Release 4 R6 Ballot (1st Full Ballot)

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU v6.0.0-ballot4: Release 6 Ballot (1st Full Ballot) (see Ballot Notes ) in it's permanent home (it will always be available at this URL). ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions for published versions icon . Page versions: R5 R4B R4

12.14 15.17 Resource ServiceRequest - Content

Responsible Owner: Orders and Observations icon Work Group Maturity Level : 2   Trial Use Normative Security Category : Patient Compartments : Device , Encounter , Group , Patient , Practitioner , RelatedPerson

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed. When the ServiceRequest is active, it represents an authorization to perform the service.

12.14.1 15.17.1 Scope and Usage

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

ServiceRequest is a record of a request for a procedure represents an order or proposal or plan to perform a diagnostic or other service to be planned, proposed, or performed, as distinguished by the ServiceRequest.intent field value, with or on a patient. The procedure will lead to either a Procedure or DiagnosticReport , which for a patient (including non-human patients in turn may reference one or more Observations , which summarize the performance veterinary settings). Examples of the procedures and associated documentation such as observations, images, findings that are relevant to the treatment/management types of the subject. This resource services that may be used to share relevant information required to support a referral or ordered by a transfer of care request from one practitioner or organization ServiceRequest are:

Note to another when a patient Balloters: The new 'servicerequest-specimenSuggestion' extension is required expected to be referred to another provider for a consultation /second opinion and/or for short term or longer term management available soon in an upcoming release of one or more health issues or problems. Examples include: the Extensions Pack.

  • diagnostic tests/studies
  • endoscopic procedures
  • counseling
  • biopsies
  • therapies (e.g., physio-, social-, psychological-)
  • (exploratory) surgeries or procedures
  • exercises
  • specialist consultation and assessments
  • community services
  • nursing services
  • pharmacist medication review, and
  • other clinical interventions.

Procedures may be performed by a healthcare professional, a friend or relative or in some cases by the patient themselves. The principal intention of ServiceRequest is to support ordering procedures for one patient (which includes non-human patients in veterinary medicine). However, in many contexts, healthcare related processes include performing diagnostic investigations on groups of subjects, devices involved in the provision of healthcare, and even environmental locations such as ducts, bodies of water, etc. A ServiceRequest supports all these usages. The service request may can represent an order that is entered by a practitioner in a CPOE system as well as Computerized Physician Order Entry (CPOE) system, or a proposal made by a clinical decision support (CDS) system based on a patient's clinical record and context of care. Planned procedures referenced by procedures, perhaps following a defined CarePlan , may also be represented by this resource.

The ServiceRequest.intent element identifies if the resource represents an order, proposal, or plan to perform the indicated service for, or on, a patient. The service to be performed might result in a Procedure ; and could be summarized in a DiagnosticReport detailing the performance and outcomes, perhaps through referencing select instances of Observation , ImagingStudy , Specimen or other resources. The various generated resources are typically linked back to this ServiceRequest through their basedOn elements. The ServiceRequest resource may be used to share information to support a referral or transfer-of-care request from one practitioner or organization to another for a consultation, second opinion, or short- or longer-term management of health issues or problems.

The general work flow that this resource facilitates is that a clinical system creates a service request. The service request is then accessed by or exchanged with a system, exchanged, perhaps via intermediaries, with a system that represents an organization (e.g., diagnostic or imaging service, surgical team, physical therapy department) that can perform the procedure. The organization receiving the service request will, after it accepts the request, update the request as the work is performed, and then finally issue a report that references the requests that it fulfilled.

The ServiceRequest resource allows requesting only Only a single procedure. If procedure is requested by each ServiceRequest; if a workflow requires requesting multiple procedures simultaneously, this is done using multiple instances of this resource. ServiceRequests. These instances can be linked in different ways, depending on the needs of the workflow. For guidance, refer to the Request pattern .

Multiple ServiceRequests may exist that are associated in some way. When the association is a simple grouping, say for billing, that grouping can be indicated with the ServiceRequest.requisition element. When the ServiceRequest execution needs to be coordinated in some fashion, another resource such as RequestOrchestration may be needed.

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

12.14.2 15.17.2 Boundaries and Relationships

ServiceRequest is a record of a proposal/plan or order for a service to be performed that would result in a Procedure , Observation , DiagnosticReport , ImagingStudy , or similar resource. In contrast to ServiceRequest, Task which spans both intent and event and event, tracks the execution through to completion completion, and is intended for "administrative" actions like requesting and tracking things to be done to a record, or keeping track of a checklist of steps such to be performed as part of a fulfilment process. A ServiceRequest can be higher-level authorization that triggered the creation of Task, or it can be the "request" resource Task is seeking to fulfill. For further information about this separation of responsibilities between ServiceRequest and Task, refer to the Fulfillment/Execution section of the Request pattern.

ServiceRequest and CommunicationRequest are related. A CommunicationRequest is a request to merely disclose information. Whereas a ServiceRequest would be used to request information as part of training or counseling - i.e. when the process will involve verification of the patient's comprehension or an attempt to change the patient's mental state. In some workflows both may exist. For example, upon receiving a CommunicationRequest a practitioner might initiate a ServiceRequest.

This resource Note to Implementers:

The ServiceRequest.orderDetail structure is referenced by subject to further feedback based on use as the modeling creates a challenge when there is no focus, while an alternate structure would yield a requirement to repeat the focus attribute on each code/value pair.

Provide feedback here icon.

15.17.3 References to this Resource

12.14.3 15.17.4 Resource Content

Structure

Quantity Ratio Preconditions for Explanation/Justification for service 0..* Location string
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . ServiceRequest I TU N DomainResource A request for a service to be performed
+ Rule: orderDetail SHALL only be present if code is present
+ Rule: asNeededFor SHALL only be present if asNeeded is empty or true

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Identifiers assigned to this order
instantiatesCanonical Σ 0..* canonical ( ActivityDefinition | PlanDefinition ) Instantiates FHIR protocol or definition instantiatesUri Σ 0..* uri Instantiates external protocol or definition
. . . basedOn Σ 0..* Reference ( CarePlan | DocumentReference | ServiceRequest | MedicationRequest | RequestOrchestration | NutritionOrder | DocumentReference ) What request fulfills

. . . replaces Σ 0..* Reference ( ServiceRequest | MedicationRequest | RequestOrchestration | CarePlan | DeviceRequest | CommunicationRequest | NutritionOrder | VisionPrescription ) What request replaces

. . . requisition Σ 0..1 Identifier Composite Request ID
. . . status ?! Σ 1..1 code draft | active | on-hold | revoked entered-in-error | ended | completed | entered-in-error revoked | unknown
Binding: RequestStatus ( Required )
. . intent . statusReason 0..* CodeableConcept Reason for current status
Binding: Service Request Status Reason ( Example )

... intent ?! Σ 1..1 code proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent ( Required )
. . . category Σ 0..* CodeableConcept Classification of service
Binding: Service Request Category Codes ( Example )

. . . priority Σ 0..1 code routine | urgent | asap | stat
Request priority Binding: RequestPriority ( Required )
. . . doNotPerform ?! Σ 0..1 boolean True if service/procedure should not be performed
. . . code Σ C 0..1 CodeableConcept CodeableReference ( ActivityDefinition | PlanDefinition ) What is being requested/ordered
Binding: Procedure Codes (SNOMED CT) ( Example )
. . . orderDetail Σ I C 0..* BackboneElement Additional information about the request

.... parameterFocus[x] 0..1 The context of the order details by reference
..... parameterFocusCodeableConcept CodeableConcept Additional order information
. . . . . parameterFocusReference Reference ( Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition )
..... parameterFocusCanonical canonical ( DeviceDefinition )
.... parameter Σ 1..* BackboneElement The parameter details for the service being requested
Service
. . . . . code Σ 1..1 CodeableConcept The detail of the order being requested
Binding: Request Order Details Codes OrderDetail Parameter Code ( Example )
. . quantity[x] . . . value[x] Σ 1..1 The value for the order detail
0..1
. . . . . . valueQuantity Quantity Service amount
. . . . . . quantityQuantity valueRatio Ratio
. . . . . . valueRange Range
. . . . . . valueBoolean boolean
. . . . . . quantityRatio valueCodeableConcept CodeableConcept
. . . . . . valueString string
. . . . . . valuePeriod Period
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
... . quantityRange quantityRatio Ratio
. . . . quantityRange Range
. . . subject Σ 1..1 Reference ( Patient | Group | Location | Device ) Individual or Entity the service is ordered for
. . . focus Σ 0..* Reference ( Any ) What the service request is about, when it is not about the subject of record

