Release 4B 5 Ballot

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-ballot: R5 Ballot - STU see ballot notes ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

12.19 12.24 Resource DeviceRequest - Content

Orders and Observations icon Work Group Maturity Level : 1 0   Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner

Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

12.19.1 12.24.1 Scope and Usage

Trial-Use Note: Note to Implementers: In terms of scope and usage, the Orders and Observations workgroups wish to draw the attention of reviewers and implementers to the following issue:

  1. We are seeking input from the implementation community on whether to combine DeviceRequest and VisionPrescription for R4. R5. The parameters element was added to DeviceRequest for representing custom details for ordering devices. With this change, VisionPrescription significantly overlaps DeviceRequest. To illustrate this, the devicerequest-left-lens and devicerequest-right-lens examples are based on the general glasses example in VisionPrescription.

This resource is a request resource from a FHIR workflow perspective - see Workflow .

This resource describes the request for the use of a device by a patient. The device may be any pertinent device specified in the Device resource. Examples of devices that may be requested include wheelchair, hearing aids, or an insulin pump. The request may lead to the dispensing delivery of the device to the patient directly, or to, e.g., a surgery suite for use by the patient. an implantation procedure.

The device use request may represent an order or a prescription entered by a practitioner in a CPOE system or a proposal made by a clinical decision support (CDS) system based on a patient's clinical record and context of care.

12.19.2 12.24.2 Boundaries and Relationships

This resource deals with the allocation of a device to a patient and while it may contain instructions on how to use the device, the data about getting the device to the patient is addressed in other resources. For example, certain when requesting an oxygen pump for home use instructions on how to use it may be included. For devices that must be implanted via a surgical or other procedure and the implantation or explantation is represented in the [Procedure](procedure.html) or [ServiceRequest](servicerequest.html) Procedure resource.

The SupplyRequest resource is similar in that it deals with requesting a particular item for a specific patient. However, DeviceRequest is concerned with items where there is To determine the purchase date, a patient focus, search of DeviceRequest, SupplyRequest, DeviceDispense, or instructions regarding their use, whereas SupplyRequest SupplyDelivery as defined in an implementation guide can be done , as the context of the use case actually determines which date of either resource is concerned with inventory management. considered the purchase date.

12.19.3 12.24.3 References to this Resource

This resource is referenced by

12.19.4 12.24.4 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . DeviceRequest TU DomainResource Medical device request

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Request identifier

. . . instantiatesCanonical Σ 0..* canonical ( ActivityDefinition | PlanDefinition ) Instantiates FHIR protocol or definition

. . . instantiatesUri Σ 0..* uri Instantiates external protocol or definition

. . . basedOn Σ 0..* Reference ( Any ) What request fulfills

. . . priorRequest replaces Σ 0..* Reference ( Any DeviceRequest ) What request replaces

. . . groupIdentifier Σ 0..1 Identifier Identifier of composite request
. . . status ?! Σ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
RequestStatus ( Required )
. . . intent ?! Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
RequestIntent ( Required )
. . . priority Σ 0..1 code routine | urgent | asap | stat
RequestPriority ( Required )
. . code[x] . doNotPerform ?! Σ 1..1 0..1 boolean Device requested True if the request is to stop or not to start using the device
FHIR Device Types ( Example )
. . . codeReference code Σ 1..1 Reference CodeableReference ( Device | DeviceDefinition ) Device requested
Device Type ( Example )
. . . quantity codeCodeableConcept 0..1 CodeableConcept integer Quantity of devices to supply
. . . parameter 0..* BackboneElement Device details

. . . . code 0..1 CodeableConcept Device detail
ParameterCode ( Example )
. . . . value[x] 0..1 Value of detail
. . . . . valueCodeableConcept CodeableConcept
. . . . . valueQuantity Quantity
. . . . . valueRange Range
. . . . . valueBoolean boolean
. . . subject Σ 1..1 Reference ( Patient | Group | Location | Device ) Focus of request
. . . encounter Σ 0..1 Reference ( Encounter ) Encounter motivating request
. . . occurrence[x] Σ 0..1 Desired time or schedule for use
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . . authoredOn Σ 0..1 dateTime When recorded
. . . requester Σ 0..1 Reference ( Device | Practitioner | PractitionerRole | Organization ) Who/what is requesting diagnostics submitted the device request
. . . performerType Σ 0..1 CodeableConcept Filler role
DeviceRequestParticipantRole Participant Roles ( Example )
. . . performer Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson ) Requested Filler
. . reasonCode . reason Σ 0..* CodeableConcept CodeableReference ( Condition | Observation | DiagnosticReport | DocumentReference ) Coded Coded/Linked Reason for request
Condition/Problem/Diagnosis Codes ( Example )

