FHIR Release 3 (STU) 4

This page is part of the FHIR Specification (v3.0.2: (v4.0.1: R4 - Mixed Normative and STU 3). ) 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 R4 R3 R2

8.21 Resource CommunicationRequest - Content

Patient Care 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 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 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 which are covered by the ReferralRequest resource. It also excludes and requests for therapy or counseling which would be handled by the ProcedureRequest ServiceRequest resource. The performance of a CommunicationRequest may result in a Communication resource.

This resource is referenced by CarePlan , ClaimResponse and ProcessResponse itself

8.21.3 Resource Content

Structure

0..* Reference ( Device | Organization | Patient | Practitioner | RelatedPerson | Group | CareTeam ) topic Organization agent is acting for
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
. . . groupIdentifier Σ 0..1 Identifier Composite request this is part of
. . . status ?! Σ 1..1 code draft | active | suspended on-hold | cancelled revoked | completed | entered-in-error | unknown
RequestStatus ( Required )
. . . statusReason 0..1 CodeableConcept Reason for current status
... category 0..* CodeableConcept Message category
CommunicationCategory ( Example )
. . . priority Σ 0..1 code Message urgency routine | urgent | asap | stat
RequestPriority Request priority ( Required )
. . . doNotPerform ?! Σ 0..1 boolean True if request is prohibiting action
. . . medium 0..* CodeableConcept A channel of communication
v3 Code System ParticipationMode ( Example )
. . . subject 0..1 Reference ( Patient | Group ) Focus of message
. . . recipient about Message recipient 0..* Reference ( Any ) Focal resources Resources that pertain to this communication request
. . context . encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter or episode leading to message created as part of
. . . payload 0..* BackboneElement Message payload
. . . . content[x] 1..1 Message part content
. . . . . contentString string
. . . . . contentAttachment Attachment
. . . . . contentReference Reference ( Any )
. . . occurrence[x] Σ 0..1 When scheduled
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . authoredOn Σ 0..1 dateTime When request transitioned to being actionable
. . sender . requester Σ 0..1 Reference ( Device Practitioner | PractitionerRole | Organization | Patient | Practitioner | RelatedPerson ) Message sender requester Σ I 0..1 BackboneElement | Device ) Who/what is requesting service + onBehalfOf can only be specified if agent is practitioner or device
. . . agent recipient Σ 1..1 0..* Reference ( Practitioner Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Device Group | CareTeam | HealthcareService ) Individual making the request Message recipient
. . onBehalfOf . sender Σ I 0..1 Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService ) Message sender
. . . reasonCode Σ 0..* CodeableConcept Why is communication needed?
v3 Code System ActReason ( Example )
. . . reasonReference Σ 0..* Reference ( Condition | Observation | DiagnosticReport | DocumentReference ) Why is communication needed?
. . . note 0..* Annotation Comments made about communication request

doco Documentation for this format

UML Diagram ( Legend )

CommunicationRequest ( DomainResource ) A unique ID of Business identifiers assigned to this communication request for reference purposes. It must be provided if user wants it returned as part of any output, otherwise it will be autogenerated, if needed, by CDS system. Does not need to be the actual ID of performer or other systems which remain constant as the source system 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 that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form 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. (Strength=Required) RequestStatus ! » Captures the reason for the current state of the CommunicationRequest statusReason : CodeableConcept [0..1] 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. (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. (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. (Strength=Example) v3 Code System ParticipationM... v3.ParticipationMode ?? » The patient or group that is the focus of this communication request subject : Reference [0..1] Patient | Group 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 | RelatedPerson | Group | CareTeam » The Other resources which were related that pertain to producing this communication request and to which this communication request should be associated topic about : Reference [0..*] « Any » The encounter or episode of care within Encounter during which the communication request this CommunicationRequest was created or to which the creation of this record is tightly associated context encounter : Reference [0..1] « Encounter | EpisodeOfCare » The time when this communication is to occur occurrence[x] : Type [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 for its activation 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 » The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication sender : Reference [0..1] « Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService » Describes why the request is being made in coded or textual form reasonCode : CodeableConcept [0..*] « Codes for describing reasons for the occurrence of a communication. (Strength=Example) v3 Code System ActReason v3.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 [1..1] « string | Attachment | Reference ( Any ) » Requester The device, practitioner, etc. who initiated the request agent : Reference [1..1] Practitioner | Organization | Patient | RelatedPerson | Device The organization the device or practitioner was acting on behalf of onBehalfOf : Reference [0..1] Organization Text, attachment(s), or resource(s) to be communicated to the recipient payload [0..*] The individual who initiated the request and has responsibility for its activation requester [0..1]

