MyHealth@Eu Medical Imaging Report
9.1.1 - ci-build 150

MyHealth@Eu Medical Imaging Report - Local Development build (v9.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ServiceRequestImgMyHealthEu - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the serviceRequest-img-myhealtheu resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. ServiceRequest
Definition

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

ShortA request for a service to be performed
Control0..*
Is Modifierfalse
Summaryfalse
Alternate Namesdiagnostic request, referral, referral request, transfer of care request
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ServiceRequest.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHALL be taken from The codes SHOULD be taken from eHDSI Languagehttp://hl7.org/fhir/ValueSet/languages|4.0.1
(required to http://terminology.ehdsi.eu/ValueSet/eHDSILanguage)
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ServiceRequest.extension:reason
Slice Namereason
Definition

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.

ShortExplanation/Justification for procedure or service
Comments

ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(R5: Explanation/Justification for procedure or service additional types) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. ServiceRequest.extension:reason.extension:concept
Slice Nameconcept
Definition

A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

ShortReference to a concept (by class)Additional content defined by implementations
Comments

ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

Control0..1*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. ServiceRequest.extension:reason.extension:concept.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valueconcept
12. ServiceRequest.extension:reason.extension:reference
Slice Namereference
Definition

A reference to a resource the provides exact details about the information being referenced.

ShortReference to a resource (by instance)Additional content defined by implementations
Comments

ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

Control0..1*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. ServiceRequest.extension:reason.extension:reference.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Shortidentifies the meaning of the extension
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
Fixed Valuereference
16. ServiceRequest.extension:reason.extension:_datatype
Slice Name_datatype
Definition

Data type name for ServiceRequest.reason from FHIR R5

ShortData type name for ServiceRequest.reason from FHIR R5
Control0..1
TypeExtension(Datatype) (Extension Type: string)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. ServiceRequest.extension:reason.extension:_datatype.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..0*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 20. ServiceRequest.extension:reason.extension:_datatype.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
    22. ServiceRequest.extension:reason.extension:_datatype.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Comments

    Must be: CodeableReference

    Control10..1
    This element is affected by the following invariants: ext-1
    Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Fixed ValueCodeableReference
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. ServiceRequest.extension:reason.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.reason
    26. ServiceRequest.extension:reason.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control0..1
    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ServiceRequest.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 28. ServiceRequest.extension:reason.value[x]:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control0..1
      TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ServiceRequest.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      32. ServiceRequest.identifier
      Definition

      Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

      ShortIdentifiers assigned to this order
      Comments

      The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ type
      • 34. ServiceRequest.identifier:accessionNumber
        Slice NameaccessionNumber
        Definition

        Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

        ShortIdentifiers assigned to this order
        Comments

        The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1*
        TypeIdentifier(Identifier: Accession Number)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. ServiceRequest.status
        Definition

        The status of the order.

        ShortThe status of a service orderdraft | active | on-hold | revoked | completed | entered-in-error | unknown
        Comments

        The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.


        The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

        Control1..1
        BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

        The status of a service order.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. ServiceRequest.intent
        Definition

        Whether the request is a proposal, plan, an original order or a reflex order.

        ShortThe kind of service requestproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
        Comments

        This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

        Control1..1
        BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
        (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

        The kind of service request.

        Typecode
        Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. ServiceRequest.category
        Definition

        A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

        ShortClassification of service
        Comments

        There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

        Control10..*
        BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1
        (example to http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1)

        Classification of the requested service.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Used for filtering what service request are retrieved and displayed.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ $this
        • 42. ServiceRequest.category:imaging
          Slice Nameimaging
          Definition

          A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

          ShortClassification of service
          Comments

          There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

          Control10..1*
          BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1
          (example to http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1)

          Classification of the requested service.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Requirements

          Used for filtering what service request are retrieved and displayed.

          Pattern Value{
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "363679005"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. ServiceRequest.doNotPerform
          Definition

          Set this to true if the record is saying that the service/procedure should NOT be performed.

          ShortTrue if service/procedure should not be performed
          Comments

          In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

          Control0..1
          Typeboolean
          Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

          Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. ServiceRequest.code
          Definition

          A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

          ShortRequested procedureWhat is being requested/ordered
          Comments

          Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

          Control0..1
          BindingThe codes SHALL be taken from For example codes, see eHDSI Imaging Procedure With Exceptionshttp://hl7.org/fhir/ValueSet/procedure-code|4.0.1
          (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSIImagingProcedureWithExceptions)
          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Alternate Namesservice requested
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. ServiceRequest.subject
          Definition

          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).