. . reasonReference . asNeeded Σ 0..* 0..1 Reference ( Condition | Observation | DiagnosticReport | DocumentReference boolean ) Linked Reason for PRN status of request
. . . asNeededFor 0..1 CodeableConcept Device usage reason
... insurance 0..* Reference ( Coverage | ClaimResponse ) Associated insurance coverage

. . . supportingInfo 0..* Reference ( Any ) Additional clinical information

. . . note 0..* Annotation Notes or comments

. . . relevantHistory 0..* Reference ( Provenance ) Request provenance


doco Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

DeviceRequest ( DomainResource ) Identifiers assigned to this order by the orderer or by the receiver identifier : Identifier [0..*] The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest instantiatesCanonical : canonical [0..*] « ActivityDefinition | PlanDefinition » The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest instantiatesUri : uri [0..*] Plan/proposal/order fulfilled by this request basedOn : Reference [0..*] « Any » The request takes the place of the referenced completed or terminated request(s) priorRequest replaces : Reference [0..*] « Any DeviceRequest » Composite request this is part of groupIdentifier : Identifier [0..1] The status of the request (this element modifies the meaning of other elements) status : code [0..1] « null (Strength=Required) RequestStatus ! » Whether the request is a proposal, plan, an original order or a reflex order (this element modifies the meaning of other elements) intent : code [1..1] « null (Strength=Required) RequestIntent ! » Indicates how quickly the {{title}} request should be addressed with respect to other requests priority : code [0..1] « null (Strength=Required) RequestPriority ! » If true, indicates that the provider is asking for the patient to either stop using or to not start using the specified device or category of devices. For example, the patient has undergone surgery and the provider is indicating that the patient should not wear contact lenses (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] The details of the device to be used code[x] code : Element CodeableReference [1..1] « Reference ( Device )| CodeableConcept | DeviceDefinition ; null (Strength=Example) FHIRDeviceTypes DeviceType ?? » The number of devices to be provided quantity : integer [0..1] The patient who will use the device subject : Reference [1..1] « Patient | Group | Location | Device » An encounter that provides additional context in which this request is made encounter : Reference [0..1] « Encounter » The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013" occurrence[x] : Element DataType [0..1] « dateTime | Period | Timing » When the request transitioned to being actionable authoredOn : dateTime [0..1] The individual or entity who initiated the request and has responsibility for its activation requester : Reference [0..1] « Device | Practitioner | PractitionerRole | Organization » Desired type The desired kind of performer for doing individual or entity to provide the diagnostic testing device to the subject of the request (e.g., patient, location) performerType : CodeableConcept [0..1] « null (Strength=Example) DeviceRequestParticipantRole ParticipantRoles ?? » The desired performer for doing individual or entity to provide the diagnostic testing device to the subject of the request (e.g., patient, location) performer : Reference [0..1] « Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson » Reason or justification for the use of this device reasonCode reason : CodeableConcept CodeableReference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference ; null (Strength=Example) Condition/Problem/DiagnosisCo... ?? » Reason or justification for This status is to indicate whether the use of this device request is a PRN or may be given as needed reasonReference asNeeded : Reference [0..*] « Condition | Observation boolean | [0..1] DiagnosticReport The reason for using the device asNeededFor | DocumentReference : CodeableConcept » [0..1] Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service insurance : Reference [0..*] « Coverage | ClaimResponse » Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site) supportingInfo : Reference [0..*] « Any » Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement note : Annotation [0..*] Key events in the history of the request relevantHistory : Reference [0..*] « Provenance » Parameter A code or string that identifies the device detail being asserted code : CodeableConcept [0..1] « null (Strength=Example) ParameterCode?? » The value of the device detail value[x] : Element DataType [0..1] « CodeableConcept | Quantity | Range | boolean » Specific parameters for the ordered item. For example, the prism value for lenses parameter [0..*]

XML Template 

<DeviceRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Request identifier --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|PlanDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <basedOn><!-- 0..* Reference(Any) What request fulfills --></basedOn>
 <</priorRequest>

 <replaces><!-- 0..* Reference(DeviceRequest) What request replaces --></replaces>