XML Template 

<

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

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>

 <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><!-- 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><!-- 0..1 CodeableConcept Reason for current status --></statusReason>

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

 <about><!-- 0..* Reference(Any) Resources that pertain to this communication request --></about>
 <encounter><!-- 0..1 Reference(Encounter) Encounter created as part of --></encounter>

 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) 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><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization|
   Patient|RelatedPerson|Device) Who/what is requesting service --></requester>

 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson|Group|CareTeam|HealthcareService) Message recipient --></recipient>
 <sender><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   </sender>
 <
  <|
    </agent>
  <</onBehalfOf>
 </requester>

   PractitionerRole|RelatedPerson|HealthcareService) Message sender --></sender>
 <reasonCode><!-- 0..* CodeableConcept Why is communication needed? --></reasonCode>
 <</reasonReference>

 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) Why is communication needed? --></reasonReference>
 <note><!-- 0..* Annotation Comments made about communication request --></note>
</CommunicationRequest>

JSON Template 

{doco
  "resourceType" : "",

  "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
  "category" : [{ CodeableConcept }], // Message category
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if request is prohibiting action
  "medium" : [{ CodeableConcept }], // A channel of communication
  "subject" : { Reference(Patient|Group) }, // Focus of message
  "about" : [{ Reference(Any) }], // Resources that pertain to this communication request
  "encounter" : { Reference(Encounter) }, // Encounter created as part of
  "payload" : [{ // Message payload

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

    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }

  }],
  // occurrence[x]: When scheduled. One of these 2:
  ">",
  " },
  "
  "|
   
  "
    "|
    
    "
  },
  "
  "
  "

  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "authoredOn" : "<dateTime>", // When request transitioned to being actionable
  "requester" : { Reference(Practitioner|PractitionerRole|Organization|
   Patient|RelatedPerson|Device) }, // Who/what is requesting service

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

  "sender" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson|HealthcareService) }, // Message sender

  "reasonCode" : [{ CodeableConcept }], // Why is communication needed?
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) }], // Why is communication needed?

  "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:CommunicationRequest.identifier [ Identifier ], ... ; # 0..* Unique identifier

  fhir:CommunicationRequest.basedOn [ Reference(Any) ], ... ; # 0..* Fulfills plan or proposal
  fhir:CommunicationRequest.replaces [ Reference(CommunicationRequest) ], ... ; # 0..* Request(s) replaced by this request
  fhir:CommunicationRequest.groupIdentifier [ Identifier ]; # 0..1 Composite request this is part of
  fhir:

  fhir:CommunicationRequest.status [ code ]; # 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:CommunicationRequest.statusReason [ CodeableConcept ]; # 0..1 Reason for current status

  fhir:CommunicationRequest.category [ CodeableConcept ], ... ; # 0..* Message category
  fhir:

  fhir:CommunicationRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat
  fhir:CommunicationRequest.doNotPerform [ boolean ]; # 0..1 True if request is prohibiting action

  fhir:CommunicationRequest.medium [ CodeableConcept ], ... ; # 0..* A channel of communication
  fhir:CommunicationRequest.subject [ Reference(Patient|Group) ]; # 0..1 Focus of message
  fhir:
  fhir:
  fhir:

  fhir:CommunicationRequest.about [ Reference(Any) ], ... ; # 0..* Resources that pertain to this communication request
  fhir:CommunicationRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter created as part of

  fhir:CommunicationRequest.payload [ # 0..* Message payload
    # CommunicationRequest.payload.content[x] : 1..1 Message part content. One of these 3
      fhir:CommunicationRequest.payload.contentString [ string ]
      fhir:CommunicationRequest.payload.contentAttachment [ Attachment ]
      fhir:CommunicationRequest.payload.contentReference [ Reference(Any) ]
  ], ...;
  # CommunicationRequest.occurrence[x] : 0..1 When scheduled. One of these 2
    fhir:CommunicationRequest.occurrenceDateTime [ dateTime ]
    fhir:CommunicationRequest.occurrencePeriod [ Period ]
  fhir:CommunicationRequest.authoredOn [ dateTime ]; # 0..1 When request transitioned to being actionable
  fhir:
  fhir:
    fhir:
    fhir:
  ];

