CH RAD-Order (R4)
1.0.0 - STU 1

This page is part of the CH RAD-Order (R4) (v1.0.0: STU 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions


Official URL: Version: 1.0.0
Active as of 2022-02-22 Computable Name: CH_RAD_Order

Download: You can download this Implementation Guide in NPM format from here.


The CH RAD-Order Implementation Guide defines the content of a radiology order and covers the follwing use cases:

  • Referral for imaging
  • Referral for radiological intervention
  • Request for second opinion
  • Request for remote reporting
  • Request for precedent imaging results

CH RAD-Order is intended for use in directional communication as well as for the use in the SWISS EPR.


This Implementation Guide uses FHIR defined resources. For details on HL7 FHIR R4 see

Because the Implementation Guide relies heavily on the FHIR Resources Questionnaire and QuestionnaireResponse, forms are addressed here as Questionnaires.

This Implementation Guide is derived from the Order & Referral by Form (ORF) Implementation Guide CH ORF which relies on HL7 Structured Data Capture Implementation Guide, see SDC IG and uses the Swiss Core Profiles, see CH Core.

There has been a discussion whether population of the resources such as Patient Resource, ServiceRequest Resource etc. with the content of the QuestionnaireResponse Resource should be done by the order placer application or rather by the order filler application. The argument for assigning the task to the order placer is a result of the following consideration: the authors of a particular implementation guide may decide to define a questionnaire and its rendering but to leave it open if in a particular implementation the questionnaire is implemented or if the representation towards the user is made (in accordance to the questionnaire definition) by other technical means. In such a case, there would be no QuestionnaireResponse Resource in the bundle because all content is already in concerning resources. In order to handle all FHIR exchange formats equal (as far as sensible), the authors decided to mandate the order placer application with the task.

Applications claiming for conformance with the ORF Implementation Guide shall:

  • Render (and in case of the Questionnaire filler allow for data entry) all elements of a questionnaire in the user interface (e.g. on screen, in print). Grouping of items and the order of items within shall be adequately reproduced according to the Questionnaire.
  • In case of an implementation without Questionnaire and QuestionnaireResponse, the content of otherwise implemented UIs shall be in accordance to the questionnaire definition.
  • Be able to process all codes related to the generic elements in a Questionnaire.

Actors, transcations and security considerations are covered in the corresponding sections of CH ORF.


CH RAD-Order allows coding of the requested imaging service by means of LOINC/RSNA RADIOL0GY PLAYBOOK.

Systems such as PIS and KIS may not yet support RADIOLOGY PLAYBOOK. For this reason, CH RAD-Order allows coding of the relevant dimensions by means of RADLEX.

The relevant dimensions are defined by PLAYBOOK such as:

  • Modality
  • Region
  • Focus
  • Laterlity
  • Maneuvre
  • Guidance for action (used for interventions)

Coding of these dimensions is done by RADLEX terms.

Value sets and coding are preliminary and not yet approved by eHealth Suisse.