Release 4 5

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0: R5 - Mixed Normative and STU ) ). This is the current published version 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 . Page versions: R5 R4B R4 R3 R2

8.21 8.23 Resource CommunicationRequest - Content

Patient Care icon Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

8.21.1 8.23.1 Scope and Usage

CommunicationRequest is one of the request resources in the FHIR workflow specification.

This resource is a record of a request for a communication to be performed. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The requester requests the sender to send the payload to the recipient. The sender and receivers may be patients, practitioners, related persons, organizations, and devices. Uses of communication request include:

  • A computer-based decision-support system requesting a reminder or alert be delivered to a responsible provider
  • A physician requesting notification from the nurse if a patient's temperature exceeds a value
  • A monitoring system or a provider requesting a staff member or department to notify a public health agency of a patient presenting with a communicable disease reportable to the public health agency
  • A computer-based decision-support system proposes to send educational material to a patient

8.21.2 8.23.2 Boundaries and Relationships

This resource is a record of a request. It does not represent the actual flow of communication.

The use of CommunicationRequest excludes requests for referrals and requests for therapy or counseling which would be handled by the ServiceRequest resource. The performance of a CommunicationRequest may result in a Communication resource.

This resource is referenced by

8.23.3 References to this Resource

8.21.3 8.23.4 Resource Content

Structure

Who/what is requesting service Message recipient 0..1
Name Flags Card. Type Description & Constraints doco
. . CommunicationRequest TU DomainResource A request for information to be sent to a receiver

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

. . . basedOn Σ 0..* Reference ( Any ) Fulfills plan or proposal

. . . replaces Σ 0..* Reference ( CommunicationRequest ) Request(s) replaced by this request

. . . status ?! Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus ( Required )
. . . statusReason 0..1 CodeableConcept Reason for current status
Binding: CommunicationRequest Status Reason ( Example )
. . category . intent ?! Σ 0..* 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent ( Required )
... category 0..* CodeableConcept Message category
CommunicationCategory Binding: Communication Category ( Example )

. . . priority Σ 0..1 code routine | urgent | asap | stat
Request priority Binding: RequestPriority ( Required )
. . . doNotPerform ?! Σ 0..1 boolean True if request is prohibiting action
. . . medium 0..* CodeableConcept A channel of communication
v3 Code System Binding: ParticipationMode icon ( Example )

. . . subject 0..1 Reference ( Patient | Group ) Focus of message
. . . about 0..* Reference ( Any ) Resources that pertain to this communication request

. . . encounter Σ 0..1 Reference ( Encounter ) The Encounter during which this CommunicationRequest was created as part of
. . . payload 0..* BackboneElement Message payload

. . . . content[x] 1..1 Message part content
. . . . contentString . contentAttachment string Attachment
. . . . contentAttachment . contentReference Attachment Reference ( Any )
. . . . contentReference . contentCodeableConcept Reference ( Any CodeableConcept )
. . . occurrence[x] Σ 0..1 When scheduled
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . authoredOn Σ 0..1 dateTime When request transitioned to being actionable
. . . requester Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device ) Who asks for the information to be shared
. . . recipient 0..* Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService | Endpoint ) Who to share the information with

. . sender . informationProvider Σ 0..* Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService ) Message sender reasonCode Σ 0..* CodeableConcept | Endpoint ) Why is communication needed? Who should share the information
v3 Code System ActReason ( Example )
. . . reasonReference reason Σ 0..* Reference CodeableReference ( Condition | Observation | DiagnosticReport | DocumentReference Any ) Why is communication needed?
Binding: v3 Code System ActReason icon ( Example )