  fhir:CommunicationRequest.requester [ Reference(Practitioner|PractitionerRole|Organization|Patient|RelatedPerson|Device) ]; # 0..1 Who/what is requesting service
  fhir:CommunicationRequest.recipient [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson|Group|
  CareTeam|HealthcareService) ], ... ; # 0..* Message recipient

  fhir:CommunicationRequest.sender [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson|
  HealthcareService) ]; # 0..1 Message sender
  fhir:CommunicationRequest.reasonCode [ CodeableConcept ], ... ; # 0..* Why is communication needed?
  fhir:

  fhir:CommunicationRequest.reasonReference [ Reference(Condition|Observation|DiagnosticReport|DocumentReference) ], ... ; # 0..* Why is communication needed?

  fhir:CommunicationRequest.note [ Annotation ], ... ; # 0..* Comments made about communication request
]

Changes since DSTU2 R3

CommunicationRequest.basedOn Added Element CommunicationRequest.replaces Added Element CommunicationRequest.groupIdentifier
CommunicationRequest Added Element
CommunicationRequest.status
  • Min Cardinality changed from 0 to 1 Change value set from http://hl7.org/fhir/ValueSet/communication-request-status to http://hl7.org/fhir/ValueSet/request-status to http://hl7.org/fhir/ValueSet/request-status|4.0.1
CommunicationRequest.category CommunicationRequest.statusReason
  • Max Cardinality changed from 1 to * Added Element
CommunicationRequest.priority
  • Type changed Change value set from CodeableConcept to code Add Binding http://hl7.org/fhir/ValueSet/request-priority (required) CommunicationRequest.subject Add Reference(Group) CommunicationRequest.recipient Add Reference(Group), Add Reference(CareTeam) to http://hl7.org/fhir/ValueSet/request-priority|4.0.1
CommunicationRequest.topic CommunicationRequest.doNotPerform
  • Added Element
CommunicationRequest.context CommunicationRequest.about
  • Renamed from encounter to context Add Reference(EpisodeOfCare) Added Element
CommunicationRequest.occurrence[x] CommunicationRequest.encounter
  • Added Element
CommunicationRequest.authoredOn CommunicationRequest.requester
  • Renamed Type changed from requestedOn BackboneElement to authoredOn Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
CommunicationRequest.requester CommunicationRequest.recipient
  • Remove Reference(Practitioner), Remove Reference(Patient), Remove Reference(RelatedPerson) Type Reference: Added Target Types PractitionerRole, HealthcareService
CommunicationRequest.requester.agent CommunicationRequest.sender
  • Type Reference: Added Element Target Types PractitionerRole, HealthcareService
CommunicationRequest.requester.onBehalfOf CommunicationRequest.reasonReference
  • Type Reference: Added Element Target Types DiagnosticReport, DocumentReference
CommunicationRequest.reasonCode CommunicationRequest.topic
  • Renamed from reason to reasonCode deleted
CommunicationRequest.reasonReference CommunicationRequest.context
  • Added Element deleted
CommunicationRequest.note CommunicationRequest.requester.agent
  • Added Element deleted
CommunicationRequest.scheduled[x] CommunicationRequest.requester.onBehalfOf
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 1 fail All tests pass round-trip testing and 1 r3 resources are invalid (1 (0 errors). ). )

Structure

0..* Organization agent is acting for
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
. . . groupIdentifier Σ 0..1 Identifier Composite request this is part of
. . . status ?! Σ 1..1 code draft | active | suspended on-hold | cancelled revoked | completed | entered-in-error | unknown
RequestStatus ( Required )
. . . statusReason 0..1 CodeableConcept Reason for current status
... category 0..* CodeableConcept Message category
CommunicationCategory ( Example )
. . . priority Σ 0..1 code Message urgency routine | urgent | asap | stat
RequestPriority Request priority ( Required )
. . . doNotPerform ?! Σ 0..1 boolean True if request is prohibiting action
. . . medium 0..* CodeableConcept A channel of communication
v3 Code System ParticipationMode ( Example )
. . . subject 0..1 Reference ( Patient | Group ) Focus of message
. . . recipient about Reference ( Device | Organization | Patient | Practitioner | RelatedPerson | Group | CareTeam ) Message recipient topic 0..* Reference ( Any ) Focal resources Resources that pertain to this communication request
. . context . encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter or episode leading to message created as part of
. . . payload 0..* BackboneElement Message payload
. . . . content[x] 1..1 Message part content
. . . . . contentString string
. . . . . contentAttachment Attachment
. . . . . contentReference Reference ( Any )
. . . occurrence[x] Σ 0..1 When scheduled
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . authoredOn Σ 0..1 dateTime When request transitioned to being actionable
. . sender . requester Σ 0..1 Reference ( Device Practitioner | PractitionerRole | Organization | Patient | Practitioner | RelatedPerson ) Message sender requester Σ I 0..1 BackboneElement | Device ) Who/what is requesting service + onBehalfOf can only be specified if agent is practitioner or device
. . . agent recipient Σ 1..1 0..* Reference ( Practitioner Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Device Group | CareTeam | HealthcareService ) Individual making the request Message recipient
. . onBehalfOf . sender Σ I 0..1 Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService ) Message sender
. . . reasonCode Σ 0..* CodeableConcept Why is communication needed?
v3 Code System ActReason ( Example )
. . . reasonReference Σ 0..* Reference ( Condition | Observation | DiagnosticReport | DocumentReference ) Why is communication needed?
. . . note 0..* Annotation Comments made about communication request