. . . encounter Σ 0..1 Reference ( Encounter ) Encounter in which the request was created
. . . occurrence[x] Σ 0..1 When service should occur
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . asNeeded[x] . asNeeded Σ 0..1 boolean Perform the service "as needed"
SNOMED CT Medication As Needed Reason Codes ( Example )
. . asNeededBoolean boolean . asNeededFor asNeededCodeableConcept Σ C 0..* CodeableConcept Specified criteria for the service
Binding: SNOMED CT Medication As Needed Reason Codes ( Example )

. . . authoredOn Σ 0..1 dateTime Date request signed
. . . requester Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | Group ) Who/what is requesting service
. . . performerType Σ 0..1 CodeableConcept Performer role
Binding: Participant Roles ( Example )
. . . performer Σ 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | Group ) Requested performer
locationCode Σ 0..* CodeableConcept Requested location V3 Value SetServiceDeliveryLocationRoleType ( Example )
. . . locationReference location Σ 0..* Reference CodeableReference ( Location ) Requested location
Binding: ServiceDeliveryLocationRoleType icon reasonCode Σ 0..* CodeableConcept Explanation/Justification for procedure or service Procedure Reason Codes ( Example )

. . reasonReference . reason Σ 0..* Reference CodeableReference ( Condition | Observation | DiagnosticReport | DocumentReference | DetectedIssue | Procedure | RiskAssessment ) Reason or indication for requesting the service
Binding: Procedure Reason Codes ( Example )

. . . insurance 0..* Reference ( Coverage | ClaimResponse ) Associated insurance coverage

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

. . . specimen Σ 0..* Reference ( Specimen ) Procedure Samples

. . bodySite . bodyStructure Σ 0..1 CodeableConcept CodeableReference ( BodyStructure ) BodyStructure-based location on Body the body
Binding: SNOMED CT Body Structures ( Example )
. . . note 0..* Annotation Comments

. . . patientInstruction 0..* Σ BackboneElement Patient or consumer-oriented instructions

0..1
. . . . instruction[x] Σ 0..1 Patient or consumer-oriented instructions
. . . . . instructionMarkdown markdown
..... instructionReference Reference ( DocumentReference )
. . . relevantHistory 0..* Reference ( Provenance ) Request provenance


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

ServiceRequest ( DomainResource ) Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller 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 ServiceRequest 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 ServiceRequest instantiatesUri : uri [0..*] Plan/proposal/order fulfilled by this request basedOn : Reference [0..*] « CarePlan | ServiceRequest DocumentReference | ServiceRequest | MedicationRequest | RequestOrchestration | NutritionOrder | DocumentReference » The request takes the place of the referenced completed or terminated request(s) replaces : Reference [0..*] « ServiceRequest | MedicationRequest | RequestOrchestration | CarePlan | DeviceRequest | CommunicationRequest | NutritionOrder | VisionPrescription » 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 requisition : Identifier [0..1] The status of the order (this element modifies the meaning of other elements) status : code [1..1] « The status of a service order. null (Strength=Required) RequestStatus ! » Provides reason why the service request status is what it is. The statusReason can be used to explain why a service request is suspended, cancelled, or on hold, including administrative and clinical reasons statusReason : CodeableConcept [0..*] « null (Strength=Example) ServiceRequestStatusReason ?? » 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] « The kind of service request. null (Strength=Required) RequestIntent ! » A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure") category : CodeableConcept [0..*] « Classification of the requested service. null (Strength=Example) ServiceRequestCategoryCodes ?? » Indicates how quickly the ServiceRequest should be addressed with respect to other requests priority : code [0..1] « Identifies the level of importance to be assigned to actioning the request. null (Strength=Required) RequestPriority ! » Set this to true if the record is saying that the service/procedure should NOT be performed (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] A code or reference that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have has been requested code : CodeableConcept CodeableReference [0..1] « 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](valueset-diagnostic-requests.html). (Strength=Example) ProcedureCodes(SNOMEDCT) ?? » 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 orderDetail ActivityDefinition : CodeableConcept | PlanDefinition [0..*] « ; Codified order entry details which are based on order context. null (Strength=Example) ServiceRequestOrderDetailsCod... ProcedureCodesSNOMEDCT ?? » « This element has or is affected by some invariants C » 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) quantity[x] : Type DataType [0..1] « Quantity | Ratio | Range » 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) subject : Reference [1..1] « Patient | Group | Location | Device » The actual focus of a service request when it is not the subject of record representing something or someone associated with the subject such as a spouse, parent, fetus, or donor. The focus of a service request could also be an existing condition, an intervention, the subject's diet, another service request on the subject, or a body structure such as tumor or implanted device focus : Reference [0..*] « Any » An encounter that provides additional information about the healthcare context in which this request is made encounter : Reference [0..1] « Encounter » The date/time at which the requested service should occur occurrence[x] : Type DataType [0..1] « dateTime | Period | Timing » If a CodeableConcept is present, it indicates the pre-condition for performing Indicates that the service. For example "pain", "on flare-up", etc service (e.g., procedure, lab test) should be performed when needed (Boolean option) asNeeded[x] asNeeded : Type boolean [0..1] « boolean Indicates specific criteria that need to be met to perform the service (e.g., lab results or symptoms) asNeededFor | : CodeableConcept ; [0..*] « A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. null (Strength=Example) SNOMEDCTMedicationAsNeededRea... ?? » « This element has or is affected by some invariants C » When the request transitioned to being actionable authoredOn : dateTime [0..1] The individual who initiated the request and has responsibility for its activation requester : Reference [0..1] « Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | Group » Desired type of performer for doing the requested service performerType : CodeableConcept [0..1] « Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. null (Strength=Example) ParticipantRoles ?? » The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc performer : Reference [0..*] « Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | Group » 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 locationCode location : CodeableConcept CodeableReference [0..*] « Location ; A location type where services are delivered. null (Strength=Example) v3.ServiceDeliveryLocationRol... ServiceDeliveryLocationRoleTy... ?? » A reference to the The reason or the preferred location(s) where indication for requesting the procedure should actually happen. E.g. at home or nursing day care center service (e.g., procedure, lab test) locationReference reason : Reference CodeableReference [0..*] « Location Condition » | Observation | 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` reasonCode DiagnosticReport : CodeableConcept | DocumentReference [0..*] « | DetectedIssue | Procedure | RiskAssessment ; Diagnosis or problem codes justifying the reason for requesting the service investigation. (Strength=Example) ProcedureReasonCodes ?? » Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in `supportingInfo` reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference » Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service insurance : Reference [0..*] « Coverage | ClaimResponse » 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 'ask at order entry questions (AOEs)". (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 supportingInfo : Reference CodeableReference [0..*] « Any » One or more specimens that the laboratory procedure will use specimen : Reference [0..*] « Specimen » Anatomic location where the procedure should be performed. This is the target site bodySite bodyStructure : CodeableConcept CodeableReference [0..*] [0..1] « BodyStructure ; Codes describing anatomical locations. body structures. May include laterality. (Strength=Example) SNOMEDCTBodyStructures ?? » Any other notes and comments made about the service request. For example, internal billing notes note : Annotation [0..*] Key events in the history of the request relevantHistory : Reference [0..*] « Provenance » OrderDetail Indicates the context of the order details by reference parameterFocus[x] : DataType [0..1] « CodeableConcept | Reference ( Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition )| canonical ( DeviceDefinition ) » Parameter A value representing the additional detail or instructions for the order (e.g., catheter insertion, body elevation, descriptive device configuration and/or setting instructions) code : CodeableConcept [1..1] « null (Strength=Example) RequestOrderDetailParameterCo... ?? » Indicates a value for the order detail value[x] : DataType [1..1] « Quantity | Ratio | Range | boolean | CodeableConcept | string | Period » PatientInstruction Instructions in terms that are understood by the patient or consumer patientInstruction instruction[x] : string DataType [0..1] « markdown | Reference ( DocumentReference ) » Key events in the history of The parameter details for the request service being requested relevantHistory parameter : Reference [1..*] Additional details and instructions about how the services are to be delivered. For example, an 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. Questions or additional information to be gathered from a patient may be included here orderDetail [0..*] « Provenance Instructions in terms that are understood by the patient or consumer patientInstruction » [0..*]

XML Template 

<

<ServiceRequest xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifiers assigned to this order --></identifier>
 <</instantiatesCanonical>
 <
 <</basedOn>
 <</replaces>

 <basedOn><!-- 0..* Reference(CarePlan|DocumentReference|DocumentReference|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest) What request fulfills --></basedOn>

 <replaces><!-- 0..* Reference(CarePlan|CommunicationRequest|DeviceRequest|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest|
   VisionPrescription) What request replaces --></replaces>
 <requisition><!-- 0..1 Identifier Composite Request ID --></requisition>
 <
 <