. . . note 0..* Annotation Comments made about communication request


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

CommunicationRequest ( DomainResource ) Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] A plan or proposal that is fulfilled in whole or in part by this request basedOn : Reference [0..*] « Any » Completed or terminated request(s) whose function is taken by this new request replaces : Reference [0..*] « CommunicationRequest » A shared identifier common to all requests multiple independent Request instances that were authorized activated/authorized more or less simultaneously by a single author, representing author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of the requisition, prescription reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or similar form a prescription number shared by all meds ordered at one time groupIdentifier : Identifier [0..1] The status of the proposal or order (this element modifies the meaning of other elements) status : code [1..1] « The status of the communication request. null (Strength=Required) RequestStatus ! » Captures the reason for the current state of the CommunicationRequest statusReason : CodeableConcept [0..1] « null (Strength=Example) CommunicationRequestStatusRea... ?? » Indicates the level of authority/intentionality associated with the CommunicationRequest and where the request fits into the workflow chain (this element modifies the meaning of other elements) intent : code [1..1] « null (Strength=Required) RequestIntent ! » The type of message to be sent such as alert, notification, reminder, instruction, etc category : CodeableConcept [0..*] « Codes for general categories of communications such as alerts, instruction, etc. null (Strength=Example) CommunicationCategory ?? » Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine priority : code [0..1] « Codes indicating the relative importance of a communication request. null (Strength=Required) RequestPriority ! » If true indicates that the CommunicationRequest is asking for the specified action to *not* occur (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] A channel that was used for this communication (e.g. email, fax) medium : CodeableConcept [0..*] « Codes for communication mediums such as phone, fax, email, in person, etc. null (Strength=Example) v3.ParticipationMode ParticipationMode ?? » The patient or group that is the focus of this communication request subject : Reference [0..1] « Patient | Group » Other resources that pertain to this communication request and to which this communication request should be associated about : Reference [0..*] « Any » The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated encounter : Reference [0..1] « Encounter » The time when this communication is to occur occurrence[x] : Type DataType [0..1] « dateTime | Period » For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation authoredOn : dateTime [0..1] The device, individual, or organization who initiated the request and has responsibility asks for its activation the information to be shared requester : Reference [0..1] « Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device » The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication recipient : Reference [0..*] « Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService | Endpoint » The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication sender informationProvider : Reference [0..1] [0..*] « Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint » Describes why the request is being made in coded or textual form reasonCode reason : CodeableConcept CodeableReference [0..*] « Any ; Codes for describing reasons for the occurrence of a communication. null (Strength=Example) v3.ActReason ActReason ?? » Indicates another resource whose existence justifies this request reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference » Comments made about the request by the requester, sender, recipient, subject or other participants note : Annotation [0..*] Payload The communicated content (or for multi-part communications, one portion of the communication) content[x] : Type DataType [1..1] « string | Attachment | Reference ( Any ) )| CodeableConcept » Text, attachment(s), or resource(s) to be communicated to the recipient payload [0..*]

XML Template 

<CommunicationRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <basedOn><!-- 0..* Reference(Any) Fulfills plan or proposal --></basedOn>
 <replaces><!-- 0..* Reference(CommunicationRequest) Request(s) replaced by this request --></replaces>
 <</groupIdentifier>

 <groupIdentifier><!-- 0..1 Identifier Composite request this is part of --></groupIdentifier>

 <status value="[code]"/><!-- 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown -->
 <</statusReason>

 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->

 <category><!-- 0..* CodeableConcept Message category --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if request is prohibiting action -->
 <</medium>
 <</subject>

 <medium><!-- 0..* CodeableConcept A channel of communication icon --></medium>
 <subject><!-- 0..1 Reference(Group|Patient) Focus of message --></subject>

 <about><!-- 0..* Reference(Any) Resources that pertain to this communication request --></about>
 <</encounter>

 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this CommunicationRequest was created --></encounter>

 <payload>  <!-- 0..* Message payload -->
  <</content[x]>

  <content[x]><!-- 1..1 Attachment|Reference(Any)|CodeableConcept Message part content --></content[x]>

 </payload>
 <occurrence[x]><!-- 0..1 dateTime|Period When scheduled --></occurrence[x]>
 <authoredOn value="[dateTime]"/><!-- 0..1 When request transitioned to being actionable -->
 <|
   </requester>
 <|
   </recipient>
 <|
   </sender>
 <</reasonCode>
 <|
   </reasonReference>

 <requester><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who asks for the information to be shared --></requester>

 <recipient><!-- 0..* Reference(CareTeam|Device|Endpoint|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Who to share the information with --></recipient>

 <informationProvider><!-- 0..* Reference(Device|Endpoint|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Who should share the information --></informationProvider>

 <reason><!-- 0..* CodeableReference(Any) Why is communication needed? icon --></reason>

 <note><!-- 0..* Annotation Comments made about communication request --></note>
</CommunicationRequest>

JSON Template 

{doco
  "resourceType" : "CommunicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "basedOn" : [{ Reference(Any) }], // Fulfills plan or proposal
  "replaces" : [{ Reference(CommunicationRequest) }], // Request(s) replaced by this request
  "

