Profile: ServiceRequest

AB:eOrder-Lab Simplifier Project Page: ServiceRequest (AB:eOrder-Lab)

Derived from CA:eReC ServiceRequest

Views of Profile Content

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PatientPresentLocationC0..*Extension(Reference(Location))
DARCC0..*Extension(Complex)
DARTC0..*Extension(Complex)
RoutingOptionsC0..*Extension(CodeableConcept)
CopiedParticipantsC0..*Extension(Reference(PractitionerRole))
ServiceProviderPreferenceC0..*Extension(Complex)
modifierExtension?! C0..*Extension
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insurance0..*Reference(Coverage | ClaimResponse)
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PatientPresentLocationC0..*Extension(Reference(Location))
DARCC0..*Extension(Complex)
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CopiedParticipantsC0..*Extension(Reference(PractitionerRole))
ServiceProviderPreferenceC0..*Extension(Complex)
modifierExtension?! C0..*Extension
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asNeededBooleanboolean
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authoredOnS Σ1..1dateTime
id0..1string
ServiceRequesterDelegateC0..1Extension(Complex)
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systemS Σ1..1uri
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systemS Σ1..1uri
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locationCodeΣ0..*CodeableConcept
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insurance0..*Reference(Coverage | ClaimResponse)
id0..1string
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referenceS Σ C0..1string
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systemS Σ1..1uri
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periodΣ0..1Period
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displayΣ0..1string
specimenΣ0..*Reference(Specimen)
bodySiteΣ0..*CodeableConcept
id0..1string
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authorStringstring
id0..1string
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referenceS Σ C0..1string
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id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
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systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
timeΣ0..1dateTime
textΣ1..1markdown
patientInstructionΣ0..1string
relevantHistory0..*Reference(Provenance)
idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
PatientPresentLocationC0..*Extension(Reference(Location))
DARCC0..*Extension(Complex)
DARTC0..*Extension(Complex)
RoutingOptionsC0..*Extension(CodeableConcept)
CopiedParticipantsC0..*Extension(Reference(PractitionerRole))
ServiceProviderPreferenceC0..*Extension(Complex)
modifierExtension?! C0..*Extension
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extensionC0..*Extension
useΣ ?!0..1codeBinding
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systemS Σ1..1uri
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displayΣ0..1string
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referenceS Σ C0..1string
typeΣ0..1uriBinding
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systemS Σ1..1uri
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extensionC0..*Extension
useΣ ?!0..1codeBinding
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systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
id0..1string
statusReasonS C0..1Extension(CodeableConcept)
value0..1System.String
intentS Σ ?!1..1codeBindingFixed Value
categoryS Σ0..*CodeableConceptBinding
priorityS Σ1..1codeBinding
doNotPerformΣ ?!0..1boolean
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemS Σ1..1uri
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
orderDetailΣ C0..*CodeableConcept
quantityQuantityQuantity
quantityRatioRatio
quantityRangeRange
id0..1string
extensionC0..*Extension
referenceS Σ C0..1string
typeΣ0..1uriBinding
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
encounterΣ0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrencePeriodPeriod
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
eventΣ0..*dateTime
id0..1string
extensionC0..*Extension
boundsDurationDuration
boundsRangeRange
boundsPeriodPeriod
countΣ0..1positiveInt
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durationΣ0..1decimal
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durationUnitΣ0..1codeBinding
frequencyΣ0..1positiveInt
frequencyMaxΣ0..1positiveInt
periodΣ0..1decimal
periodMaxΣ0..1decimal
periodUnitΣ0..1codeBinding
dayOfWeekΣ0..*codeBinding
timeOfDayΣ0..*time
whenΣ0..*codeBinding
offsetΣ0..1unsignedInt
codeΣ0..1CodeableConceptBinding
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
authoredOnS Σ1..1dateTime
id0..1string
ServiceRequesterDelegateC0..1Extension(Complex)
referenceS Σ C0..1string
typeΣ0..1uriBinding
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
performerTypeΣ0..1CodeableConcept
id0..1string
PerformerIdentifierC0..1Extension(Identifier)
referenceS Σ C0..1string
typeΣ0..1uriBinding
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
locationCodeΣ0..*CodeableConcept
locationReferenceΣ0..*Reference(Location)
reasonCodeS Σ0..*CodeableConceptBinding
reasonReferenceΣ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)
insurance0..*Reference(Coverage | ClaimResponse)
id0..1string
extensionC0..*Extension
referenceS Σ C0..1string
typeΣ0..1uriBinding
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
specimenΣ0..*Reference(Specimen)
bodySiteΣ0..*CodeableConcept
id0..1string
extensionC0..*Extension
authorStringstring
id0..1string
extensionC0..*Extension
referenceS Σ C0..1string
typeΣ0..1uriBinding
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ1..1uri
valueS Σ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
displayΣ0..1string
timeΣ0..1dateTime
textΣ1..1markdown
patientInstructionΣ0..1string
relevantHistory0..*Reference(Provenance)

Restrictions

Alberta eOrder Laboratory (AB:eOrder-Lab) employs a set of constraints on the Bundle (AB:eOrder-Lab) Profile that prevents laboratory orders created in Alberta to include certain elements from ServiceRequest.