 <status value="[code]"/><!-- 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <intent value="[code]"/><!-- 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->

 <category><!-- 0..* CodeableConcept Classification of service --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if service/procedure should not be performed -->
 <</code>
 <</orderDetail>
 <</quantity[x]>
 <</subject>

 <code><!-- I 0..1 CodeableReference(ActivityDefinition|PlanDefinition) What is being requested/ordered --></code>
 <orderDetail>  <!-- I 0..* Additional information about the request -->
  <parameterFocus[x]><!-- 0..1 CodeableConcept|Reference(
    BiologicallyDerivedProduct|Device|DeviceRequest|Medication|MedicationRequest|
    MedicinalProductDefinition|Substance|SubstanceDefinition)|canonical(
    DeviceDefinition) The context of the order details by reference --></parameterFocus[x]>

  <parameter>  <!-- 1..* The parameter details for the service being requested -->
   <code><!-- 1..1 CodeableConcept The detail of the order being requested --></code>
   <value[x]><!-- 1..1 Quantity|Ratio|Range|boolean|CodeableConcept|string|
     Period The value for the order detail --></value[x]>

  </parameter>
 </orderDetail>
 <quantity[x]><!-- 0..1 Quantity|Ratio|Range Service amount --></quantity[x]>
 <subject><!-- 1..1 Reference(Device|Group|Location|Patient) Individual or Entity the service is ordered for --></subject>
 <focus><!-- 0..* Reference(Any) What the service request is about, when it is not about the subject of record --></focus>

 <encounter><!-- 0..1 Reference(Encounter) Encounter in which the request was created --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing When service should occur --></occurrence[x]>
 <</asNeeded[x]>

 <asNeeded value="[boolean]"/><!-- 0..1 Perform the service "as needed" -->
 <asNeededFor><!-- I 0..* CodeableConcept Specified criteria for the service --></asNeededFor>

 <authoredOn value="[dateTime]"/><!-- 0..1 Date request signed -->
 <|
   </requester>

 <requester><!-- 0..1 Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who/what is requesting service --></requester>
 <performerType><!-- 0..1 CodeableConcept Performer role --></performerType>
 <|
   </performer>
 <</locationCode>
 <</locationReference>
 <</reasonCode>
 <|
   </reasonReference>
 <</insurance>
 <</supportingInfo>

 <performer><!-- 0..* Reference(CareTeam|Device|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Requested performer --></performer>

 <location><!-- 0..* CodeableReference(Location) Requested location icon --></location>
 <reason><!-- 0..* CodeableReference(Condition|DetectedIssue|DiagnosticReport|
   DocumentReference|Observation|Procedure|RiskAssessment) Reason or indication for requesting the service --></reason>

 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <supportingInfo><!-- 0..* CodeableReference(Any) Additional clinical information --></supportingInfo>

 <specimen><!-- 0..* Reference(Specimen) Procedure Samples --></specimen>
 <</bodySite>

 <bodyStructure><!-- 0..1 CodeableReference(BodyStructure) BodyStructure-based location on the body --></bodyStructure>

 <note><!-- 0..* Annotation Comments --></note>
 <

 <patientInstruction>  <!-- 0..* Patient or consumer-oriented instructions -->
  <instruction[x]><!-- 0..1 markdown|Reference(DocumentReference) Patient or consumer-oriented instructions --></instruction[x]>
 </patientInstruction>

 <relevantHistory><!-- 0..* Reference(Provenance) Request provenance --></relevantHistory>
</ServiceRequest>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "ServiceRequest",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifiers assigned to this order
  "
  "
  "
  "

  "basedOn" : [{ Reference(CarePlan|DocumentReference|DocumentReference|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest) }], // What request fulfills

  "replaces" : [{ Reference(CarePlan|CommunicationRequest|DeviceRequest|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest|
   VisionPrescription) }], // What request replaces
  "requisition" : { Identifier }, // Composite Request ID
  "
  "

  "status" : "<code>", // R!  draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "intent" : "<code>", // R!  proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option

  "category" : [{ CodeableConcept }], // Classification of service
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if service/procedure should not be performed
  "
  "

  "code" : { CodeableReference(ActivityDefinition|PlanDefinition) }, // I What is being requested/ordered
  "orderDetail" : [{ // I Additional information about the request
    // parameterFocus[x]: The context of the order details by reference. One of these 3:

    "parameterFocusCodeableConcept" : { CodeableConcept },
    "parameterFocusReference" : { Reference(BiologicallyDerivedProduct|Device|
    DeviceRequest|Medication|MedicationRequest|MedicinalProductDefinition|
    Substance|SubstanceDefinition) },

    "parameterFocusCanonical" : "<canonical(DeviceDefinition)>",
    "parameter" : [{ // R!  The parameter details for the service being requested
      "code" : { CodeableConcept }, // R!  The detail of the order being requested
      // value[x]: The value for the order detail. One of these 7:

      "valueQuantity" : { Quantity },
      "valueRatio" : { Ratio },
      "valueRange" : { Range },
      "valueBoolean" : <boolean>,
      "valueCodeableConcept" : { CodeableConcept },
      "valueString" : "<string>",
      "valuePeriod" : { Period }
    }]
  }],

  // quantity[x]: Service amount. One of these 3:
  " },
  " },
  " },
  "

  "quantityQuantity" : { Quantity },
  "quantityRatio" : { Ratio },
  "quantityRange" : { Range },
  "subject" : { Reference(Device|Group|Location|Patient) }, // R!  Individual or Entity the service is ordered for
  "focus" : [{ Reference(Any) }], // What the service request is about, when it is not about the subject of record

  "encounter" : { Reference(Encounter) }, // Encounter in which the request was created
  // occurrence[x]: When service should occur. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  
  ">,
  " },

  "asNeeded" : <boolean>, // Perform the service "as needed"
  "asNeededFor" : [{ CodeableConcept }], // I Specified criteria for the service

  "authoredOn" : "<dateTime>", // Date request signed
  "|
   

  "requester" : { Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who/what is requesting service
  "performerType" : { CodeableConcept }, // Performer role
  "|
   
  "
  "
  "
  "|
   
  "
  "

  "performer" : [{ Reference(CareTeam|Device|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Requested performer

  "location" : [{ CodeableReference(Location) }], // Requested location icon
  "reason" : [{ CodeableReference(Condition|DetectedIssue|DiagnosticReport|
   DocumentReference|Observation|Procedure|RiskAssessment) }], // Reason or indication for requesting the service

  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "supportingInfo" : [{ CodeableReference(Any) }], // Additional clinical information

  "specimen" : [{ Reference(Specimen) }], // Procedure Samples
  "

  "bodyStructure" : { CodeableReference(BodyStructure) }, // BodyStructure-based location on the body

  "note" : [{ Annotation }], // Comments
  "

  "patientInstruction" : [{ // Patient or consumer-oriented instructions
    // instruction[x]: Patient or consumer-oriented instructions. One of these 2:

    "instructionMarkdown" : "<markdown>",
    "instructionReference" : { Reference(DocumentReference) }
  }],

  "relevantHistory" : [{ Reference(Provenance) }] // Request provenance
}

Turtle Template 

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


[ a fhir:;

[ a fhir:ServiceRequest;

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

  # from 
  # from 
  fhir:
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  fhir:
  fhir:
  fhir:
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  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  # . One of these 3
    fhir: ]
    fhir: ]
    fhir: ]
  fhir:
  fhir:
  # . One of these 3
    fhir: ]
    fhir: ]
    fhir: ]
  # . One of these 2
    fhir: ]
    fhir: ]
  fhir:
  fhir:
  fhir:
  fhir:|
  
  fhir:
  fhir:
  fhir:
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  fhir:
  fhir:
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  fhir:

