..*
                  BindingFor example codes, see ProcedureReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/procedure-reason)

                  Diagnosis or problem codes justifying the reason for requesting the service investigation.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  116. ServiceRequest.reasonCode.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
                  118. ServiceRequest.reasonCode.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())
                  SlicingThis element introduces a set of slices on ServiceRequest.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 120. ServiceRequest.reasonCode.coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..*
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows for alternative encodings within a code system, and translations to other code systems.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    122. ServiceRequest.reasonCode.text
                    Definition

                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                    ShortPlain text representation of the concept
                    Comments

                    Very often the text is the same as a displayName of one of the codings.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    124. ServiceRequest.reasonReference
                    Definition

                    Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                    ShortExplanation/Justification for service or service (primary diagnosis)
                    Comments

                    This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                    Control0..*
                    TypeReference(CH eTOC Primary Diagnosis Condition)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    126. ServiceRequest.insurance
                    Definition

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

                    ShortAssociated insurance coverage
                    Control0..*
                    TypeReference(CH ORF Coverage)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    128. ServiceRequest.supportingInfo
                    Definition

                    Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                    ShortAdditional clinical information
                    Comments

                    To represent information about how the services are to be delivered use the instructions element.

                    Control0..*
                    TypeReference(Resource)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Alternate NamesAsk at order entry question, AOE
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • profile @ resolve()
                    • 130. ServiceRequest.supportingInfo:secondarydiagnosis
                      Slice Namesecondarydiagnosis
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional problem / secondary diagnosis
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Secondary Diagnosis Condition)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      132. ServiceRequest.supportingInfo:bodyHeight
                      Slice NamebodyHeight
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..1
                      TypeReference(CH eTOC Body Height Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      134. ServiceRequest.supportingInfo:bodyWeight
                      Slice NamebodyWeight
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..1
                      TypeReference(CH eTOC Body Weight Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      136. ServiceRequest.supportingInfo:pregnancy
                      Slice Namepregnancy
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..1
                      TypeReference(CH eTOC Pregnancy Status Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      138. ServiceRequest.supportingInfo:historyofIllnesses
                      Slice NamehistoryofIllnesses
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Past History of Illnesses Condition)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      140. ServiceRequest.supportingInfo:historyofProcedures
                      Slice NamehistoryofProcedures
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Procedure)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      142. ServiceRequest.supportingInfo:devices
                      Slice Namedevices
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Device)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      144. ServiceRequest.supportingInfo:socialHistory
                      Slice NamesocialHistory
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..1
                      TypeReference(CH eTOC Social History Condition)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      146. ServiceRequest.supportingInfo:functionalStatus
                      Slice NamefunctionalStatus
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Functional Status Condition)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      148. ServiceRequest.supportingInfo:medicationstatement
                      Slice Namemedicationstatement
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortMedicationStatement contains one medication with dosage
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH Core MedicationStatement)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      150. ServiceRequest.supportingInfo:allergiesIntolerances
                      Slice NameallergiesIntolerances
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Allergy Intolerance)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      152. ServiceRequest.supportingInfo:immunizations
                      Slice Nameimmunizations
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC immunizationstatus)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      154. ServiceRequest.supportingInfo:labresults
                      Slice Namelabresults
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Lab Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      156. ServiceRequest.supportingInfo:pathologyresults
                      Slice Namepathologyresults
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Pathology Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      158. ServiceRequest.supportingInfo:imagingresults
                      Slice Nameimagingresults
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Radiology Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      160. ServiceRequest.supportingInfo:cardiologyresults
                      Slice Namecardiologyresults
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(CH eTOC Cardiology Observation)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      162. ServiceRequest.supportingInfo:attachment
                      Slice Nameattachment
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(Resource)
                      Is Modifierfalse
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      164. ServiceRequest.specimen
                      Definition

                      One or more specimens that the laboratory procedure will use.

                      ShortProcedure Samples
                      Comments

                      Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

                      Control0..*
                      TypeReference(Specimen)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      166. ServiceRequest.bodySite
                      Definition

                      Anatomic location where the procedure should be performed. This is the target site.

                      ShortLocation on Body
                      Comments

                      Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

                      Control0..*
                      BindingFor example codes, see SNOMEDCTBodyStructures
                      (example to http://hl7.org/fhir/ValueSet/body-site)

                      Codes describing anatomical locations. May include laterality.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Knowing where the procedure is performed is important for tracking if multiple sites are possible.

                      Alternate Nameslocation
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      168. ServiceRequest.note
                      Definition

                      Any other notes and comments made about the service request. For example, internal billing notes.

                      ShortComments
                      Control0..*
                      TypeAnnotation
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      170. ServiceRequest.note.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
                      172. ServiceRequest.note.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())
                      SlicingThis element introduces a set of slices on ServiceRequest.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 174. ServiceRequest.note.author[x]
                        Definition

                        The individual responsible for making the annotation.

                        ShortIndividual responsible for the annotation
                        Comments

                        Organization is used when there's no need for specific attribution as to who made the comment.

                        Control0..1
                        TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                        [x] NoteSee Choice of Data Types for 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()))
                        176. ServiceRequest.note.time
                        Definition

                        Indicates when this particular annotation was made.

                        ShortWhen the annotation was made
                        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()))
                        178. ServiceRequest.note.text
                        Definition

                        The text of the annotation in markdown format.

                        ShortThe annotation - text content (as markdown)
                        Control1..1
                        Typemarkdown
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        180. ServiceRequest.patientInstruction
                        Definition

                        Instructions in terms that are understood by the patient or consumer.

                        ShortUse Appointment.patientInstruction (referenced via ServiceRequest.extension) for patient-oriented instructions
                        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()))
                        182. ServiceRequest.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()))