doco Documentation for this format

UML Diagram ( Legend )

CommunicationRequest ( DomainResource ) A unique ID of Business identifiers assigned to this communication request for reference purposes. It must be provided if user wants it returned as part of any output, otherwise it will be autogenerated, if needed, by CDS system. Does not need to be the actual ID of performer or other systems which remain constant as the source system 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 that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form 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. (Strength=Required) RequestStatus ! » Captures the reason for the current state of the CommunicationRequest statusReason : CodeableConcept [0..1] 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. (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. (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. (Strength=Example) v3 Code System ParticipationM... v3.ParticipationMode ?? » The patient or group that is the focus of this communication request subject : Reference [0..1] Patient | Group 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 | RelatedPerson | Group | CareTeam » The Other resources which were related that pertain to producing this communication request and to which this communication request should be associated topic about : Reference [0..*] « Any » The encounter or episode of care within Encounter during which the communication request this CommunicationRequest was created or to which the creation of this record is tightly associated context encounter : Reference [0..1] « Encounter | EpisodeOfCare » The time when this communication is to occur occurrence[x] : Type [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 for its activation 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 » The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication sender : Reference [0..1] « Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService » Describes why the request is being made in coded or textual form reasonCode : CodeableConcept [0..*] « Codes for describing reasons for the occurrence of a communication. (Strength=Example) v3 Code System ActReason v3.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 [1..1] « string | Attachment | Reference ( Any ) » Requester The device, practitioner, etc. who initiated the request agent : Reference [1..1] Practitioner | Organization | Patient | RelatedPerson | Device The organization the device or practitioner was acting on behalf of onBehalfOf : Reference [0..1] Organization Text, attachment(s), or resource(s) to be communicated to the recipient payload [0..*] The individual who initiated the request and has responsibility for its activation requester [0..1]

XML Template 

<

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

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>

 <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><!-- 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><!-- 0..1 CodeableConcept Reason for current status --></statusReason>

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

 <about><!-- 0..* Reference(Any) Resources that pertain to this communication request --></about>
 <encounter><!-- 0..1 Reference(Encounter) Encounter created as part of --></encounter>

 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) 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><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization|
   Patient|RelatedPerson|Device) Who/what is requesting service --></requester>

 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson|Group|CareTeam|HealthcareService) Message recipient --></recipient>
 <sender><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   </sender>
 <
  <|
    </agent>
  <</onBehalfOf>
 </requester>

   PractitionerRole|RelatedPerson|HealthcareService) Message sender --></sender>
 <reasonCode><!-- 0..* CodeableConcept Why is communication needed? --></reasonCode>
 <</reasonReference>

 <reasonReference><!-- 0..* Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) Why is communication needed? --></reasonReference>
 <note><!-- 0..* Annotation Comments made about communication request --></note>
</CommunicationRequest>

JSON Template 

{doco
  "resourceType" : "",

  "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
  "category" : [{ CodeableConcept }], // Message category
  "priority" : "<code>", // routine | urgent | asap | stat
  "doNotPerform" : <boolean>, // True if request is prohibiting action
  "medium" : [{ CodeableConcept }], // A channel of communication
  "subject" : { Reference(Patient|Group) }, // Focus of message
  "about" : [{ Reference(Any) }], // Resources that pertain to this communication request
  "encounter" : { Reference(Encounter) }, // Encounter created as part of
  "payload" : [{ // Message payload