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Identifiers assigned to this order
  fhir:basedOn  ( [ Reference(CarePlan|DocumentReference|DocumentReference|MedicationRequest|NutritionOrder|
  RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* What request fulfills

  fhir:replaces  ( [ Reference(CarePlan|CommunicationRequest|DeviceRequest|MedicationRequest|NutritionOrder|
  RequestOrchestration|ServiceRequest|VisionPrescription) ] ... ) ; # 0..* What request replaces

  fhir:requisition [ Identifier ] ; # 0..1 Composite Request ID
  fhir:status [ code ] ; # 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for current status
  fhir:intent [ code ] ; # 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Classification of service
  fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat
  fhir:doNotPerform [ boolean ] ; # 0..1 True if service/procedure should not be performed
  fhir:code [ CodeableReference(ActivityDefinition|PlanDefinition) ] ; # 0..1 I What is being requested/ordered
  fhir:orderDetail ( [ # 0..* I Additional information about the request
    # parameterFocus[x] : 0..1 The context of the order details by reference. One of these 3
      fhir:parameterFocus [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:parameterFocus [  a fhir:Reference ; Reference(BiologicallyDerivedProduct|Device|DeviceRequest|Medication|MedicationRequest|
  MedicinalProductDefinition|Substance|SubstanceDefinition) ]

      fhir:parameterFocus [  a fhir:Canonical ; canonical(DeviceDefinition) ]
    fhir:parameter ( [ # 1..* The parameter details for the service being requested
      fhir:code [ CodeableConcept ] ; # 1..1 The detail of the order being requested
      # value[x] : 1..1 The value for the order detail. One of these 7
        fhir:value [  a fhir:Quantity ; Quantity ]
        fhir:value [  a fhir:Ratio ; Ratio ]
        fhir:value [  a fhir:Range ; Range ]
        fhir:value [  a fhir:Boolean ; boolean ]
        fhir:value [  a fhir:CodeableConcept ; CodeableConcept ]
        fhir:value [  a fhir:String ; string ]
        fhir:value [  a fhir:Period ; Period ]
    ] ... ) ;
  ] ... ) ;
  # quantity[x] : 0..1 Service amount. One of these 3
    fhir:quantity [  a fhir:Quantity ; Quantity ]
    fhir:quantity [  a fhir:Ratio ; Ratio ]
    fhir:quantity [  a fhir:Range ; Range ]
  fhir:subject [ Reference(Device|Group|Location|Patient) ] ; # 1..1 Individual or Entity the service is ordered for
  fhir:focus  ( [ Reference(Any) ] ... ) ; # 0..* What the service request is about, when it is not about the subject of record
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter in which the request was created
  # occurrence[x] : 0..1 When service should occur. One of these 3
    fhir:occurrence [  a fhir:DateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
    fhir:occurrence [  a fhir:Timing ; Timing ]
  fhir:asNeeded [ boolean ] ; # 0..1 Perform the service "as needed"
  fhir:asNeededFor  ( [ CodeableConcept ] ... ) ; # 0..* I Specified criteria for the service
  fhir:authoredOn [ dateTime ] ; # 0..1 Date request signed
  fhir:requester [ Reference(Device|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who/what is requesting service
  fhir:performerType [ CodeableConcept ] ; # 0..1 Performer role
  fhir:performer  ( [ Reference(CareTeam|Device|Group|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Requested performer

  fhir:location  ( [ CodeableReference(Location) ] ... ) ; # 0..* Requested location
  fhir:reason  ( [ CodeableReference(Condition|DetectedIssue|DiagnosticReport|DocumentReference|Observation|Procedure|
  RiskAssessment) ] ... ) ; # 0..* Reason or indication for requesting the service

  fhir:insurance  ( [ Reference(ClaimResponse|Coverage) ] ... ) ; # 0..* Associated insurance coverage
  fhir:supportingInfo  ( [ CodeableReference(Any) ] ... ) ; # 0..* Additional clinical information
  fhir:specimen  ( [ Reference(Specimen) ] ... ) ; # 0..* Procedure Samples
  fhir:bodyStructure [ CodeableReference(BodyStructure) ] ; # 0..1 BodyStructure-based location on the body
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments
  fhir:patientInstruction ( [ # 0..* Patient or consumer-oriented instructions
    # instruction[x] : 0..1 Patient or consumer-oriented instructions. One of these 2
      fhir:instruction [  a fhir:Markdown ; markdown ]
      fhir:instruction [  a fhir:Reference ; Reference(DocumentReference) ]
  ] ... ) ;
  fhir:relevantHistory  ( [ Reference(Provenance) ] ... ) ; # 0..* Request provenance

]

Changes since R3 from R5 to R6

ServiceRequest
ServiceRequest.basedOn
  • Type Reference: Added Target Types DocumentReference, RequestOrchestration, NutritionOrder, DocumentReference
ServiceRequest.replaces
  • Type Reference: Added Target Types MedicationRequest, RequestOrchestration, CarePlan, DeviceRequest, CommunicationRequest, NutritionOrder, VisionPrescription
ServiceRequest.status
  • Remove codes revoked , completed
  • Add code ended
ServiceRequest.statusReason
  • Added Element
ServiceRequest.intent
  • Remove codes original-order , reflex-order , filler-order , instance-order
ServiceRequest.orderDetail.parameterFocus[x]
  • Renamed from parameterFocus to parameterFocus[x]
  • Add Types CodeableConcept, Reference(Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition), canonical(DeviceDefinition)
  • Remove Type CodeableReference
ServiceRequest.asNeeded
  • Renamed from asNeeded[x] to asNeeded
  • Remove Type CodeableConcept
ServiceRequest.asNeededFor
  • Added Element
ServiceRequest.requester
  • Type Reference: Added Target Type Group
ServiceRequest.performer
  • Type Reference: Added Target Type Group
ServiceRequest.bodyStructure
  • Type changed from Reference(BodyStructure) to CodeableReference
ServiceRequest.instantiatesCanonical
  • Deleted
ServiceRequest.instantiatesUri
  • Deleted
ServiceRequest.bodySite
  • Deleted

This resource did not exist in Release 2 Changes from R4 and R4B to R6

ServiceRequest
ServiceRequest.basedOn
  • Type Reference: Added Target Types DocumentReference, RequestOrchestration, NutritionOrder, DocumentReference
ServiceRequest.replaces
  • Type Reference: Added Target Types MedicationRequest, RequestOrchestration, CarePlan, DeviceRequest, CommunicationRequest, NutritionOrder, VisionPrescription
ServiceRequest.status
  • Remove codes revoked , completed
  • Add code ended
ServiceRequest.statusReason
  • Added Element
ServiceRequest.intent
  • Remove codes original-order , reflex-order , filler-order , instance-order
ServiceRequest.code
  • Type changed from CodeableConcept to CodeableReference
ServiceRequest.orderDetail
  • Type changed from CodeableConcept to BackboneElement
ServiceRequest.orderDetail.parameterFocus[x]
  • Added Element
ServiceRequest.orderDetail.parameter
  • Added Mandatory Element
ServiceRequest.orderDetail.parameter.code
  • Added Mandatory Element
ServiceRequest.orderDetail.parameter.value[x]
  • Added Mandatory Element
ServiceRequest.focus
  • Added Element
ServiceRequest.asNeeded
  • Renamed from asNeeded[x] to asNeeded
  • Remove Type CodeableConcept
ServiceRequest.asNeededFor
  • Added Element
ServiceRequest.requester
  • Type Reference: Added Target Type Group
ServiceRequest.performer
  • Type Reference: Added Target Type Group
ServiceRequest.location
  • Added Element
  • Merged both locationCode and locationReference into location
ServiceRequest.reason
  • Added Element
  • Merged both reasonCode and reasonReference into reason
ServiceRequest.supportingInfo
  • Type changed from Reference(Resource) to CodeableReference
ServiceRequest.bodyStructure
  • Added Element
ServiceRequest.patientInstruction
  • Max Cardinality changed from 1 to *
  • Type changed from string to BackboneElement
ServiceRequest.patientInstruction.instruction[x]
  • Added Element
ServiceRequest.instantiatesCanonical
  • Deleted
ServiceRequest.instantiatesUri
  • Deleted
ServiceRequest.locationCode
  • Deleted (-> ServiceRequest.location.concept)
ServiceRequest.locationReference
  • Deleted (-> ServiceRequest.location.reference)
ServiceRequest.reasonCode
  • Deleted (-> reason.concept)
ServiceRequest.reasonReference
  • Deleted (-> reason.reference)
ServiceRequest.bodySite
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Structure

instantiatesUri Σ 0..* uri Instantiates external protocol or definition Quantity Ratio Preconditions for Explanation/Justification for service 0..* Location string
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . ServiceRequest I TU N DomainResource A request for a service to be performed
+ Rule: orderDetail SHALL only be present if code is present
+ Rule: asNeededFor SHALL only be present if asNeeded is empty or true

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Identifiers assigned to this order
instantiatesCanonical Σ 0..* canonical ( ActivityDefinition | PlanDefinition ) Instantiates FHIR protocol or definition
. . . basedOn Σ 0..* Reference ( CarePlan | DocumentReference | ServiceRequest | MedicationRequest | RequestOrchestration | NutritionOrder | DocumentReference ) What request fulfills

. . . replaces Σ 0..* Reference ( ServiceRequest | MedicationRequest | RequestOrchestration | CarePlan | DeviceRequest | CommunicationRequest | NutritionOrder | VisionPrescription ) What request replaces