  "groupIdentifier" : { Identifier }, // Composite request this is part of

  "status" : "<code>", // R!  draft | active | on-hold | revoked | completed | entered-in-error | unknown
  "

  "statusReason" : { CodeableConcept }, // Reason for current status
  "intent" : "<code>", // R!  proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option

  "category" : [{ CodeableConcept }], // Message category
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if request is prohibiting action
  "
  "

  "medium" : [{ CodeableConcept }], // A channel of communication icon
  "subject" : { Reference(Group|Patient) }, // Focus of message

  "about" : [{ Reference(Any) }], // Resources that pertain to this communication request
  "

  "encounter" : { Reference(Encounter) }, // The Encounter during which this CommunicationRequest was created

  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    ">"
    " }
    " }

    "contentAttachment" : { Attachment },
    "contentReference" : { Reference(Any) },
    "contentCodeableConcept" : { CodeableConcept }

  }],
  // occurrence[x]: When scheduled. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "authoredOn" : "<dateTime>", // When request transitioned to being actionable
  "|
   
  "|
   
  "|
   
  "
  "|
   

  "requester" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who asks for the information to be shared

  "recipient" : [{ Reference(CareTeam|Device|Endpoint|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Who to share the information with

  "informationProvider" : [{ Reference(Device|Endpoint|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Who should share the information

  "reason" : [{ CodeableReference(Any) }], // Why is communication needed? icon

  "note" : [{ Annotation }] // Comments made about communication request
}

Turtle Template 

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


[ a fhir:CommunicationRequest;
  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:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  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:identifier  ( [ Identifier ] ... ) ; # 0..* Unique identifier
  fhir:basedOn  ( [ Reference(Any) ] ... ) ; # 0..* Fulfills plan or proposal
  fhir:replaces  ( [ Reference(CommunicationRequest) ] ... ) ; # 0..* Request(s) replaced by this request
  fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite request this is part of
  fhir:status [ code ] ; # 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status
  fhir:intent [ code ] ; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Message category
  fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat
  fhir:doNotPerform [ boolean ] ; # 0..1 True if request is prohibiting action
  fhir:medium  ( [ CodeableConcept ] ... ) ; # 0..* A channel of communication
  fhir:subject [ Reference(Group|Patient) ] ; # 0..1 Focus of message
  fhir:about  ( [ Reference(Any) ] ... ) ; # 0..* Resources that pertain to this communication request
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 The Encounter during which this CommunicationRequest was created
  fhir:payload ( [ # 0..* Message payload
    # content[x] : 1..1 Message part content. One of these 3
      fhir:content [  a fhir:Attachment ; Attachment ]
      fhir:content [  a fhir:Reference ; Reference(Any) ]
      fhir:content [  a fhir:CodeableConcept ; CodeableConcept ]
  ] ... ) ;
  # occurrence[x] : 0..1 When scheduled. One of these 2
    fhir:occurrence [  a fhir:dateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
  fhir:authoredOn [ dateTime ] ; # 0..1 When request transitioned to being actionable
  fhir:requester [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who asks for the information to be shared
  fhir:recipient  ( [ Reference(CareTeam|Device|Endpoint|Group|HealthcareService|Organization|Patient|
  Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who to share the information with

  fhir:informationProvider  ( [ Reference(Device|Endpoint|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who should share the information

  fhir:reason  ( [ CodeableReference(Any) ] ... ) ; # 0..* Why is communication needed?
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments made about communication request

]

Changes since R3 from both R4 and R4B

CommunicationRequest.status Change value set from http://hl7.org/fhir/ValueSet/request-status to http://hl7.org/fhir/ValueSet/request-status|4.0.1
CommunicationRequest
CommunicationRequest.statusReason CommunicationRequest.intent
  • Added Mandatory Element
CommunicationRequest.priority CommunicationRequest.payload.content[x]
  • Change value set from http://hl7.org/fhir/ValueSet/request-priority to http://hl7.org/fhir/ValueSet/request-priority|4.0.1 Add Type CodeableConcept
    • CommunicationRequest.doNotPerform
  • Added Element Remove Type string
CommunicationRequest.about CommunicationRequest.recipient
  • Type Reference: Added Element Target Type Endpoint
CommunicationRequest.encounter CommunicationRequest.informationProvider
  • Added Element Renamed from sender to informationProvider
    • CommunicationRequest.requester
  • Type Max Cardinality changed from BackboneElement 1 to Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) *
    • CommunicationRequest.recipient
  • Type Reference: Added Target Types PractitionerRole, HealthcareService CommunicationRequest.sender Type Reference: Added Target Types PractitionerRole, HealthcareService Endpoint
CommunicationRequest.reasonReference CommunicationRequest.reason
  • Type Reference: Added Target Types DiagnosticReport, DocumentReference CommunicationRequest.topic deleted CommunicationRequest.context deleted Element
CommunicationRequest.requester.agent CommunicationRequest.reasonCode
  • deleted Deleted (-> CommunicationRequest.reason)
CommunicationRequest.requester.onBehalfOf CommunicationRequest.reasonReference
  • deleted Deleted (-> CommunicationRequest.reason)