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

    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }

  }],
  // occurrence[x]: When scheduled. One of these 2:
  ">",
  " },
  "
  "|
   
  "
    "|
    
    "
  },
  "
  "
  "

  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "authoredOn" : "<dateTime>", // When request transitioned to being actionable
  "requester" : { Reference(Practitioner|PractitionerRole|Organization|
   Patient|RelatedPerson|Device) }, // Who/what is requesting service

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

  "sender" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson|HealthcareService) }, // Message sender

  "reasonCode" : [{ CodeableConcept }], // Why is communication needed?
  "reasonReference" : [{ Reference(Condition|Observation|DiagnosticReport|
   DocumentReference) }], // Why is communication needed?

  "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:CommunicationRequest.identifier [ Identifier ], ... ; # 0..* Unique identifier

  fhir:CommunicationRequest.basedOn [ Reference(Any) ], ... ; # 0..* Fulfills plan or proposal
  fhir:CommunicationRequest.replaces [ Reference(CommunicationRequest) ], ... ; # 0..* Request(s) replaced by this request
  fhir:CommunicationRequest.groupIdentifier [ Identifier ]; # 0..1 Composite request this is part of
  fhir:

  fhir:CommunicationRequest.status [ code ]; # 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:CommunicationRequest.statusReason [ CodeableConcept ]; # 0..1 Reason for current status

  fhir:CommunicationRequest.category [ CodeableConcept ], ... ; # 0..* Message category
  fhir:

  fhir:CommunicationRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat
  fhir:CommunicationRequest.doNotPerform [ boolean ]; # 0..1 True if request is prohibiting action

  fhir:CommunicationRequest.medium [ CodeableConcept ], ... ; # 0..* A channel of communication
  fhir:CommunicationRequest.subject [ Reference(Patient|Group) ]; # 0..1 Focus of message
  fhir:
  fhir:
  fhir:

  fhir:CommunicationRequest.about [ Reference(Any) ], ... ; # 0..* Resources that pertain to this communication request
  fhir:CommunicationRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter created as part of

  fhir:CommunicationRequest.payload [ # 0..* Message payload
    # CommunicationRequest.payload.content[x] : 1..1 Message part content. One of these 3
      fhir:CommunicationRequest.payload.contentString [ string ]
      fhir:CommunicationRequest.payload.contentAttachment [ Attachment ]
      fhir:CommunicationRequest.payload.contentReference [ Reference(Any) ]
  ], ...;
  # CommunicationRequest.occurrence[x] : 0..1 When scheduled. One of these 2
    fhir:CommunicationRequest.occurrenceDateTime [ dateTime ]
    fhir:CommunicationRequest.occurrencePeriod [ Period ]
  fhir:CommunicationRequest.authoredOn [ dateTime ]; # 0..1 When request transitioned to being actionable
  fhir:
  fhir:
    fhir:
    fhir:
  ];

  fhir:CommunicationRequest.requester [ Reference(Practitioner|PractitionerRole|Organization|Patient|RelatedPerson|Device) ]; # 0..1 Who/what is requesting service
  fhir:CommunicationRequest.recipient [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson|Group|
  CareTeam|HealthcareService) ], ... ; # 0..* Message recipient

  fhir:CommunicationRequest.sender [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson|
  HealthcareService) ]; # 0..1 Message sender
  fhir:CommunicationRequest.reasonCode [ CodeableConcept ], ... ; # 0..* Why is communication needed?
  fhir:

  fhir:CommunicationRequest.reasonReference [ Reference(Condition|Observation|DiagnosticReport|DocumentReference) ], ... ; # 0..* Why is communication needed?

  fhir:CommunicationRequest.note [ Annotation ], ... ; # 0..* Comments made about communication request
]