. . . requisition Σ 0..1 Identifier Composite Request ID
. . . status ?! Σ 1..1 code draft | active | on-hold | revoked entered-in-error | ended | completed | entered-in-error revoked | unknown
Binding: RequestStatus ( Required )
. . intent . statusReason 0..* CodeableConcept Reason for current status
Binding: Service Request Status Reason ( Example )

... intent ?! Σ 1..1 code proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent ( Required )
. . . category Σ 0..* CodeableConcept Classification of service
Binding: Service Request Category Codes ( Example )

. . . priority Σ 0..1 code routine | urgent | asap | stat
Request priority Binding: RequestPriority ( Required )
. . . doNotPerform ?! Σ 0..1 boolean True if service/procedure should not be performed
. . . code Σ C 0..1 CodeableConcept CodeableReference ( ActivityDefinition | PlanDefinition ) What is being requested/ordered
Binding: Procedure Codes (SNOMED CT) ( Example )
. . . orderDetail Σ I C 0..* BackboneElement Additional information about the request

.... parameterFocus[x] 0..1 The context of the order details by reference
..... parameterFocusCodeableConcept CodeableConcept Additional order information
. . . . . parameterFocusReference Reference ( Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition )
..... parameterFocusCanonical canonical ( DeviceDefinition )
.... parameter Σ 1..* BackboneElement The parameter details for the service being requested
Service
. . . . . code Σ 1..1 CodeableConcept The detail of the order being requested
Binding: Request Order Details Codes OrderDetail Parameter Code ( Example )
. . quantity[x] . . . value[x] Σ 1..1 The value for the order detail
0..1
. . . . . . valueQuantity Quantity Service amount
. . . . . . quantityQuantity valueRatio Ratio
. . . . . . valueRange Range
. . . . . . valueBoolean boolean
. . . . . . quantityRatio valueCodeableConcept CodeableConcept
. . . . . . valueString string
. . . . . . valuePeriod Period
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
... . quantityRange quantityRatio Ratio
. . . . quantityRange Range
. . . subject Σ 1..1 Reference ( Patient | Group | Location | Device ) Individual or Entity the service is ordered for
. . . focus Σ 0..* Reference ( Any ) What the service request is about, when it is not about the subject of record

. . . encounter Σ 0..1 Reference ( Encounter ) Encounter in which the request was created
. . . occurrence[x] Σ 0..1 When service should occur
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . asNeeded[x] . asNeeded Σ 0..1 boolean Perform the service "as needed"
SNOMED CT Medication As Needed Reason Codes ( Example )
. . asNeededBoolean boolean . asNeededFor asNeededCodeableConcept Σ C 0..* CodeableConcept Specified criteria for the service
Binding: SNOMED CT Medication As Needed Reason Codes ( Example )

. . . authoredOn Σ 0..1 dateTime Date request signed
. . . requester Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | Group ) Who/what is requesting service
. . . performerType Σ 0..1 CodeableConcept Performer role
Binding: Participant Roles ( Example )
. . . performer Σ 0..* Reference ( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | Group ) Requested performer
locationCode Σ 0..* CodeableConcept Requested location V3 Value SetServiceDeliveryLocationRoleType ( Example )
. . . locationReference location Σ 0..* Reference CodeableReference ( Location ) Requested location
Binding: ServiceDeliveryLocationRoleType icon reasonCode Σ 0..* CodeableConcept Explanation/Justification for procedure or service Procedure Reason Codes ( Example )

. . reasonReference . reason Σ 0..* Reference CodeableReference ( Condition | Observation | DiagnosticReport | DocumentReference | DetectedIssue | Procedure | RiskAssessment ) Reason or indication for requesting the service
Binding: Procedure Reason Codes ( Example )

. . . insurance 0..* Reference ( Coverage | ClaimResponse ) Associated insurance coverage

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

. . . specimen Σ 0..* Reference ( Specimen ) Procedure Samples

. . bodySite . bodyStructure Σ 0..1 CodeableConcept CodeableReference ( BodyStructure ) BodyStructure-based location on Body the body
Binding: SNOMED CT Body Structures ( Example )
. . . note 0..* Annotation Comments

. . . patientInstruction 0..* Σ BackboneElement Patient or consumer-oriented instructions

0..1
. . . . instruction[x] Σ 0..1 Patient or consumer-oriented instructions
. . . . . instructionMarkdown markdown
..... instructionReference Reference ( DocumentReference )
. . . relevantHistory 0..* Reference ( Provenance ) Request provenance


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

ServiceRequest ( DomainResource ) Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller 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 ServiceRequest 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 ServiceRequest instantiatesUri : uri [0..*] Plan/proposal/order fulfilled by this request basedOn : Reference [0..*] « CarePlan | ServiceRequest DocumentReference | ServiceRequest | MedicationRequest | RequestOrchestration | NutritionOrder | DocumentReference » The request takes the place of the referenced completed or terminated request(s) replaces : Reference [0..*] « ServiceRequest | MedicationRequest | RequestOrchestration | CarePlan | DeviceRequest | CommunicationRequest | NutritionOrder | VisionPrescription » 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 requisition : Identifier [0..1] The status of the order (this element modifies the meaning of other elements) status : code [1..1] « The status of a service order. null (Strength=Required) RequestStatus ! » Provides reason why the service request status is what it is. The statusReason can be used to explain why a service request is suspended, cancelled, or on hold, including administrative and clinical reasons statusReason : CodeableConcept [0..*] « null (Strength=Example) ServiceRequestStatusReason ?? » 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] « The kind of service request. null (Strength=Required) RequestIntent ! » A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure") category : CodeableConcept [0..*] « Classification of the requested service. null (Strength=Example) ServiceRequestCategoryCodes ?? » Indicates how quickly the ServiceRequest should be addressed with respect to other requests priority : code [0..1] « Identifies the level of importance to be assigned to actioning the request. null (Strength=Required) RequestPriority ! » Set this to true if the record is saying that the service/procedure should NOT be performed (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] A code or reference that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have has been requested code : CodeableConcept CodeableReference [0..1] « 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](valueset-diagnostic-requests.html). (Strength=Example) ProcedureCodes(SNOMEDCT) ?? » 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 orderDetail ActivityDefinition : CodeableConcept | PlanDefinition [0..*] « ; Codified order entry details which are based on order context. null (Strength=Example) ServiceRequestOrderDetailsCod... ProcedureCodesSNOMEDCT ?? » « This element has or is affected by some invariants C » 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) quantity[x] : Type DataType [0..1] « Quantity | Ratio | Range » 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) subject : Reference [1..1] « Patient | Group | Location | Device » The actual focus of a service request when it is not the subject of record representing something or someone associated with the subject such as a spouse, parent, fetus, or donor. The focus of a service request could also be an existing condition, an intervention, the subject's diet, another service request on the subject, or a body structure such as tumor or implanted device focus : Reference [0..*] « Any » An encounter that provides additional information about the healthcare context in which this request is made encounter : Reference [0..1] « Encounter » The date/time at which the requested service should occur occurrence[x] : Type DataType [0..1] « dateTime | Period | Timing » If a CodeableConcept is present, it indicates the pre-condition for performing Indicates that the service. For example "pain", "on flare-up", etc service (e.g., procedure, lab test) should be performed when needed (Boolean option) asNeeded[x] asNeeded : Type boolean [0..1] « boolean Indicates specific criteria that need to be met to perform the service (e.g., lab results or symptoms) asNeededFor | : CodeableConcept ; [0..*] « A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. null (Strength=Example) SNOMEDCTMedicationAsNeededRea... ?? » « This element has or is affected by some invariants C » When the request transitioned to being actionable authoredOn : dateTime [0..1] The individual who initiated the request and has responsibility for its activation requester : Reference [0..1] « Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | Group » Desired type of performer for doing the requested service performerType : CodeableConcept [0..1] « Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. null (Strength=Example) ParticipantRoles ?? » The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc performer : Reference [0..*] « Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | Group » 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 locationCode location : CodeableConcept CodeableReference [0..*] « Location ; A location type where services are delivered. null (Strength=Example) v3.ServiceDeliveryLocationRol... ServiceDeliveryLocationRoleTy... ?? » A reference to the The reason or the preferred location(s) where indication for requesting the procedure should actually happen. E.g. at home or nursing day care center service (e.g., procedure, lab test) locationReference reason : Reference CodeableReference [0..*] « Location Condition » | Observation | 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` reasonCode DiagnosticReport : CodeableConcept | DocumentReference [0..*] « | DetectedIssue | Procedure | RiskAssessment ; Diagnosis or problem codes justifying the reason for requesting the service investigation. (Strength=Example) ProcedureReasonCodes ?? » Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in `supportingInfo` reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference » Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service insurance : Reference [0..*] « Coverage | ClaimResponse » 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 'ask at order entry questions (AOEs)". (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 supportingInfo : Reference CodeableReference [0..*] « Any » One or more specimens that the laboratory procedure will use specimen : Reference [0..*] « Specimen » Anatomic location where the procedure should be performed. This is the target site bodySite bodyStructure : CodeableConcept CodeableReference [0..*] [0..1] « BodyStructure ; Codes describing anatomical locations. body structures. May include laterality. (Strength=Example) SNOMEDCTBodyStructures ?? » Any other notes and comments made about the service request. For example, internal billing notes note : Annotation [0..*] Key events in the history of the request relevantHistory : Reference [0..*] « Provenance » OrderDetail Indicates the context of the order details by reference parameterFocus[x] : DataType [0..1] « CodeableConcept | Reference ( Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition )| canonical ( DeviceDefinition ) » Parameter A value representing the additional detail or instructions for the order (e.g., catheter insertion, body elevation, descriptive device configuration and/or setting instructions) code : CodeableConcept [1..1] « null (Strength=Example) RequestOrderDetailParameterCo... ?? » Indicates a value for the order detail value[x] : DataType [1..1] « Quantity | Ratio | Range | boolean | CodeableConcept | string | Period » PatientInstruction Instructions in terms that are understood by the patient or consumer patientInstruction instruction[x] : string DataType [0..1] « markdown | Reference ( DocumentReference ) » Key events in the history of The parameter details for the request service being requested relevantHistory parameter : Reference [1..*] Additional details and instructions about how the services are to be delivered. For example, an 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. Questions or additional information to be gathered from a patient may be included here orderDetail [0..*] « Provenance Instructions in terms that are understood by the patient or consumer patientInstruction » [0..*]