 <groupIdentifier><!-- 0..1 Identifier Identifier of composite request --></groupIdentifier>
 <status value="[code]"/><!-- 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->
 <
 <</code[x]>

 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if the request is to stop or not to start using the device -->
 <code><!-- 1..1 CodeableReference(Device|DeviceDefinition) Device requested --></code>
 <quantity value="[integer]"/><!-- 0..1 Quantity of devices to supply -->

 <parameter>  <!-- 0..* Device details -->
  <code><!-- 0..1 CodeableConcept Device detail --></code>
  <value[x]><!-- 0..1 CodeableConcept|Quantity|Range|boolean Value of detail --></value[x]>
 </parameter>
 <subject><!-- 1..1 Reference(Device|Group|Location|Patient) Focus of request --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter motivating request --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing Desired time or schedule for use --></occurrence[x]>
 <authoredOn value="[dateTime]"/><!-- 0..1 When recorded -->
 <</requester>
 <</performerType>
 <|

 <requester><!-- 0..1 Reference(Device|Organization|Practitioner|PractitionerRole) Who/what submitted the device request --></requester>
 <performerType><!-- 0..1 CodeableConcept Filler role --></performerType>
 <performer><!-- 0..1 Reference(CareTeam|Device|HealthcareService|Organization|

   Patient|Practitioner|PractitionerRole|RelatedPerson) Requested Filler --></performer>
 <</reasonCode>
 <|
   </reasonReference>

 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) Coded/Linked Reason for request --></reason>

 <asNeeded value="[boolean]"/><!-- 0..1 PRN status of request -->
 <asNeededFor><!-- 0..1 CodeableConcept Device usage reason --></asNeededFor>

 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <supportingInfo><!-- 0..* Reference(Any) Additional clinical information --></supportingInfo>
 <note><!-- 0..* Annotation Notes or comments --></note>
 <relevantHistory><!-- 0..* Reference(Provenance) Request provenance --></relevantHistory>
</DeviceRequest>

JSON Template 

{doco
  "resourceType" : "DeviceRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Request identifier
  "

  "instantiatesCanonical" : ["<canonical(ActivityDefinition|PlanDefinition)>"], // Instantiates FHIR protocol or definition

  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "basedOn" : [{ Reference(Any) }], // What request fulfills
  "

  "replaces" : [{ Reference(DeviceRequest) }], // What request replaces

  "groupIdentifier" : { Identifier }, // Identifier of composite request
  "status" : "<code>", // draft | active | on-hold | revoked | completed | entered-in-error | unknown
  "intent" : "<code>", // R!  proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  "
  
  " },
  " },

  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if the request is to stop or not to start using the device
  "code" : { CodeableReference(Device|DeviceDefinition) }, // R!  Device requested
  "quantity" : <integer>, // Quantity of devices to supply

  "parameter" : [{ // Device details
    "code" : { CodeableConcept }, // Device detail
    // value[x]: Value of detail. One of these 4:
    " }
    " }
    " }

    "valueCodeableConcept" : { CodeableConcept },
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },

    "valueBoolean" : <boolean>
  }],
  "subject" : { Reference(Device|Group|Location|Patient) }, // R!  Focus of request
  "encounter" : { Reference(Encounter) }, // Encounter motivating request
  // occurrence[x]: Desired time or schedule for use. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  "authoredOn" : "<dateTime>", // When recorded
  "
  "
  "|

  "requester" : { Reference(Device|Organization|Practitioner|PractitionerRole) }, // Who/what submitted the device request
  "performerType" : { CodeableConcept }, // Filler role
  "performer" : { Reference(CareTeam|Device|HealthcareService|Organization|

   Patient|Practitioner|PractitionerRole|RelatedPerson) }, // Requested Filler
  "
  "|
   

  "reason" : [{ CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) }], // Coded/Linked Reason for request

  "asNeeded" : <boolean>, // PRN status of request
  "asNeededFor" : { CodeableConcept }, // Device usage reason