          ShortIndividual or Entity the service is ordered for
          Control1..1
          TypeReference(Patient (Core), Patient, Group, Location, Device)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. ServiceRequest.requester
          Definition

          The individual who initiated the request and has responsibility for its activation.

          ShortWho/what is requesting service
          Comments

          This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

          Control0..1
          TypeReference(Practitioner (Core), PractitionerRole (Core), Organization (Core), Patient (Core), RelatedPerson, Device, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
          Is Modifierfalse
          Summarytrue
          Alternate Namesauthor, orderer
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. ServiceRequest.reasonCode
          Definition

          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.

          ShortExplanation/Justification for procedure or service
          Comments

          This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.


          This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

          Control0..*
          BindingThe codes SHALL be taken from For example codes, see eHDSI Order Reason With Exceptionshttp://hl7.org/fhir/ValueSet/procedure-reason|4.0.1
          (required to http://fhir.ehdsi.eu/core/ValueSet/eHDSIOrderReasonWithExceptions)
          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. ServiceRequest.reasonReference
          Definition

          Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

          ShortAn explanation or justification for why this service is being requested.Explanation/Justification for service or service
          Comments

          This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.


          This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

          Control0..*
          TypeReference(Condition (Core), Observation, Condition, Observation, DiagnosticReport, DocumentReference)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be foundhere

          0. ServiceRequest
          2. ServiceRequest.language
          BindingThe codes SHALL be taken from eHDSI Language
          (required to http://terminology.ehdsi.eu/ValueSet/eHDSILanguage)
          4. ServiceRequest.status
          ShortThe status of a service order
          6. ServiceRequest.intent
          ShortThe kind of service request
          8. ServiceRequest.code
          BindingThe codes SHALL be taken from eHDSI Imaging Procedure With Exceptions
          (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSIImagingProcedureWithExceptions)
          10. ServiceRequest.subject
          TypeReference(Patient (Core))
          12. ServiceRequest.requester
          TypeReference(Practitioner (Core), PractitionerRole (Core), Organization (Core), Patient (Core), RelatedPerson, Device)
          14. ServiceRequest.reasonCode
          BindingThe codes SHALL be taken from eHDSI Order Reason With Exceptions
          (required to http://fhir.ehdsi.eu/core/ValueSet/eHDSIOrderReasonWithExceptions)
          16. ServiceRequest.reasonReference
          ShortAn explanation or justification for why this service is being requested.
          TypeReference(Condition (Core), Observation)

          Guidance on how to interpret the contents of this table can be foundhere

          0. ServiceRequest
          Definition

          A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

          ShortA request for a service to be performed
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate Namesdiagnostic request, referral, referral request, transfer of care request
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
          2. ServiceRequest.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. ServiceRequest.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. ServiceRequest.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. ServiceRequest.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Control0..1
          BindingThe codes SHALL be taken from eHDSI Language
          (required to http://terminology.ehdsi.eu/ValueSet/eHDSILanguage)
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. ServiceRequest.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. ServiceRequest.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. ServiceRequest.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. ServiceRequest.extension:reason
            Slice Namereason
            Definition

            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.

            ShortExplanation/Justification for procedure or service
            Comments

            ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(R5: Explanation/Justification for procedure or service additional types) (Complex Extension)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. ServiceRequest.extension:reason.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            20. ServiceRequest.extension:reason.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on ServiceRequest.extension.extension. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • value @ url
            • 22. ServiceRequest.extension:reason.extension:concept
              Slice Nameconcept
              Definition

              A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

              ShortReference to a concept (by class)
              Comments

              ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

              Control0..1
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              24. ServiceRequest.extension:reason.extension:concept.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              26. ServiceRequest.extension:reason.extension:concept.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 28. ServiceRequest.extension:reason.extension:concept.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valueconcept
                30. ServiceRequest.extension:reason.extension:concept.value[x]
                Definition

                A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

                ShortReference to a concept (by class)
                Comments

                ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

                Control0..1
                TypeCodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. ServiceRequest.extension:reason.extension:reference
                Slice Namereference
                Definition

                A reference to a resource the provides exact details about the information being referenced.