XML Template 

<

<ServiceRequest xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifiers assigned to this order --></identifier>
 <</instantiatesCanonical>
 <
 <</basedOn>
 <</replaces>

 <basedOn><!-- 0..* Reference(CarePlan|DocumentReference|DocumentReference|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest) What request fulfills --></basedOn>

 <replaces><!-- 0..* Reference(CarePlan|CommunicationRequest|DeviceRequest|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest|
   VisionPrescription) What request replaces --></replaces>
 <requisition><!-- 0..1 Identifier Composite Request ID --></requisition>
 <
 <

 <status value="[code]"/><!-- 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <intent value="[code]"/><!-- 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->

 <category><!-- 0..* CodeableConcept Classification of service --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if service/procedure should not be performed -->
 <</code>
 <</orderDetail>
 <</quantity[x]>
 <</subject>

 <code><!-- I 0..1 CodeableReference(ActivityDefinition|PlanDefinition) What is being requested/ordered --></code>
 <orderDetail>  <!-- I 0..* Additional information about the request -->
  <parameterFocus[x]><!-- 0..1 CodeableConcept|Reference(
    BiologicallyDerivedProduct|Device|DeviceRequest|Medication|MedicationRequest|
    MedicinalProductDefinition|Substance|SubstanceDefinition)|canonical(
    DeviceDefinition) The context of the order details by reference --></parameterFocus[x]>

  <parameter>  <!-- 1..* The parameter details for the service being requested -->
   <code><!-- 1..1 CodeableConcept The detail of the order being requested --></code>
   <value[x]><!-- 1..1 Quantity|Ratio|Range|boolean|CodeableConcept|string|
     Period The value for the order detail --></value[x]>

  </parameter>
 </orderDetail>
 <quantity[x]><!-- 0..1 Quantity|Ratio|Range Service amount --></quantity[x]>
 <subject><!-- 1..1 Reference(Device|Group|Location|Patient) Individual or Entity the service is ordered for --></subject>
 <focus><!-- 0..* Reference(Any) What the service request is about, when it is not about the subject of record --></focus>

 <encounter><!-- 0..1 Reference(Encounter) Encounter in which the request was created --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing When service should occur --></occurrence[x]>
 <</asNeeded[x]>

 <asNeeded value="[boolean]"/><!-- 0..1 Perform the service "as needed" -->
 <asNeededFor><!-- I 0..* CodeableConcept Specified criteria for the service --></asNeededFor>

 <authoredOn value="[dateTime]"/><!-- 0..1 Date request signed -->
 <|
   </requester>

 <requester><!-- 0..1 Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who/what is requesting service --></requester>
 <performerType><!-- 0..1 CodeableConcept Performer role --></performerType>
 <|
   </performer>
 <</locationCode>
 <</locationReference>
 <</reasonCode>
 <|
   </reasonReference>
 <</insurance>
 <</supportingInfo>

 <performer><!-- 0..* Reference(CareTeam|Device|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Requested performer --></performer>

 <location><!-- 0..* CodeableReference(Location) Requested location icon --></location>
 <reason><!-- 0..* CodeableReference(Condition|DetectedIssue|DiagnosticReport|
   DocumentReference|Observation|Procedure|RiskAssessment) Reason or indication for requesting the service --></reason>

 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <supportingInfo><!-- 0..* CodeableReference(Any) Additional clinical information --></supportingInfo>

 <specimen><!-- 0..* Reference(Specimen) Procedure Samples --></specimen>
 <</bodySite>

 <bodyStructure><!-- 0..1 CodeableReference(BodyStructure) BodyStructure-based location on the body --></bodyStructure>

 <note><!-- 0..* Annotation Comments --></note>
 <

 <patientInstruction>  <!-- 0..* Patient or consumer-oriented instructions -->
  <instruction[x]><!-- 0..1 markdown|Reference(DocumentReference) Patient or consumer-oriented instructions --></instruction[x]>
 </patientInstruction>

 <relevantHistory><!-- 0..* Reference(Provenance) Request provenance --></relevantHistory>
</ServiceRequest>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "ServiceRequest",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifiers assigned to this order
  "
  "
  "
  "

  "basedOn" : [{ Reference(CarePlan|DocumentReference|DocumentReference|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest) }], // What request fulfills

  "replaces" : [{ Reference(CarePlan|CommunicationRequest|DeviceRequest|
   MedicationRequest|NutritionOrder|RequestOrchestration|ServiceRequest|
   VisionPrescription) }], // What request replaces
  "requisition" : { Identifier }, // Composite Request ID
  "
  "

  "status" : "<code>", // R!  draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "intent" : "<code>", // R!  proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option

  "category" : [{ CodeableConcept }], // Classification of service
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if service/procedure should not be performed
  "
  "

  "code" : { CodeableReference(ActivityDefinition|PlanDefinition) }, // I What is being requested/ordered
  "orderDetail" : [{ // I Additional information about the request
    // parameterFocus[x]: The context of the order details by reference. One of these 3:

    "parameterFocusCodeableConcept" : { CodeableConcept },
    "parameterFocusReference" : { Reference(BiologicallyDerivedProduct|Device|
    DeviceRequest|Medication|MedicationRequest|MedicinalProductDefinition|
    Substance|SubstanceDefinition) },

    "parameterFocusCanonical" : "<canonical(DeviceDefinition)>",
    "parameter" : [{ // R!  The parameter details for the service being requested
      "code" : { CodeableConcept }, // R!  The detail of the order being requested
      // value[x]: The value for the order detail. One of these 7:

      "valueQuantity" : { Quantity },
      "valueRatio" : { Ratio },
      "valueRange" : { Range },
      "valueBoolean" : <boolean>,
      "valueCodeableConcept" : { CodeableConcept },
      "valueString" : "<string>",
      "valuePeriod" : { Period }
    }]
  }],

  // quantity[x]: Service amount. One of these 3:
  " },
  " },
  " },
  "

  "quantityQuantity" : { Quantity },
  "quantityRatio" : { Ratio },
  "quantityRange" : { Range },
  "subject" : { Reference(Device|Group|Location|Patient) }, // R!  Individual or Entity the service is ordered for
  "focus" : [{ Reference(Any) }], // What the service request is about, when it is not about the subject of record

  "encounter" : { Reference(Encounter) }, // Encounter in which the request was created
  // occurrence[x]: When service should occur. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  
  ">,
  " },

  "asNeeded" : <boolean>, // Perform the service "as needed"
  "asNeededFor" : [{ CodeableConcept }], // I Specified criteria for the service

  "authoredOn" : "<dateTime>", // Date request signed
  "|
   

  "requester" : { Reference(Device|Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who/what is requesting service
  "performerType" : { CodeableConcept }, // Performer role
  "|
   
  "
  "
  "
  "|
   
  "
  "

  "performer" : [{ Reference(CareTeam|Device|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Requested performer