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 R3 <--> R4 <--> R5 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors). ) See Conversions Summary .)

Structure

Who/what is requesting service Message recipient 0..1
Name Flags Card. Type Description & Constraints doco
. . CommunicationRequest TU DomainResource A request for information to be sent to a receiver

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

. . . basedOn Σ 0..* Reference ( Any ) Fulfills plan or proposal

. . . replaces Σ 0..* Reference ( CommunicationRequest ) Request(s) replaced by this request

. . . status ?! Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus ( Required )
. . . statusReason 0..1 CodeableConcept Reason for current status
Binding: CommunicationRequest Status Reason ( Example )
. . category . intent ?! Σ 0..* 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent ( Required )
... category 0..* CodeableConcept Message category
CommunicationCategory Binding: Communication Category ( Example )

. . . priority Σ 0..1 code routine | urgent | asap | stat
Request priority Binding: RequestPriority ( Required )
. . . doNotPerform ?! Σ 0..1 boolean True if request is prohibiting action
. . . medium 0..* CodeableConcept A channel of communication
v3 Code System Binding: ParticipationMode icon ( Example )

. . . subject 0..1 Reference ( Patient | Group ) Focus of message
. . . about 0..* Reference ( Any ) Resources that pertain to this communication request

. . . encounter Σ 0..1 Reference ( Encounter ) The Encounter during which this CommunicationRequest was created as part of
. . . payload 0..* BackboneElement Message payload

. . . . content[x] 1..1 Message part content
. . . . contentString . contentAttachment string Attachment
. . . . contentAttachment . contentReference Attachment Reference ( Any )
. . . . contentReference . contentCodeableConcept Reference ( Any CodeableConcept )
. . . occurrence[x] Σ 0..1 When scheduled
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . authoredOn Σ 0..1 dateTime When request transitioned to being actionable
. . . requester Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device ) Who asks for the information to be shared
. . . recipient 0..* Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService | Endpoint ) Who to share the information with

. . sender . informationProvider Σ 0..* Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService ) Message sender reasonCode Σ 0..* CodeableConcept | Endpoint ) Why is communication needed? Who should share the information
v3 Code System ActReason ( Example )
. . . reasonReference reason Σ 0..* Reference CodeableReference ( Condition | Observation | DiagnosticReport | DocumentReference Any ) Why is communication needed?
Binding: v3 Code System ActReason icon ( Example )