Changes since DSTU2 Release 3

CommunicationRequest.basedOn Added Element CommunicationRequest.replaces
CommunicationRequest Added Element CommunicationRequest.groupIdentifier Added Element
CommunicationRequest.status
  • Min Cardinality changed from 0 to 1 Change value set from http://hl7.org/fhir/ValueSet/communication-request-status to http://hl7.org/fhir/ValueSet/request-status to http://hl7.org/fhir/ValueSet/request-status|4.0.1
CommunicationRequest.category CommunicationRequest.statusReason
  • Max Cardinality changed from 1 to * Added Element
CommunicationRequest.priority
  • Type changed Change value set from CodeableConcept to code Add Binding http://hl7.org/fhir/ValueSet/request-priority (required) CommunicationRequest.subject Add Reference(Group) CommunicationRequest.recipient Add Reference(Group), Add Reference(CareTeam) to http://hl7.org/fhir/ValueSet/request-priority|4.0.1
CommunicationRequest.topic CommunicationRequest.doNotPerform
  • Added Element
CommunicationRequest.context CommunicationRequest.about
  • Renamed from encounter to context Add Reference(EpisodeOfCare) Added Element
CommunicationRequest.occurrence[x] CommunicationRequest.encounter
  • Added Element
CommunicationRequest.authoredOn CommunicationRequest.requester
  • Renamed Type changed from requestedOn BackboneElement to authoredOn Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
CommunicationRequest.requester CommunicationRequest.recipient
  • Remove Reference(Practitioner), Remove Reference(Patient), Remove Reference(RelatedPerson) Type Reference: Added Target Types PractitionerRole, HealthcareService
CommunicationRequest.requester.agent CommunicationRequest.sender
  • Type Reference: Added Element Target Types PractitionerRole, HealthcareService
CommunicationRequest.requester.onBehalfOf CommunicationRequest.reasonReference
  • Type Reference: Added Element Target Types DiagnosticReport, DocumentReference
CommunicationRequest.reasonCode CommunicationRequest.topic
  • Renamed from reason to reasonCode deleted
CommunicationRequest.reasonReference CommunicationRequest.context
  • Added Element deleted
CommunicationRequest.note CommunicationRequest.requester.agent
  • Added Element deleted
CommunicationRequest.scheduled[x] CommunicationRequest.requester.onBehalfOf
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 1 fail All tests pass round-trip testing and 1 r3 resources are invalid (1 (0 errors). ). )

 

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

8.21.3.1 Terminology Bindings

Path Definition Type Reference
CommunicationRequest.status The status of the communication request. Required RequestStatus
CommunicationRequest.statusReason Codes identifying the reason for the current state of a request. Unknown No details provided yet
CommunicationRequest.category Codes for general categories of communications such as alerts, instruction, etc. Example CommunicationCategory
CommunicationRequest.priority Codes indicating the relative importance of a communication request. Required RequestPriority
CommunicationRequest.medium Codes for communication mediums such as phone, fax, email, in person, etc. Example v3 Code System ParticipationMode v3.ParticipationMode
CommunicationRequest.reasonCode Codes for describing reasons for the occurrence of a communication. Example v3 Code System ActReason v3.ActReason

8.21.3.2 Constraints cmr-1 : On CommunicationRequest.requester: onBehalfOf can only be specified if agent is practitioner or device ( expression on CommunicationRequest.requester: (agent.resolve() is Practitioner) or (agent.resolve() is Device) or onBehalfOf.exists().not() )

Notes to reviewers:

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

8.21.3.3 8.21.3.2 CommunicationRequest.sender and CommunicationRequest.recepient

CommunicationRequest.sender allows Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService and CommunicationRequest.recipient allow Patient|Practitioner|RelatedPerson 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 Search Parameters

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

context Encounter or episode leading to message CommunicationRequest.context ( EpisodeOfCare , Encounter )
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 reference
encounter reference Encounter leading to message created as part of CommunicationRequest.context CommunicationRequest.encounter
( Encounter )
group-identifier token Composite request this is part of CommunicationRequest.groupIdentifier
identifier token Unique identifier CommunicationRequest.identifier
medium token A channel of communication CommunicationRequest.medium
occurrence date When scheduled CommunicationRequest.occurrence.as(DateTime) (CommunicationRequest.occurrence as dateTime)
patient reference Focus of message CommunicationRequest.subject CommunicationRequest.subject.where(resolve() is Patient)
( Patient )
priority token Message urgency routine | urgent | asap | stat CommunicationRequest.priority
recipient reference Message recipient CommunicationRequest.recipient
( Practitioner , Group , Organization , CareTeam , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
replaces reference Request(s) replaced by this request CommunicationRequest.replaces
( CommunicationRequest )
requester reference Individual making the request Who/what is requesting service CommunicationRequest.requester.agent CommunicationRequest.requester
( Practitioner , Organization , Device , Patient , PractitionerRole , RelatedPerson )
sender reference Message sender CommunicationRequest.sender
( Practitioner , Organization , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
status token draft | active | suspended on-hold | cancelled revoked | completed | entered-in-error | unknown CommunicationRequest.status
subject reference Focus of message CommunicationRequest.subject
( Group , Patient )