                ShortReference to a resource (by instance)
                Comments

                ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

                Control0..1
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                34. ServiceRequest.extension:reason.extension:reference.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                36. ServiceRequest.extension:reason.extension:reference.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 38. ServiceRequest.extension:reason.extension:reference.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuereference
                  40. ServiceRequest.extension:reason.extension:reference.value[x]
                  Definition

                  A reference to a resource the provides exact details about the information being referenced.

                  ShortReference to a resource (by instance)
                  Comments

                  ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent. ServiceRequest.reasonCode maps to R4 ServiceRequest.reasonCode. So is mapped as Equivalent. ServiceRequest.reasonReference maps to R4 ServiceRequest.reasonReference. So is mapped as Equivalent.

                  Control0..1
                  TypeReference
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. ServiceRequest.extension:reason.extension:_datatype
                  Slice Name_datatype
                  Definition

                  Data type name for ServiceRequest.reason from FHIR R5

                  ShortData type name for ServiceRequest.reason from FHIR R5
                  Control0..1
                  TypeExtension(Datatype) (Extension Type: string)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  44. ServiceRequest.extension:reason.extension:_datatype.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  46. ServiceRequest.extension:reason.extension:_datatype.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..0
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 48. ServiceRequest.extension:reason.extension:_datatype.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
                    50. ServiceRequest.extension:reason.extension:_datatype.value[x]
                    Definition

                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortValue of extension
                    Comments

                    Must be: CodeableReference

                    Control1..1
                    This element is affected by the following invariants: ext-1
                    Typestring
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Fixed ValueCodeableReference
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    52. ServiceRequest.extension:reason.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-ServiceRequest.reason
                    54. ServiceRequest.extension:reason.value[x]
                    Definition

                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortValue of extension
                    Control0..1
                    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on ServiceRequest.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 56. ServiceRequest.extension:reason.value[x]:valueCodeableConcept
                      Slice NamevalueCodeableConcept
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control0..1
                      TypeCodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      58. ServiceRequest.extension:reason.value[x]:valueCodeableConcept.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      60. ServiceRequest.extension:reason.value[x]:valueCodeableConcept.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on ServiceRequest.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 62. ServiceRequest.extension:reason.value[x]:valueCodeableConcept.coding
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        Comments

                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                        Control0..*
                        TypeCoding
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows for alternative encodings within a code system, and translations to other code systems.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        64. ServiceRequest.extension:reason.value[x]:valueCodeableConcept.text
                        Definition

                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                        ShortPlain text representation of the concept
                        Comments

                        Very often the text is the same as a displayName of one of the codings.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        66. ServiceRequest.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Summaryfalse
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        68. ServiceRequest.identifier
                        Definition

                        Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

                        ShortIdentifiers assigned to this order
                        Comments

                        The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..*
                        TypeIdentifier
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ type
                        • 70. ServiceRequest.identifier:accessionNumber
                          Slice NameaccessionNumber
                          Definition

                          Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

                          ShortIdentifiers assigned to this order
                          Comments

                          The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier(Identifier: Accession Number)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. ServiceRequest.instantiatesCanonical
                          Definition

                          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.

                          ShortInstantiates FHIR protocol or definition
                          Comments

                          Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                          Control0..*
                          Typecanonical(ActivityDefinition, PlanDefinition)
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. ServiceRequest.instantiatesUri
                          Definition

                          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.

                          ShortInstantiates external protocol or definition
                          Comments

                          This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                          Control0..*
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          76. ServiceRequest.basedOn
                          Definition

                          Plan/proposal/order fulfilled by this request.

                          ShortWhat request fulfills
                          Control0..*
                          TypeReference(CarePlan, ServiceRequest, MedicationRequest)
                          Is Modifierfalse
                          Summarytrue
                          Alternate Namesfulfills
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          78. ServiceRequest.replaces
                          Definition

                          The request takes the place of the referenced completed or terminated request(s).

                          ShortWhat request replaces
                          Control0..*
                          TypeReference(ServiceRequest)
                          Is Modifierfalse
                          Summarytrue
                          Alternate Namessupersedes, prior, renewed order
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. ServiceRequest.requisition
                          Definition

                          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.

                          ShortComposite Request ID
                          Comments

                          Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

                          Alternate NamesgrouperId, groupIdentifier
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          82. ServiceRequest.status
                          Definition

                          The status of the order.

                          ShortThe status of a service order
                          Comments

                          The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

                          Control1..1
                          BindingThe codes SHALL be taken from RequestStatus
                          (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

                          The status of a service order.