. . . note 0..* Annotation Comments made about communication request


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

CommunicationRequest ( DomainResource ) Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] A plan or proposal that is fulfilled in whole or in part by this request basedOn : Reference [0..*] « Any » Completed or terminated request(s) whose function is taken by this new request replaces : Reference [0..*] « CommunicationRequest » A shared identifier common to all requests multiple independent Request instances that were authorized activated/authorized more or less simultaneously by a single author, representing author. The presence of the same identifier on each request ties those requests together and may have business ramifications in terms of the requisition, prescription reporting of results, billing, etc. E.g. a requisition number shared by a set of lab tests ordered together, or similar form a prescription number shared by all meds ordered at one time groupIdentifier : Identifier [0..1] The status of the proposal or order (this element modifies the meaning of other elements) status : code [1..1] « The status of the communication request. null (Strength=Required) RequestStatus ! » Captures the reason for the current state of the CommunicationRequest statusReason : CodeableConcept [0..1] « null (Strength=Example) CommunicationRequestStatusRea... ?? » Indicates the level of authority/intentionality associated with the CommunicationRequest and where the request fits into the workflow chain (this element modifies the meaning of other elements) intent : code [1..1] « null (Strength=Required) RequestIntent ! » The type of message to be sent such as alert, notification, reminder, instruction, etc category : CodeableConcept [0..*] « Codes for general categories of communications such as alerts, instruction, etc. null (Strength=Example) CommunicationCategory ?? » Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine priority : code [0..1] « Codes indicating the relative importance of a communication request. null (Strength=Required) RequestPriority ! » If true indicates that the CommunicationRequest is asking for the specified action to *not* occur (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] A channel that was used for this communication (e.g. email, fax) medium : CodeableConcept [0..*] « Codes for communication mediums such as phone, fax, email, in person, etc. null (Strength=Example) v3.ParticipationMode ParticipationMode ?? » The patient or group that is the focus of this communication request subject : Reference [0..1] « Patient | Group » Other resources that pertain to this communication request and to which this communication request should be associated about : Reference [0..*] « Any » The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated encounter : Reference [0..1] « Encounter » The time when this communication is to occur occurrence[x] : Type DataType [0..1] « dateTime | Period » For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation authoredOn : dateTime [0..1] The device, individual, or organization who initiated the request and has responsibility asks for its activation the information to be shared requester : Reference [0..1] « Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device » The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication recipient : Reference [0..*] « Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService | Endpoint » The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication sender informationProvider : Reference [0..1] [0..*] « Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint » Describes why the request is being made in coded or textual form reasonCode reason : CodeableConcept CodeableReference [0..*] « Any ; Codes for describing reasons for the occurrence of a communication. null (Strength=Example) v3.ActReason ActReason ?? » Indicates another resource whose existence justifies this request reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference » Comments made about the request by the requester, sender, recipient, subject or other participants note : Annotation [0..*] Payload The communicated content (or for multi-part communications, one portion of the communication) content[x] : Type DataType [1..1] « string | Attachment | Reference ( Any ) )| CodeableConcept » Text, attachment(s), or resource(s) to be communicated to the recipient payload [0..*]

XML Template 

<CommunicationRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <basedOn><!-- 0..* Reference(Any) Fulfills plan or proposal --></basedOn>
 <replaces><!-- 0..* Reference(CommunicationRequest) Request(s) replaced by this request --></replaces>
 <</groupIdentifier>

 <groupIdentifier><!-- 0..1 Identifier Composite request this is part of --></groupIdentifier>

 <status value="[code]"/><!-- 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown -->
 <</statusReason>

 <statusReason><!-- 0..1 CodeableConcept Reason for current status --></statusReason>
 <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->

 <category><!-- 0..* CodeableConcept Message category --></category>
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->
 <doNotPerform value="[boolean]"/><!-- 0..1 True if request is prohibiting action -->
 <</medium>
 <</subject>

 <medium><!-- 0..* CodeableConcept A channel of communication icon --></medium>
 <subject><!-- 0..1 Reference(Group|Patient) Focus of message --></subject>

 <about><!-- 0..* Reference(Any) Resources that pertain to this communication request --></about>
 <</encounter>

 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this CommunicationRequest was created --></encounter>

 <payload>  <!-- 0..* Message payload -->
  <</content[x]>

  <content[x]><!-- 1..1 Attachment|Reference(Any)|CodeableConcept Message part content --></content[x]>

 </payload>
 <occurrence[x]><!-- 0..1 dateTime|Period When scheduled --></occurrence[x]>
 <authoredOn value="[dateTime]"/><!-- 0..1 When request transitioned to being actionable -->
 <|
   </requester>
 <|
   </recipient>
 <|
   </sender>
 <</reasonCode>
 <|
   </reasonReference>

 <requester><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who asks for the information to be shared --></requester>

 <recipient><!-- 0..* Reference(CareTeam|Device|Endpoint|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Who to share the information with --></recipient>

 <informationProvider><!-- 0..* Reference(Device|Endpoint|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) Who should share the information --></informationProvider>

 <reason><!-- 0..* CodeableReference(Any) Why is communication needed? icon --></reason>

 <note><!-- 0..* Annotation Comments made about communication request --></note>
</CommunicationRequest>

JSON Template 

{doco
  "resourceType" : "CommunicationRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "basedOn" : [{ Reference(Any) }], // Fulfills plan or proposal
  "replaces" : [{ Reference(CommunicationRequest) }], // Request(s) replaced by this request
  "

  "groupIdentifier" : { Identifier }, // Composite request this is part of

  "status" : "<code>", // R!  draft | active | on-hold | revoked | completed | entered-in-error | unknown
  "