ServiceRequest records sent in an AB:eOrder-Lab Bundle SHALL NOT contain any of the following `ServiceRequest details:

  • .contained
  • .replaces
  • .reasonReference
  • **.insurance
  • .relevantHistory

These elements are restricted based on current privacy requirements that require data that is collected, used or disclosed be limited to only the amount of health information that is essential to enable the custodian or the recipient of the information to carry out the intended purpose.

Usage

Information about a healthcare provider's laboratory order to be performed for a patient.

The ServiceRequest resource contains the key information about lab test being requested, who requested it, which patient it's for, who is assigned to perform.

Notes

.id

  • TESTED element
  • an identifier for the ServiceRequest resource, unique within the submitted bundle
  • if a persistent identity for the resource is not available to use when constructing a Bundle for transmission, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)

.meta

  • TESTED element
  • metadata about the ServiceRequest resource, relevant to the submission or data exchange.
  • .lastUpdated
    • TESTED element
    • the date and time when the ServiceRequest was last updated, spanning all contained resources and data elements
    • contains the create-date for a new request, or the date when it was most recently updated by the ordering provider or by any workflow participant authorized to create or change the request

.identifier

  • TESTED element
  • one or more version-independent identifiers for the ServiceRequest resource
  • SHALL always be populated
  • TBD additional guidance...
  • .system
    • TESTED element
    • the namespace / naming system used for this service request identifier
    • SHALL always be populated
  • .value
    • TESTED element
    • the value of the assigned service request identifier
    • SHALL always be populated

.basedOn

  • CONDITIONALLY TESTED element
  • links this particular ServiceRequest to another existing ServiceRequest, when both are explicitly linked
  • if an identifier is previously known to both systems, .identifier SHALL be populated and used for reference to minimize the amount of detail required from submitting systems
  • otherwise .reference SHALL be used
    • the referenced resource SHALL be included in the Bundle.entry
    • SHALL be the UUID in the Bundle.entry.fullURL of the referenced resource

.status

  • TESTED element
  • the workflow state of the service request
  • SHALL always be populated
  • SHALL be set to 'active' when ordered and will remain in that state until 'completed' or 'revoked'

.intent

  • TESTED element
  • the intention and authorization underlying the service request, indicating how it should be received and acted upon
  • SHALL always be populated with fixed value of 'proposal'
  • a nationally-defined set of standard values cannot be modified or extended. The value of 'proposal' is standard for referral and eConsult requests

.priority

  • TESTED element
  • the priority with which the service request should be addressed with respect to other requests
  • SHALL always be provided
  • SHALL only use 'routine' (default value) and 'stat'

.code

  • TESTED element
  • a code or text description identifying the type of laboratory test being requested
  • SHALL be populated from the provincially published list of eligible codes
  • NOTE the codes provided in the bound value set do not constitute the full list, only a few examples
  • SHALL always be populated
    • .coding
      • TESTED element
      • .code
        • TESTED element
        • a codified value that represents the type of laboratory test ordered
        • SHALL always be populated
      • .system
        • TESTED element
        • the terminology system used by the code
        • SHALL always be populated
      • .text
        • TESTED element
        • the name or textual description of the type of laboratory test ordered
        • SHOULD be populated with the published text from Alberta Health to EMRs, accompanying the allowed codes

.orderDetail

  • TESTED element
  • any additional notes or details that the ordering provider may choose to include (e.g. lab instructions)
  • if populated, only .text SHALL be used