  "location" : [{ CodeableReference(Location) }], // Requested location icon
  "reason" : [{ CodeableReference(Condition|DetectedIssue|DiagnosticReport|
   DocumentReference|Observation|Procedure|RiskAssessment) }], // Reason or indication for requesting the service

  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "supportingInfo" : [{ CodeableReference(Any) }], // Additional clinical information

  "specimen" : [{ Reference(Specimen) }], // Procedure Samples
  "

  "bodyStructure" : { CodeableReference(BodyStructure) }, // BodyStructure-based location on the body

  "note" : [{ Annotation }], // Comments
  "

  "patientInstruction" : [{ // Patient or consumer-oriented instructions
    // instruction[x]: Patient or consumer-oriented instructions. One of these 2:

    "instructionMarkdown" : "<markdown>",
    "instructionReference" : { Reference(DocumentReference) }
  }],

  "relevantHistory" : [{ Reference(Provenance) }] // Request provenance
}

Turtle Template 

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


[ a fhir:;

[ a fhir:ServiceRequest;

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

  # from 
  # from 
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  # . One of these 3
    fhir: ]
    fhir: ]
    fhir: ]
  fhir:
  fhir:
  # . One of these 3
    fhir: ]
    fhir: ]
    fhir: ]
  # . One of these 2
    fhir: ]
    fhir: ]
  fhir:
  fhir:
  fhir:
  fhir:|
  
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Identifiers assigned to this order
  fhir:basedOn  ( [ Reference(CarePlan|DocumentReference|DocumentReference|MedicationRequest|NutritionOrder|
  RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* What request fulfills

  fhir:replaces  ( [ Reference(CarePlan|CommunicationRequest|DeviceRequest|MedicationRequest|NutritionOrder|
  RequestOrchestration|ServiceRequest|VisionPrescription) ] ... ) ; # 0..* What request replaces

  fhir:requisition [ Identifier ] ; # 0..1 Composite Request ID
  fhir:status [ code ] ; # 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for current status
  fhir:intent [ code ] ; # 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Classification of service
  fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat
  fhir:doNotPerform [ boolean ] ; # 0..1 True if service/procedure should not be performed
  fhir:code [ CodeableReference(ActivityDefinition|PlanDefinition) ] ; # 0..1 I What is being requested/ordered
  fhir:orderDetail ( [ # 0..* I Additional information about the request
    # parameterFocus[x] : 0..1 The context of the order details by reference. One of these 3
      fhir:parameterFocus [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:parameterFocus [  a fhir:Reference ; Reference(BiologicallyDerivedProduct|Device|DeviceRequest|Medication|MedicationRequest|
  MedicinalProductDefinition|Substance|SubstanceDefinition) ]

      fhir:parameterFocus [  a fhir:Canonical ; canonical(DeviceDefinition) ]
    fhir:parameter ( [ # 1..* The parameter details for the service being requested
      fhir:code [ CodeableConcept ] ; # 1..1 The detail of the order being requested
      # value[x] : 1..1 The value for the order detail. One of these 7
        fhir:value [  a fhir:Quantity ; Quantity ]
        fhir:value [  a fhir:Ratio ; Ratio ]
        fhir:value [  a fhir:Range ; Range ]
        fhir:value [  a fhir:Boolean ; boolean ]
        fhir:value [  a fhir:CodeableConcept ; CodeableConcept ]
        fhir:value [  a fhir:String ; string ]
        fhir:value [  a fhir:Period ; Period ]
    ] ... ) ;
  ] ... ) ;
  # quantity[x] : 0..1 Service amount. One of these 3
    fhir:quantity [  a fhir:Quantity ; Quantity ]
    fhir:quantity [  a fhir:Ratio ; Ratio ]
    fhir:quantity [  a fhir:Range ; Range ]
  fhir:subject [ Reference(Device|Group|Location|Patient) ] ; # 1..1 Individual or Entity the service is ordered for
  fhir:focus  ( [ Reference(Any) ] ... ) ; # 0..* What the service request is about, when it is not about the subject of record
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter in which the request was created
  # occurrence[x] : 0..1 When service should occur. One of these 3
    fhir:occurrence [  a fhir:DateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
    fhir:occurrence [  a fhir:Timing ; Timing ]
  fhir:asNeeded [ boolean ] ; # 0..1 Perform the service "as needed"
  fhir:asNeededFor  ( [ CodeableConcept ] ... ) ; # 0..* I Specified criteria for the service
  fhir:authoredOn [ dateTime ] ; # 0..1 Date request signed
  fhir:requester [ Reference(Device|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who/what is requesting service
  fhir:performerType [ CodeableConcept ] ; # 0..1 Performer role
  fhir:performer  ( [ Reference(CareTeam|Device|Group|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Requested performer

  fhir:location  ( [ CodeableReference(Location) ] ... ) ; # 0..* Requested location
  fhir:reason  ( [ CodeableReference(Condition|DetectedIssue|DiagnosticReport|DocumentReference|Observation|Procedure|
  RiskAssessment) ] ... ) ; # 0..* Reason or indication for requesting the service

  fhir:insurance  ( [ Reference(ClaimResponse|Coverage) ] ... ) ; # 0..* Associated insurance coverage
  fhir:supportingInfo  ( [ CodeableReference(Any) ] ... ) ; # 0..* Additional clinical information
  fhir:specimen  ( [ Reference(Specimen) ] ... ) ; # 0..* Procedure Samples
  fhir:bodyStructure [ CodeableReference(BodyStructure) ] ; # 0..1 BodyStructure-based location on the body
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments
  fhir:patientInstruction ( [ # 0..* Patient or consumer-oriented instructions
    # instruction[x] : 0..1 Patient or consumer-oriented instructions. One of these 2
      fhir:instruction [  a fhir:Markdown ; markdown ]
      fhir:instruction [  a fhir:Reference ; Reference(DocumentReference) ]
  ] ... ) ;
  fhir:relevantHistory  ( [ Reference(Provenance) ] ... ) ; # 0..* Request provenance

]

Changes since Release 3 from R5 to R6

ServiceRequest
ServiceRequest.basedOn
  • Type Reference: Added Target Types DocumentReference, RequestOrchestration, NutritionOrder, DocumentReference
ServiceRequest.replaces
  • Type Reference: Added Target Types MedicationRequest, RequestOrchestration, CarePlan, DeviceRequest, CommunicationRequest, NutritionOrder, VisionPrescription
ServiceRequest.status
  • Remove codes revoked , completed
  • Add code ended
ServiceRequest.statusReason
  • Added Element
ServiceRequest.intent
  • Remove codes original-order , reflex-order , filler-order , instance-order
ServiceRequest.orderDetail.parameterFocus[x]
  • Renamed from parameterFocus to parameterFocus[x]
  • Add Types CodeableConcept, Reference(Device | DeviceRequest | Medication | MedicationRequest | BiologicallyDerivedProduct | Substance | SubstanceDefinition | MedicinalProductDefinition), canonical(DeviceDefinition)
  • Remove Type CodeableReference
ServiceRequest.asNeeded
  • Renamed from asNeeded[x] to asNeeded
  • Remove Type CodeableConcept
ServiceRequest.asNeededFor
  • Added Element
ServiceRequest.requester
  • Type Reference: Added Target Type Group
ServiceRequest.performer
  • Type Reference: Added Target Type Group
ServiceRequest.bodyStructure
  • Type changed from Reference(BodyStructure) to CodeableReference
ServiceRequest.instantiatesCanonical
  • Deleted
ServiceRequest.instantiatesUri
  • Deleted
ServiceRequest.bodySite
  • Deleted