                          Typecode
                          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          84. ServiceRequest.intent
                          Definition

                          Whether the request is a proposal, plan, an original order or a reflex order.

                          ShortThe kind of service request
                          Comments

                          This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                          Control1..1
                          BindingThe codes SHALL be taken from RequestIntent
                          (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

                          The kind of service request.

                          Typecode
                          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          86. ServiceRequest.category
                          Definition

                          A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                          ShortClassification of service
                          Comments

                          There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                          Control1..*
                          BindingFor example codes, see ServiceRequestCategoryCodes
                          (example to http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1)

                          Classification of the requested service.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Used for filtering what service request are retrieved and displayed.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ $this
                          • 88. ServiceRequest.category:imaging
                            Slice Nameimaging
                            Definition

                            A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                            ShortClassification of service
                            Comments

                            There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                            Control1..1
                            BindingFor example codes, see ServiceRequestCategoryCodes
                            (example to http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1)

                            Classification of the requested service.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Used for filtering what service request are retrieved and displayed.

                            Pattern Value{
                              "coding" : [{
                                "system" : "http://snomed.info/sct",
                                "code" : "363679005"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            90. ServiceRequest.priority
                            Definition

                            Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

                            Shortroutine | urgent | asap | stat
                            Control0..1
                            BindingThe codes SHALL be taken from RequestPriority
                            (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

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

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Meaning if MissingIf missing, this task should be performed with normal priority
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            92. ServiceRequest.doNotPerform
                            Definition

                            Set this to true if the record is saying that the service/procedure should NOT be performed.

                            ShortTrue if service/procedure should not be performed
                            Comments

                            In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

                            Control0..1
                            Typeboolean
                            Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

                            Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            94. ServiceRequest.code
                            Definition

                            A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

                            ShortRequested procedure
                            Comments

                            Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

                            Control0..1
                            BindingThe codes SHALL be taken from eHDSI Imaging Procedure With Exceptions
                            (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSIImagingProcedureWithExceptions)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namesservice requested
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            96. ServiceRequest.orderDetail
                            Definition

                            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.

                            ShortAdditional order information
                            Comments

                            For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

                            Control0..*
                            This element is affected by the following invariants: prr-1
                            BindingFor example codes, see ServiceRequestOrderDetailsCodes
                            (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail|4.0.1)

                            Codified order entry details which are based on order context.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namesdetailed instructions
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            98. ServiceRequest.quantity[x]
                            Definition

                            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).

                            ShortService amount
                            Control0..1
                            TypeChoice of: Quantity, Ratio, Range
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            When ordering a service the number of service items may need to be specified separately from the the service item.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            100. ServiceRequest.subject
                            Definition

                            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).

                            ShortIndividual or Entity the service is ordered for
                            Control1..1
                            TypeReference(Patient (Core))
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. ServiceRequest.encounter
                            Definition

                            An encounter that provides additional information about the healthcare context in which this request is made.

                            ShortEncounter in which the request was created
                            Control0..1
                            TypeReference(Encounter)
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namescontext
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            104. ServiceRequest.occurrence[x]
                            Definition

                            The date/time at which the requested service should occur.

                            ShortWhen service should occur
                            Control0..1
                            TypeChoice of: dateTime, Period, Timing
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate Namesschedule
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            106. ServiceRequest.asNeeded[x]
                            Definition

                            If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

                            ShortPreconditions for service
                            Control0..1
                            BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                            (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

                            A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

                            TypeChoice of: boolean, CodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            108. ServiceRequest.authoredOn
                            Definition

                            When the request transitioned to being actionable.

                            ShortDate request signed
                            Control0..1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesorderedOn
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            110. ServiceRequest.requester
                            Definition

                            The individual who initiated the request and has responsibility for its activation.

                            ShortWho/what is requesting service
                            Comments

                            This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

                            Control0..1
                            TypeReference(Practitioner (Core), PractitionerRole (Core), Organization (Core), Patient (Core), RelatedPerson, Device)
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namesauthor, orderer
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            112. ServiceRequest.performerType
                            Definition

                            Desired type of performer for doing the requested service.

                            ShortPerformer role
                            Comments

                            This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

                            Control0..1
                            BindingFor example codes, see ParticipantRoles
                            (example to http://hl7.org/fhir/ValueSet/participant-role|4.0.1)

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

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namesspecialty
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            114. ServiceRequest.performer
                            Definition

                            The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

                            ShortRequested performer
                            Comments

                            If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

                            Control0..*
                            TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namesrequest recipient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. ServiceRequest.locationCode
                            Definition

                            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.