  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "supportingInfo" : [{ Reference(Any) }], // Additional clinical information
  "note" : [{ Annotation }], // Notes or comments
  "relevantHistory" : [{ Reference(Provenance) }] // Request provenance
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:DeviceRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:DeviceRequest.identifier [ Identifier ], ... ; # 0..* External Request identifier
  fhir:DeviceRequest.instantiatesCanonical [ canonical(ActivityDefinition|PlanDefinition) ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:DeviceRequest.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:DeviceRequest.basedOn [ Reference(Any) ], ... ; # 0..* What request fulfills
  fhir:

  fhir:DeviceRequest.replaces [ Reference(DeviceRequest) ], ... ; # 0..* What request replaces

  fhir:DeviceRequest.groupIdentifier [ Identifier ]; # 0..1 Identifier of composite request
  fhir:DeviceRequest.status [ code ]; # 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:DeviceRequest.intent [ code ]; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:
  # . One of these 2
    fhir:) ]
    fhir: ]

  fhir:DeviceRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat
  fhir:DeviceRequest.doNotPerform [ boolean ]; # 0..1 True if the request is to stop or not to start using the device
  fhir:DeviceRequest.code [ CodeableReference(Device|DeviceDefinition) ]; # 1..1 Device requested
  fhir:DeviceRequest.quantity [ integer ]; # 0..1 Quantity of devices to supply

  fhir:DeviceRequest.parameter [ # 0..* Device details
    fhir:DeviceRequest.parameter.code [ CodeableConcept ]; # 0..1 Device detail
    # DeviceRequest.parameter.value[x] : 0..1 Value of detail. One of these 4
      fhir:DeviceRequest.parameter.valueCodeableConcept [ CodeableConcept ]
      fhir:DeviceRequest.parameter.valueQuantity [ Quantity ]
      fhir:DeviceRequest.parameter.valueRange [ Range ]
      fhir:DeviceRequest.parameter.valueBoolean [ boolean ]
  ], ...;
  fhir:DeviceRequest.subject [ Reference(Device|Group|Location|Patient) ]; # 1..1 Focus of request
  fhir:DeviceRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter motivating request
  # DeviceRequest.occurrence[x] : 0..1 Desired time or schedule for use. One of these 3
    fhir:DeviceRequest.occurrenceDateTime [ dateTime ]
    fhir:DeviceRequest.occurrencePeriod [ Period ]
    fhir:DeviceRequest.occurrenceTiming [ Timing ]
  fhir:DeviceRequest.authoredOn [ dateTime ]; # 0..1 When recorded
  fhir:
  fhir:
  fhir:|

  fhir:DeviceRequest.requester [ Reference(Device|Organization|Practitioner|PractitionerRole) ]; # 0..1 Who/what submitted the device request
  fhir:DeviceRequest.performerType [ CodeableConcept ]; # 0..1 Filler role
  fhir:DeviceRequest.performer [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|

  PractitionerRole|RelatedPerson) ]; # 0..1 Requested Filler
  fhir:
  fhir:

  fhir:DeviceRequest.reason [ CodeableReference(Condition|DiagnosticReport|DocumentReference|Observation) ], ... ; # 0..* Coded/Linked Reason for request
  fhir:DeviceRequest.asNeeded [ boolean ]; # 0..1 PRN status of request
  fhir:DeviceRequest.asNeededFor [ CodeableConcept ]; # 0..1 Device usage reason

  fhir:DeviceRequest.insurance [ Reference(ClaimResponse|Coverage) ], ... ; # 0..* Associated insurance coverage
  fhir:DeviceRequest.supportingInfo [ Reference(Any) ], ... ; # 0..* Additional clinical information
  fhir:DeviceRequest.note [ Annotation ], ... ; # 0..* Notes or comments
  fhir:DeviceRequest.relevantHistory [ Reference(Provenance) ], ... ; # 0..* Request provenance
]

Changes since R4

DeviceRequest
DeviceRequest.replaces
  • No Changes Added Element
DeviceRequest.doNotPerform
  • Added Element
DeviceRequest.code
  • Added Mandatory Element
DeviceRequest.quantity
  • Added Element
DeviceRequest.reason
  • Added Element
DeviceRequest.asNeeded
  • Added Element
DeviceRequest.asNeededFor
  • Added Element
DeviceRequest.priorRequest
  • deleted
DeviceRequest.code[x]
  • deleted
DeviceRequest.reasonCode
  • deleted
DeviceRequest.reasonReference
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 2 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . DeviceRequest TU DomainResource Medical device request

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Request identifier

. . . instantiatesCanonical Σ 0..* canonical ( ActivityDefinition | PlanDefinition ) Instantiates FHIR protocol or definition

. . . instantiatesUri Σ 0..* uri Instantiates external protocol or definition

. . . basedOn Σ 0..* Reference ( Any ) What request fulfills

. . . priorRequest replaces Σ 0..* Reference ( Any DeviceRequest ) What request replaces