  "statusReason" : { CodeableConcept }, // Reason for current status
  "intent" : "<code>", // R!  proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option

  "category" : [{ CodeableConcept }], // Message category
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if request is prohibiting action
  "
  "

  "medium" : [{ CodeableConcept }], // A channel of communication icon
  "subject" : { Reference(Group|Patient) }, // Focus of message

  "about" : [{ Reference(Any) }], // Resources that pertain to this communication request
  "

  "encounter" : { Reference(Encounter) }, // The Encounter during which this CommunicationRequest was created

  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    ">"
    " }
    " }

    "contentAttachment" : { Attachment },
    "contentReference" : { Reference(Any) },
    "contentCodeableConcept" : { CodeableConcept }

  }],
  // occurrence[x]: When scheduled. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "authoredOn" : "<dateTime>", // When request transitioned to being actionable
  "|
   
  "|
   
  "|
   
  "
  "|
   

  "requester" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who asks for the information to be shared

  "recipient" : [{ Reference(CareTeam|Device|Endpoint|Group|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Who to share the information with

  "informationProvider" : [{ Reference(Device|Endpoint|HealthcareService|
   Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) }], // Who should share the information

  "reason" : [{ CodeableReference(Any) }], // Why is communication needed? icon

  "note" : [{ Annotation }] // Comments made about communication request
}

Turtle Template 

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


[ a fhir:CommunicationRequest;
  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:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  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:identifier  ( [ Identifier ] ... ) ; # 0..* Unique identifier
  fhir:basedOn  ( [ Reference(Any) ] ... ) ; # 0..* Fulfills plan or proposal
  fhir:replaces  ( [ Reference(CommunicationRequest) ] ... ) ; # 0..* Request(s) replaced by this request
  fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite request this is part of
  fhir:status [ code ] ; # 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:statusReason [ CodeableConcept ] ; # 0..1 Reason for current status
  fhir:intent [ code ] ; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Message category
  fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat
  fhir:doNotPerform [ boolean ] ; # 0..1 True if request is prohibiting action
  fhir:medium  ( [ CodeableConcept ] ... ) ; # 0..* A channel of communication
  fhir:subject [ Reference(Group|Patient) ] ; # 0..1 Focus of message
  fhir:about  ( [ Reference(Any) ] ... ) ; # 0..* Resources that pertain to this communication request
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 The Encounter during which this CommunicationRequest was created
  fhir:payload ( [ # 0..* Message payload
    # content[x] : 1..1 Message part content. One of these 3
      fhir:content [  a fhir:Attachment ; Attachment ]
      fhir:content [  a fhir:Reference ; Reference(Any) ]
      fhir:content [  a fhir:CodeableConcept ; CodeableConcept ]
  ] ... ) ;
  # occurrence[x] : 0..1 When scheduled. One of these 2
    fhir:occurrence [  a fhir:dateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
  fhir:authoredOn [ dateTime ] ; # 0..1 When request transitioned to being actionable
  fhir:requester [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who asks for the information to be shared
  fhir:recipient  ( [ Reference(CareTeam|Device|Endpoint|Group|HealthcareService|Organization|Patient|
  Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who to share the information with

  fhir:informationProvider  ( [ Reference(Device|Endpoint|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who should share the information

  fhir:reason  ( [ CodeableReference(Any) ] ... ) ; # 0..* Why is communication needed?
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments made about communication request

]

Changes since Release 3 from both R4 and R4B

CommunicationRequest.status Change value set from http://hl7.org/fhir/ValueSet/request-status to http://hl7.org/fhir/ValueSet/request-status|4.0.1
CommunicationRequest
CommunicationRequest.statusReason CommunicationRequest.intent
  • Added Mandatory Element
CommunicationRequest.priority CommunicationRequest.payload.content[x]
  • Change value set from http://hl7.org/fhir/ValueSet/request-priority to http://hl7.org/fhir/ValueSet/request-priority|4.0.1 Add Type CodeableConcept
    • CommunicationRequest.doNotPerform
  • Added Element Remove Type string
CommunicationRequest.about CommunicationRequest.recipient
  • Type Reference: Added Element Target Type Endpoint
CommunicationRequest.encounter CommunicationRequest.informationProvider
  • Added Element Renamed from sender to informationProvider
    • CommunicationRequest.requester
  • Type Max Cardinality changed from BackboneElement 1 to Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) *
    • CommunicationRequest.recipient
  • Type Reference: Added Target Types PractitionerRole, HealthcareService CommunicationRequest.sender Type Reference: Added Target Types PractitionerRole, HealthcareService Endpoint
CommunicationRequest.reasonReference CommunicationRequest.reason
  • Type Reference: Added Target Types DiagnosticReport, DocumentReference CommunicationRequest.topic deleted CommunicationRequest.context deleted Element
CommunicationRequest.requester.agent CommunicationRequest.reasonCode
  • deleted Deleted (-> CommunicationRequest.reason)
CommunicationRequest.requester.onBehalfOf CommunicationRequest.reasonReference
  • deleted Deleted (-> CommunicationRequest.reason)