                            ShortRequested location
                            Control0..*
                            BindingFor example codes, see ServiceDeliveryLocationRoleType
                            (example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

                            A location type where services are delivered.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            118. ServiceRequest.locationReference
                            Definition

                            A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

                            ShortRequested location
                            Control0..*
                            TypeReference(Location)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. ServiceRequest.reasonCode
                            Definition

                            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.

                            ShortExplanation/Justification for procedure or service
                            Comments

                            This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                            Control0..*
                            BindingThe codes SHALL be taken from eHDSI Order Reason With Exceptions
                            (required to http://fhir.ehdsi.eu/core/ValueSet/eHDSIOrderReasonWithExceptions)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. ServiceRequest.reasonReference
                            Definition

                            Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                            ShortAn explanation or justification for why this service is being requested.
                            Comments

                            This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                            Control0..*
                            TypeReference(Condition (Core), Observation)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            124. ServiceRequest.insurance
                            Definition

                            Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

                            ShortAssociated insurance coverage
                            Control0..*
                            TypeReference(Coverage, ClaimResponse)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. ServiceRequest.supportingInfo
                            Definition

                            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 at order entry questions (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.

                            ShortAdditional clinical information
                            Comments

                            To represent information about how the services are to be delivered use the instructions element.

                            Control0..*
                            TypeReference(Resource)
                            Is Modifierfalse
                            Summaryfalse
                            Alternate NamesAsk at order entry question, AOE
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. ServiceRequest.supportingInfo.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            130. ServiceRequest.supportingInfo.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 132. ServiceRequest.supportingInfo.extension:codeableConcept
                              Slice NamecodeableConcept
                              Definition

                              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 at order entry questions (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.

                              ShortAdditional clinical information
                              Comments

                              ServiceRequest.supportingInfo maps to R4 ServiceRequest.supportingInfo. So is mapped as Equivalent. ServiceRequest.supportingInfo maps to R4 ServiceRequest.supportingInfo. So is mapped as Equivalent. ServiceRequest.supportingInfo maps to R4 ServiceRequest.supportingInfo. So is mapped as Equivalent.

                              Control0..*
                              TypeExtension(R5: supportingInfo additional types) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              134. ServiceRequest.supportingInfo.reference
                              Definition

                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                              ShortLiteral reference, Relative, internal or absolute URL
                              Comments

                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                              Control0..1
                              This element is affected by the following invariants: ref-1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. ServiceRequest.supportingInfo.type
                              Definition

                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                              ShortType the reference refers to (e.g. "Patient")
                              Comments

                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                              Aa resource (or, for logical models, the URI of the logical model).

                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              138. ServiceRequest.supportingInfo.identifier
                              Definition

                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                              ShortLogical reference, when literal reference is not known
                              Comments

                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..1
                              TypeIdentifier
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              140. ServiceRequest.supportingInfo.display
                              Definition

                              Plain text narrative that identifies the resource in addition to the resource reference.

                              ShortText alternative for the resource
                              Comments

                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              142. ServiceRequest.specimen
                              Definition

                              One or more specimens that the laboratory procedure will use.

                              ShortProcedure Samples
                              Comments

                              Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

                              Control0..*
                              TypeReference(Specimen)
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              144. ServiceRequest.bodySite
                              Definition

                              Anatomic location where the procedure should be performed. This is the target site.

                              ShortLocation on Body
                              Comments

                              Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

                              Control0..*
                              BindingFor example codes, see SNOMEDCTBodyStructures
                              (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

                              Codes describing anatomical locations. May include laterality.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Knowing where the procedure is performed is important for tracking if multiple sites are possible.

                              Alternate Nameslocation
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              146. ServiceRequest.note
                              Definition

                              Any other notes and comments made about the service request. For example, internal billing notes.

                              ShortComments
                              Control0..*
                              TypeAnnotation
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              148. ServiceRequest.patientInstruction
                              Definition

                              Instructions in terms that are understood by the patient or consumer.

                              ShortPatient or consumer-oriented instructions
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              150. ServiceRequest.relevantHistory
                              Definition

                              Key events in the history of the request.

                              ShortRequest provenance
                              Comments

                              This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                              Control0..*
                              TypeReference(Provenance)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))