.subject

  • TESTED element
  • a reference to the Patient resource of the submitted service request, specifying that the patient is the subject of the requested service
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated subject (patient) resource within the submission bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the subject's information
  • .identifier
    • TESTED element
    • .system
      • TESTED element
      • SHALL always be populated
    • .value
      • TESTED element
      • SHALL always be populated
  • the Patient resource SHALL be included on any new ServiceRequest, but can be referenced through the patient's provicial identifier (without needing to include the Patient resource in the Bundle) on subsequent updates to the ServiceRequest or when the ServiceRequest is otherwise included in the Bundle
  • if an identifier is previously known to both systems, .identifier SHALL be populated and used for reference to minimize the amount of detail required from submitting systems
  • otherwise .reference SHALL be used
    • the referenced resource SHALL be included in the Bundle.entry
    • SHALL be the UUID in the Bundle.entry.fullURL of the referenced resource

.occurence[x]

  • TESTED element
  • .occurenceTiming
    • TESTED element
    • .repeat
      • TESTED element
      • .boundsPeriod
        • TESTED element
        • .start
          • TESTED element
          • indicates when the order is to be started
          • start date SHALL NOT be more than one year in the future
        • .end
          • indicates when the order is to be ended
          • end date SHALL NOT be more than one year from the filing date in Connect Care
      • .count
        • TESTED element
        • indicates the total occurrences
    • .code
      • TESTED element
      • indicates the frequency

The following table shows how the .occurenceTiming will be populated according to whether the order is single occurence or standing order:

Single Occurrence

Element Optionality Value Comment
.occurenceTiming.repeat.boundsPeriod.start Optional Desired date and time SHALL be valued if desired start date and time is in the future
.occurenceTiming.repeat.boundsPeriod.end Optional Desired date and time SHALL be valued if there is a specific desired end date, otherwise order will expire in 1 year after order date
.occurenceTiming.repeat.boundsPeriod.count N/A N/A SHALL NOT be valued
.occurenceTiming.code N/A N/A SHALL NOT be valued

Standing Order

Element Optionality Value Comment
.occurenceTiming.repeat.boundsPeriod.start Optional Desired date and time SHALL be valued if desired start date and time is in the future
.occurenceTiming.repeat.boundsPeriod.end Optional Desired date and time SHALL be valued if there is a specific desired end date, otherwise order will expire in 1 year after order date
.occurenceTiming.repeat.boundsPeriod.count Required >1
.occurenceTiming.code Required Desired frequency

.authoredOn

  • TESTED element
  • the date and time when the service request was created from the source system's information and submitted for action
  • SHALL always be populated

.requester

  • TESTED element
  • a reference to the healthcare provider role resource for the provider requesting the service, specifying the requesting healthcare provider's role, services, and location for the purpose of this service request
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated healthcare provider role resource within the submission bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the requester's information

.performer

  • TESTED element
  • a reference to the resource of the performer requested to fulfill the service
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated resource within the submission bundle
  • type
    • TESTED element
    • identifies the type of FHIR resource used to convey the requested performer's information

.supportingInfo

  • TESTED element
  • refers to either an additional information such as questions and answers specific to laboratory test ordered (QuestionnaireResponse) and/or the requisition in PDF format (DocumentReference)
  • .reference
    • TESTED element
    • a reference to the associated supporting information (QuestionnaireResponse or DocumentReference) within the submission bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the supporting information

.specimen

  • TESTED element
  • specimen that the laboratory procedure will use
  • SHALL always be populated
  • .reference
    • TESTED element
    • a reference to the associated Specimen within the submission bundle
  • .type
    • TESTED element
    • identifies the type of FHIR resource used to convey the specimen

.bodySite

  • SHALL NOT be used; see Specimen.collection.bodySite.text

Extensions

  • .CopiedParticipants
    • TESTED element
    • when valued, these are the providers who will be copied on results distribution
    • note: the Alberta PractitionerRole, Practitioner, and Location profiles were intentionally not used for this purpose as there are certain constraints (e.g. mandatory identifier) that are not available for the copy to provider.
    • .PractitionerRole.Practioner
      • CONDITIONALLY TESTED element including all the following elements:
      • .name
        • .family
          • if .CopiedParticipants is valued, .family SHALL always be populated
        • .given
          • if .CopiedParticipants is valued, .name SHALL always be populated with full first name
    • .PractitionerRole.Location
      • CONDITIONALLY TESTED element including all the following elements:
      • .name
        • if .CopiedParticipants is valued, .name SHALL always be populated
      • .telecom
        • if .CopiedParticipants is valued, the following SHOULD be populated
          • .value
          • .system
      • .address
        • if .CopiedParticipants is valued, the following SHOULD be populated
          • .line
          • .city
          • .state
          • .postalCode
  • .status.extension.statusReason
    • .text
      • CONDITIONALLY TESTED element
      • used to capture reason for status change (e.g. cancellation reason from EMR)
      • SHOULD be populated when EMR cancels a lab test