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 R3 <--> R4 <--> R5 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 1 r3 resources are invalid (0 errors). ) See Conversions Summary .)

 

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

8.21.3.1 8.23.4.1 Terminology Bindings

Path Definition ValueSet Type Reference Documentation
CommunicationRequest.status The status of the communication request. RequestStatus Required RequestStatus

Codes identifying the lifecycle stage of a request.

CommunicationRequest.statusReason Codes identifying CommunicationRequestStatusReason Example

Example codes indicating the reason for the current state of why a request. CommunicationRequest is on hold or revoked. Note that these are in no way complete and might not even be appropriate for some uses.

CommunicationRequest.intent RequestIntent Unknown Required No details provided yet

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

CommunicationRequest.category Codes for general categories of communications such as alerts, instruction, etc. CommunicationCategory Example CommunicationCategory

Codes for general categories of communications such as alerts, instructions, etc.

CommunicationRequest.priority Codes indicating the relative importance of a communication request. RequestPriority Required RequestPriority

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

CommunicationRequest.medium Codes for communication mediums such as phone, fax, email, in person, etc. ParticipationMode icon Example v3.ParticipationMode

Identifies the primary means by which an Entity participates in an Act.

CommunicationRequest.reasonCode CommunicationRequest.reason Codes for describing reasons for the occurrence of a communication. ActReason icon Example v3.ActReason

A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type "has reason" linking to another Act. Examples: Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".

Notes to reviewers:

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

8.21.3.2 8.23.4.2 CommunicationRequest.sender and CommunicationRequest.recepient

CommunicationRequest.sender allows Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService and CommunicationRequest.recipient allows Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService - but it is not unusual to have a communication target - even a defined one - where it is unknown what kind of role the person is playing.

If the communication request is to or from an individual, whose role is not known (practitioner, patient or related person), - for example, only email address is captured in the system; then RelatedPerson should be used by default.

8.21.4 8.23.5 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.

sender
Name Type Description Expression In Common
authored date When request transitioned to being actionable CommunicationRequest.authoredOn
based-on reference Fulfills plan or proposal CommunicationRequest.basedOn
(Any)
category token Message category CommunicationRequest.category
encounter reference The Encounter during which this CommunicationRequest was created as part of CommunicationRequest.encounter
( Encounter ) 		29 Resources
group-identifier token Composite request this is part of CommunicationRequest.groupIdentifier
identifier token Unique identifier CommunicationRequest.identifier 65 Resources
information-provider reference Who should share the information CommunicationRequest.informationProvider
( Practitioner , Organization , Endpoint , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
medium token A channel of communication CommunicationRequest.medium
occurrence date When scheduled (CommunicationRequest.occurrence as dateTime) CommunicationRequest.occurrence.ofType(dateTime) | CommunicationRequest.occurrence.ofType(Period)
patient reference Focus of message CommunicationRequest.subject.where(resolve() is Patient)
( Patient ) 		66 Resources
priority token routine | urgent | asap | stat CommunicationRequest.priority
recipient reference Message recipient Who to share the information with CommunicationRequest.recipient
( Practitioner , Group , Organization , CareTeam , Endpoint , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
replaces reference Request(s) replaced by this request CommunicationRequest.replaces
( CommunicationRequest )
requester reference Who/what is requesting service CommunicationRequest.requester ( Practitioner , Organization , Device , Patient , PractitionerRole , RelatedPerson requester ) reference Message sender Who asks for the information to be shared CommunicationRequest.sender CommunicationRequest.requester
( Practitioner , Organization , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
status token draft | active | on-hold | revoked | completed | entered-in-error | unknown CommunicationRequest.status
subject reference Focus of message CommunicationRequest.subject
( Group , Patient )