. . . groupIdentifier Σ 0..1 Identifier Identifier of composite request
. . . status ?! Σ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
RequestStatus ( Required )
. . . intent ?! Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
RequestIntent ( Required )
. . . priority Σ 0..1 code routine | urgent | asap | stat
RequestPriority ( Required )
. . code[x] . doNotPerform ?! Σ 1..1 0..1 boolean Device requested True if the request is to stop or not to start using the device
FHIR Device Types ( Example )
. . . codeReference code Σ 1..1 Reference CodeableReference ( Device | DeviceDefinition ) Device requested
Device Type ( Example )
. . . quantity codeCodeableConcept 0..1 CodeableConcept integer Quantity of devices to supply
. . . parameter 0..* BackboneElement Device details

. . . . code 0..1 CodeableConcept Device detail
ParameterCode ( Example )
. . . . value[x] 0..1 Value of detail
. . . . . valueCodeableConcept CodeableConcept
. . . . . valueQuantity Quantity
. . . . . valueRange Range
. . . . . valueBoolean boolean
. . . subject Σ 1..1 Reference ( Patient | Group | Location | Device ) Focus of request
. . . encounter Σ 0..1 Reference ( Encounter ) Encounter motivating request
. . . occurrence[x] Σ 0..1 Desired time or schedule for use
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . . authoredOn Σ 0..1 dateTime When recorded
. . . requester Σ 0..1 Reference ( Device | Practitioner | PractitionerRole | Organization ) Who/what is requesting diagnostics submitted the device request
. . . performerType Σ 0..1 CodeableConcept Filler role
DeviceRequestParticipantRole Participant Roles ( Example )
. . . performer Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson ) Requested Filler
. . reasonCode . reason Σ 0..* CodeableConcept CodeableReference ( Condition | Observation | DiagnosticReport | DocumentReference ) Coded Coded/Linked Reason for request
Condition/Problem/Diagnosis Codes ( Example )

. . reasonReference . asNeeded Σ 0..* 0..1 Reference ( Condition | Observation | DiagnosticReport | DocumentReference boolean ) Linked Reason for PRN status of request
. . . asNeededFor 0..1 CodeableConcept Device usage reason
... insurance 0..* Reference ( Coverage | ClaimResponse ) Associated insurance coverage

. . . supportingInfo 0..* Reference ( Any ) Additional clinical information

. . . note 0..* Annotation Notes or comments

. . . relevantHistory 0..* Reference ( Provenance ) Request provenance


doco Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

DeviceRequest ( DomainResource ) Identifiers assigned to this order by the orderer or by the receiver identifier : Identifier [0..*] The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest instantiatesCanonical : canonical [0..*] « ActivityDefinition | PlanDefinition » The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest instantiatesUri : uri [0..*] Plan/proposal/order fulfilled by this request basedOn : Reference [0..*] « Any » The request takes the place of the referenced completed or terminated request(s) priorRequest replaces : Reference [0..*] « Any DeviceRequest » Composite request this is part of groupIdentifier : Identifier [0..1] The status of the request (this element modifies the meaning of other elements) status : code [0..1] « null (Strength=Required) RequestStatus ! » Whether the request is a proposal, plan, an original order or a reflex order (this element modifies the meaning of other elements) intent : code [1..1] « null (Strength=Required) RequestIntent ! » Indicates how quickly the {{title}} request should be addressed with respect to other requests priority : code [0..1] « null (Strength=Required) RequestPriority ! » If true, indicates that the provider is asking for the patient to either stop using or to not start using the specified device or category of devices. For example, the patient has undergone surgery and the provider is indicating that the patient should not wear contact lenses (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] The details of the device to be used code[x] code : Element CodeableReference [1..1] « Reference ( Device )| CodeableConcept | DeviceDefinition ; null (Strength=Example) FHIRDeviceTypes DeviceType ?? » The number of devices to be provided quantity : integer [0..1] The patient who will use the device subject : Reference [1..1] « Patient | Group | Location | Device » An encounter that provides additional context in which this request is made encounter : Reference [0..1] « Encounter » The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013" occurrence[x] : Element DataType [0..1] « dateTime | Period | Timing » When the request transitioned to being actionable authoredOn : dateTime [0..1] The individual or entity who initiated the request and has responsibility for its activation requester : Reference [0..1] « Device | Practitioner | PractitionerRole | Organization » Desired type The desired kind of performer for doing individual or entity to provide the diagnostic testing device to the subject of the request (e.g., patient, location) performerType : CodeableConcept [0..1] « null (Strength=Example) DeviceRequestParticipantRole ParticipantRoles ?? » The desired performer for doing individual or entity to provide the diagnostic testing device to the subject of the request (e.g., patient, location) performer : Reference [0..1] « Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson » Reason or justification for the use of this device reasonCode reason : CodeableConcept CodeableReference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference ; null (Strength=Example) Condition/Problem/DiagnosisCo... ?? » Reason or justification for This status is to indicate whether the use of this device request is a PRN or may be given as needed reasonReference asNeeded : Reference [0..*] « Condition | Observation boolean | [0..1] DiagnosticReport The reason for using the device asNeededFor | DocumentReference : CodeableConcept » [0..1] Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service insurance : Reference [0..*] « Coverage | ClaimResponse » Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site) supportingInfo : Reference [0..*] « Any » Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement note : Annotation [0..*] Key events in the history of the request relevantHistory : Reference [0..*] « Provenance » Parameter A code or string that identifies the device detail being asserted code : CodeableConcept [0..1] « null (Strength=Example) ParameterCode?? » The value of the device detail value[x] : Element DataType [0..1] « CodeableConcept | Quantity | Range | boolean » Specific parameters for the ordered item. For example, the prism value for lenses parameter [0..*]