This resource did not exist in Release 2 Changes from R4 and R4B to R6

ServiceRequest
ServiceRequest.basedOn
  • Type Reference: Added Target Types DocumentReference, RequestOrchestration, NutritionOrder, DocumentReference
ServiceRequest.replaces
  • Type Reference: Added Target Types MedicationRequest, RequestOrchestration, CarePlan, DeviceRequest, CommunicationRequest, NutritionOrder, VisionPrescription
ServiceRequest.status
  • Remove codes revoked , completed
  • Add code ended
ServiceRequest.statusReason
  • Added Element
ServiceRequest.intent
  • Remove codes original-order , reflex-order , filler-order , instance-order
ServiceRequest.code
  • Type changed from CodeableConcept to CodeableReference
ServiceRequest.orderDetail
  • Type changed from CodeableConcept to BackboneElement
ServiceRequest.orderDetail.parameterFocus[x]
  • Added Element
ServiceRequest.orderDetail.parameter
  • Added Mandatory Element
ServiceRequest.orderDetail.parameter.code
  • Added Mandatory Element
ServiceRequest.orderDetail.parameter.value[x]
  • Added Mandatory Element
ServiceRequest.focus
  • Added Element
ServiceRequest.asNeeded
  • Renamed from asNeeded[x] to asNeeded
  • Remove Type CodeableConcept
ServiceRequest.asNeededFor
  • Added Element
ServiceRequest.requester
  • Type Reference: Added Target Type Group
ServiceRequest.performer
  • Type Reference: Added Target Type Group
ServiceRequest.location
  • Added Element
  • Merged both locationCode and locationReference into location
ServiceRequest.reason
  • Added Element
  • Merged both reasonCode and reasonReference into reason
ServiceRequest.supportingInfo
  • Type changed from Reference(Resource) to CodeableReference
ServiceRequest.bodyStructure
  • Added Element
ServiceRequest.patientInstruction
  • Max Cardinality changed from 1 to *
  • Type changed from string to BackboneElement
ServiceRequest.patientInstruction.instruction[x]
  • Added Element
ServiceRequest.instantiatesCanonical
  • Deleted
ServiceRequest.instantiatesUri
  • Deleted
ServiceRequest.locationCode
  • Deleted (-> ServiceRequest.location.concept)
ServiceRequest.locationReference
  • Deleted (-> ServiceRequest.location.reference)
ServiceRequest.reasonCode
  • Deleted (-> reason.concept)
ServiceRequest.reasonReference
  • Deleted (-> reason.reference)
ServiceRequest.bodySite
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

 

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

12.14.3.1 15.17.4.1 Terminology Bindings

ServiceRequest.orderDetail ServiceRequest.locationCode
Path Definition ValueSet Type Reference Documentation
ServiceRequest.status The status of a service order. RequestStatus Required

Codes identifying the lifecycle stage of a request.

ServiceRequest.statusReason RequestStatus ServiceRequestStatusReason (a valid code from Service Request Status Reason Codes ) Example

Example codes indicating the reason why the service request is in its current status (e.g., on hold, cancelled, suspended). Note that these are in no way complete and might not even be appropriate for some uses.

ServiceRequest.intent The kind of service request. RequestIntent Required RequestIntent

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

ServiceRequest.category Classification of the requested service. ServiceRequestCategoryCodes Example ServiceRequestCategoryCodes

An example value set of SNOMED CT concepts that can classify a requested service

ServiceRequest.priority RequestPriority Required

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

ServiceRequest.code 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](valueset-diagnostic-requests.html). ProcedureCodesSNOMEDCT Example ProcedureCodes(SNOMEDCT)

Procedure Code: All SNOMED CT procedure codes.

ServiceRequest.orderDetail.parameter.code Codified order entry details which are based on order context. RequestOrderDetailParameterCode Example ServiceRequestOrderDetailsCodes

The order detail parameter codes.

ServiceRequest.asNeeded[x] ServiceRequest.asNeededFor A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. SNOMEDCTMedicationAsNeededReasonCodes Example SNOMEDCTMedicationAsNeededReasonCodes

This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set.

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

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

ServiceRequest.location A location type where services are delivered. ServiceDeliveryLocationRoleType icon Example v3.ServiceDeliveryLocationRoleType

A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.

ServiceRequest.reasonCode ServiceRequest.reason Diagnosis or problem codes justifying the reason for requesting the service investigation. ProcedureReasonCodes Example ProcedureReasonCodes

This example value set defines the set of codes that can be used to indicate a reason for a procedure.

ServiceRequest.bodySite ServiceRequest.bodyStructure Codes describing anatomical locations. May include laterality. SNOMEDCTBodyStructures Example SNOMEDCTBodyStructures

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).

12.14.3.2 15.17.4.2 Constraints

id UniqueKey Level Location Description Expression
prr-1 img  prr-1 Rule (base) orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
img  asn-1 Rule (base) asNeededFor SHALL only be present if asNeeded is empty or true asNeededFor.empty() or (asNeeded = true or asNeeded.empty())

12.14.4 15.17.5 Notes:

  • Many service requests will create a need to specify a specimen, body site, or body system. The request code will often have this information embedded in it - for example, 'serum glucose' or 'chest x-ray'. Alternatively, the specimen servicerequest-specimenSuggestion extension may be used to specify an existing specimen or the type of specimen expected to be collected, or a bodysite bodyStructure element may be used to specify it. a body site or body system.
  • The Most commonly the association between the Specimen and ServiceRequest should only reference resources will be from the Specimen to the ServiceRequest, as usually the ServiceRequest is created first and provides the authorization for the specimen to be collected, and the reference to the ServiceRequest is recorded using the Specimen.request resource directly when element.
  • In the diagnostic investigation less common cases where the specimen to be used to perform the test is requested on already existing specimens. Conversely, if known and available and needs to be specified at the request time the ServiceRequest is entered first with an uncollected specimen, created, it is preferable to use the Specimen resource will 'specimenSuggestion' extension on the ServiceRequest resource, which enables specifying a particular specimen to be used either by a direct reference to a Specimen resource, more generally by a coded concept specifying the specimen type, or by a reference to another ServiceRequest resource when that produced the existing specimen(s). When a specimen is suggested, it is created. expected to be used. If for some reason the suggested specimen is unable to be used (doesn't exist, wrong specimen type, insufficient quantity or quality, etc.), the decision to collect another specimen or to not perform the test must be based on established policies or determined by some other means agreed to with the requester.
  • The reasonCode reason element is often for billing purposes. may be used to support billing. It may relate to the resources referred to in supportingInfo element and may also be used to decide how a procedure or diagnostic investigation will be performed, or even if it will be performed at all
  • To capture the workflow around the solicitation of potential ServiceRequests based on time, price, etc, use the level 2 code "solicit-offer" on the "ask" ServiceRequest. For the ServiceRequest response to an "ask" ServiceRequest, use the level 2 code "offer-response" along with a basedOn reference to the "ask" ServiceRequest.

12.14.5 15.17.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

specimen
Name Type Description Expression In Common
authored date Date request signed ServiceRequest.authoredOn
based-on reference What request fulfills ServiceRequest.basedOn
( CarePlan , MedicationRequest , RequestOrchestration , NutritionOrder , DocumentReference , ServiceRequest )
body-structure-code body-site token Where Code for body structure where procedure is going to be done ServiceRequest.bodySite ServiceRequest.bodyStructure.concept
category token Classification of service ServiceRequest.category
code code-concept token What is being requested/ordered ServiceRequest.code ServiceRequest.code.concept
code-reference 13 Resources reference What is being requested/ordered ServiceRequest.code.reference
encounter reference An encounter in which this request is made ServiceRequest.encounter
( Encounter ) 		11 26 Resources
group-or-identifier token Requisition ID or other identifier ServiceRequest.requisition | ServiceRequest.identifier
identifier token Identifiers assigned to this order ServiceRequest.identifier 29 58 Resources
intent instantiates-canonical reference token Instantiates FHIR protocol or definition proposal | plan | directive | order + ServiceRequest.instantiatesCanonical ( PlanDefinition , ActivityDefinition ) ServiceRequest.intent
instantiates-uri location-code uri token Instantiates external protocol or definition The preferred location specified in the ServiceRequest (coded) ServiceRequest.instantiatesUri ServiceRequest.location.concept
intent location-reference token reference proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option The preferred location specified in the ServiceRequest (resource reference) ServiceRequest.intent ServiceRequest.location.reference
occurrence date When service should occur ServiceRequest.occurrence ServiceRequest.occurrence.ofType(dateTime) | ServiceRequest.occurrence.ofType(Period) | ServiceRequest.occurrence.ofType(Timing)
patient reference Search by subject - a patient ServiceRequest.subject.where(resolve() is Patient)
( Patient ) 		32 60 Resources
performer reference Requested performer ServiceRequest.performer
( Practitioner , Group , Organization , CareTeam , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
performer-type token Performer role ServiceRequest.performerType
priority token routine | urgent | asap | stat ServiceRequest.priority
reference reference Body structure where procedure is going to be done (reference) ServiceRequest.bodyStructure.reference
( BodyStructure )
replaces reference What request replaces ServiceRequest.replaces
( MedicationRequest , CarePlan , RequestOrchestration , NutritionOrder , VisionPrescription , DeviceRequest , ServiceRequest , CommunicationRequest )
requester reference Who/what is requesting service ServiceRequest.requester
( Practitioner , Group , Organization , Device , Patient , PractitionerRole , RelatedPerson )
requisition token Composite Request ID ServiceRequest.requisition
reference Specimen to be tested ServiceRequest.specimen ( Specimen status ) status token draft | active | on-hold | revoked | completed | entered-in-error | unknown ServiceRequest.status
subject reference Search by subject ServiceRequest.subject
( Group , Device , Patient , Location )