XML Template 

<DeviceRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Request identifier --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|PlanDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <basedOn><!-- 0..* Reference(Any) What request fulfills --></basedOn>
 <</priorRequest>

 <replaces><!-- 0..* Reference(DeviceRequest) What request replaces --></replaces>

 <groupIdentifier><!-- 0..1 Identifier Identifier of composite request --></groupIdentifier>
 <status value="[code]"/><!-- 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->
 <
 <</code[x]>

 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if the request is to stop or not to start using the device -->
 <code><!-- 1..1 CodeableReference(Device|DeviceDefinition) Device requested --></code>
 <quantity value="[integer]"/><!-- 0..1 Quantity of devices to supply -->

 <parameter>  <!-- 0..* Device details -->
  <code><!-- 0..1 CodeableConcept Device detail --></code>
  <value[x]><!-- 0..1 CodeableConcept|Quantity|Range|boolean Value of detail --></value[x]>
 </parameter>
 <subject><!-- 1..1 Reference(Device|Group|Location|Patient) Focus of request --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter motivating request --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing Desired time or schedule for use --></occurrence[x]>
 <authoredOn value="[dateTime]"/><!-- 0..1 When recorded -->
 <</requester>
 <</performerType>
 <|

 <requester><!-- 0..1 Reference(Device|Organization|Practitioner|PractitionerRole) Who/what submitted the device request --></requester>
 <performerType><!-- 0..1 CodeableConcept Filler role --></performerType>
 <performer><!-- 0..1 Reference(CareTeam|Device|HealthcareService|Organization|

   Patient|Practitioner|PractitionerRole|RelatedPerson) Requested Filler --></performer>
 <</reasonCode>
 <|
   </reasonReference>

 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) Coded/Linked Reason for request --></reason>

 <asNeeded value="[boolean]"/><!-- 0..1 PRN status of request -->
 <asNeededFor><!-- 0..1 CodeableConcept Device usage reason --></asNeededFor>

 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <supportingInfo><!-- 0..* Reference(Any) Additional clinical information --></supportingInfo>
 <note><!-- 0..* Annotation Notes or comments --></note>
 <relevantHistory><!-- 0..* Reference(Provenance) Request provenance --></relevantHistory>
</DeviceRequest>

JSON Template 

{doco
  "resourceType" : "DeviceRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Request identifier
  "

  "instantiatesCanonical" : ["<canonical(ActivityDefinition|PlanDefinition)>"], // Instantiates FHIR protocol or definition

  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "basedOn" : [{ Reference(Any) }], // What request fulfills
  "

  "replaces" : [{ Reference(DeviceRequest) }], // What request replaces

  "groupIdentifier" : { Identifier }, // Identifier of composite request
  "status" : "<code>", // draft | active | on-hold | revoked | completed | entered-in-error | unknown
  "intent" : "<code>", // R!  proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  "
  
  " },
  " },

  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if the request is to stop or not to start using the device
  "code" : { CodeableReference(Device|DeviceDefinition) }, // R!  Device requested
  "quantity" : <integer>, // Quantity of devices to supply

  "parameter" : [{ // Device details
    "code" : { CodeableConcept }, // Device detail
    // value[x]: Value of detail. One of these 4:
    " }
    " }
    " }

    "valueCodeableConcept" : { CodeableConcept },
    "valueQuantity" : { Quantity },
    "valueRange" : { Range },

    "valueBoolean" : <boolean>
  }],
  "subject" : { Reference(Device|Group|Location|Patient) }, // R!  Focus of request
  "encounter" : { Reference(Encounter) }, // Encounter motivating request
  // occurrence[x]: Desired time or schedule for use. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  "authoredOn" : "<dateTime>", // When recorded
  "
  "
  "|

  "requester" : { Reference(Device|Organization|Practitioner|PractitionerRole) }, // Who/what submitted the device request
  "performerType" : { CodeableConcept }, // Filler role
  "performer" : { Reference(CareTeam|Device|HealthcareService|Organization|

   Patient|Practitioner|PractitionerRole|RelatedPerson) }, // Requested Filler
  "
  "|
   

  "reason" : [{ CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) }], // Coded/Linked Reason for request

  "asNeeded" : <boolean>, // PRN status of request
  "asNeededFor" : { CodeableConcept }, // Device usage reason

  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "supportingInfo" : [{ Reference(Any) }], // Additional clinical information
  "note" : [{ Annotation }], // Notes or comments
  "relevantHistory" : [{ Reference(Provenance) }] // Request provenance
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:DeviceRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:DeviceRequest.identifier [ Identifier ], ... ; # 0..* External Request identifier
  fhir:DeviceRequest.instantiatesCanonical [ canonical(ActivityDefinition|PlanDefinition) ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:DeviceRequest.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition
  fhir:DeviceRequest.basedOn [ Reference(Any) ], ... ; # 0..* What request fulfills
  fhir:

  fhir:DeviceRequest.replaces [ Reference(DeviceRequest) ], ... ; # 0..* What request replaces

  fhir:DeviceRequest.groupIdentifier [ Identifier ]; # 0..1 Identifier of composite request
  fhir:DeviceRequest.status [ code ]; # 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:DeviceRequest.intent [ code ]; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:
  # . One of these 2
    fhir:) ]
    fhir: ]

  fhir:DeviceRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat
  fhir:DeviceRequest.doNotPerform [ boolean ]; # 0..1 True if the request is to stop or not to start using the device
  fhir:DeviceRequest.code [ CodeableReference(Device|DeviceDefinition) ]; # 1..1 Device requested
  fhir:DeviceRequest.quantity [ integer ]; # 0..1 Quantity of devices to supply

  fhir:DeviceRequest.parameter [ # 0..* Device details
    fhir:DeviceRequest.parameter.code [ CodeableConcept ]; # 0..1 Device detail
    # DeviceRequest.parameter.value[x] : 0..1 Value of detail. One of these 4
      fhir:DeviceRequest.parameter.valueCodeableConcept [ CodeableConcept ]
      fhir:DeviceRequest.parameter.valueQuantity [ Quantity ]
      fhir:DeviceRequest.parameter.valueRange [ Range ]
      fhir:DeviceRequest.parameter.valueBoolean [ boolean ]
  ], ...;
  fhir:DeviceRequest.subject [ Reference(Device|Group|Location|Patient) ]; # 1..1 Focus of request
  fhir:DeviceRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter motivating request
  # DeviceRequest.occurrence[x] : 0..1 Desired time or schedule for use. One of these 3
    fhir:DeviceRequest.occurrenceDateTime [ dateTime ]
    fhir:DeviceRequest.occurrencePeriod [ Period ]
    fhir:DeviceRequest.occurrenceTiming [ Timing ]
  fhir:DeviceRequest.authoredOn [ dateTime ]; # 0..1 When recorded
  fhir:
  fhir:
  fhir:|

  fhir:DeviceRequest.requester [ Reference(Device|Organization|Practitioner|PractitionerRole) ]; # 0..1 Who/what submitted the device request
  fhir:DeviceRequest.performerType [ CodeableConcept ]; # 0..1 Filler role
  fhir:DeviceRequest.performer [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|

  PractitionerRole|RelatedPerson) ]; # 0..1 Requested Filler
  fhir:
  fhir:

  fhir:DeviceRequest.reason [ CodeableReference(Condition|DiagnosticReport|DocumentReference|Observation) ], ... ; # 0..* Coded/Linked Reason for request
  fhir:DeviceRequest.asNeeded [ boolean ]; # 0..1 PRN status of request
  fhir:DeviceRequest.asNeededFor [ CodeableConcept ]; # 0..1 Device usage reason

  fhir:DeviceRequest.insurance [ Reference(ClaimResponse|Coverage) ], ... ; # 0..* Associated insurance coverage
  fhir:DeviceRequest.supportingInfo [ Reference(Any) ], ... ; # 0..* Additional clinical information
  fhir:DeviceRequest.note [ Annotation ], ... ; # 0..* Notes or comments
  fhir:DeviceRequest.relevantHistory [ Reference(Provenance) ], ... ; # 0..* Request provenance
]

Changes since Release 4

DeviceRequest
DeviceRequest.replaces
  • No Changes Added Element
DeviceRequest.doNotPerform
  • Added Element
DeviceRequest.code
  • Added Mandatory Element
DeviceRequest.quantity
  • Added Element
DeviceRequest.reason
  • Added Element
DeviceRequest.asNeeded
  • Added Element
DeviceRequest.asNeededFor
  • Added Element
DeviceRequest.priorRequest
  • deleted
DeviceRequest.code[x]
  • deleted
DeviceRequest.reasonCode
  • deleted
DeviceRequest.reasonReference
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 2 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

 

See the Profiles & Extensions and the alternate Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

12.19.4.1 12.24.4.1 Terminology Bindings

DeviceRequest.code[x]
Path Definition Type Reference
DeviceRequest.status

Codes identifying the lifecycle stage of a request.

Required RequestStatus
DeviceRequest.intent

Codes indicating the degree of authority/intentionality associated with a request.

Required RequestIntent
DeviceRequest.priority

Identifies the level of importance to be assigned to actioning the request.

Required RequestPriority
DeviceRequest.code

Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.

Example FHIRDeviceTypes DeviceType
DeviceRequest.parameter.code Example ??
DeviceRequest.performerType

Roles of participants that may be included in a care team. Defined as: Healthcare professional (occupation) or Services (qualifier value).

Example http://hl7.org/fhir/ValueSet/participant-role ParticipantRoles
DeviceRequest.reasonCode DeviceRequest.reason

Example value set for Condition/Problem/Diagnosis codes.

Example Condition/Problem/DiagnosisCodes

Notes to reviewers:

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

12.19.5 12.24.5 Search Parameters

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

Name Type Description Expression In Common
authored-on N date When the request transitioned to being actionable DeviceRequest.authoredOn
based-on reference Plan/proposal/order fulfilled by this request DeviceRequest.basedOn
(Any)
code D token Code for what is being requested/ordered (DeviceRequest.code as CodeableConcept) DeviceRequest.code.concept
device D reference Reference to resource that is being requested/ordered (DeviceRequest.code as Reference) ( Device ) DeviceRequest.code.reference
encounter reference Encounter during which request was created DeviceRequest.encounter
( Encounter )
event-date date When service should occur (DeviceRequest.occurrence as dateTime) | (DeviceRequest.occurrence as Period)
group-identifier token Composite request this is part of DeviceRequest.groupIdentifier
identifier token Business identifier for request/order DeviceRequest.identifier
instantiates-canonical N reference Instantiates FHIR protocol or definition DeviceRequest.instantiatesCanonical
( PlanDefinition , ActivityDefinition )
instantiates-uri N uri Instantiates external protocol or definition DeviceRequest.instantiatesUri
insurance reference Associated insurance coverage DeviceRequest.insurance
( ClaimResponse , Coverage )
intent N token proposal | plan | original-order |reflex-order DeviceRequest.intent
patient reference Individual the service is ordered for DeviceRequest.subject.where(resolve() is Patient)
( Patient )
performer reference Desired performer for service DeviceRequest.performer
( Practitioner , Organization , CareTeam , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
prior-request reference Request takes the place of referenced completed or terminated requests DeviceRequest.priorRequest DeviceRequest.replaces
(Any) ( DeviceRequest )
requester reference Who/what is requesting service DeviceRequest.requester
( Practitioner , Organization , Device , PractitionerRole )
status N token entered-in-error | draft | active |suspended | completed DeviceRequest.status
subject reference Individual the service is ordered for DeviceRequest.subject
( Group , Device , Patient , Location )