StructureDefinition UKCore-ServiceRequest-Lab

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Labactive2.0.02024-07-11

This profile defines the specific UK constraints and extensions on the International FHIR resource ServiceRequest, in order to support requesting laboratory services.


Profile_Purpose

To provide implementers additional support for requesting a procedure or diagnostic or other service to be planned, proposed, or performed, with regards to a laboratory observation or a laboratory diagnostic report.

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
sourceOfServiceRequestI0..1Extension(CodeableConcept)
additionalContactI0..*Extension(Reference(Organization | Practitioner | PractitionerRole))
coverageI0..1Extension(CodeableConcept)
modifierExtension?! I0..*Extension
identifierΣ0..*Identifier
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | PlanDefinition)
instantiatesUriΣ0..*uri
basedOnΣ I0..*Reference(CarePlan | ServiceRequest | MedicationRequest)
replacesΣ I0..*Reference(ServiceRequest)
requisitionΣ0..1Identifier
statusS Σ ?!1..1codeBinding
intentS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
priorityReasonI0..*Extension(CodeableConcept)
value0..1System.String
doNotPerformΣ ?!0..1boolean
codeΣ0..1CodeableConceptBinding
orderDetailΣ I0..*CodeableConceptBinding
quantityQuantityQuantity
quantityRatioRatio
quantityRangeRange
subjectS Σ I1..1Reference(Patient | Group | Location | Device)
encounterΣ I0..1Reference(Encounter)
occurrenceDateTimedateTime
occurrencePeriodPeriod
occurrenceTimingTiming
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
authoredOnΣ0..1dateTime
requesterS Σ I0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
performerTypeΣ0..1CodeableConcept
performerΣ I0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)
locationCodeΣ0..*CodeableConcept
locationReferenceΣ I0..*Reference(Location)
reasonCodeΣ0..*CodeableConceptBinding
reasonReferenceΣ I0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)
insuranceI0..*Reference(Coverage | ClaimResponse)
supportingInfoI0..*Reference(Resource)
specimenΣ I0..*Reference(Specimen)
bodySiteΣ0..*CodeableConceptBinding
note0..*Annotation
patientInstructionΣ0..1string
relevantHistoryI0..*Reference(Provenance)

Detailed Descriptions

ServiceRequest
DefinitionA record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
Cardinality0...*
Aliasdiagnostic request, referral, referral request, transfer of care request
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.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-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-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • prr-1: orderDetail SHALL only be present if code is present
    orderDetail.empty() or code.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Request
  • v2: ORC
  • rim: Act[moodCode<=INT]
ServiceRequest.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
SummaryTrue
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.

ServiceRequest.meta
DefinitionThe 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.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.implicitRules
DefinitionA 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.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
ServiceRequest.text
DefinitionA 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.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
ServiceRequest.contained
DefinitionThese 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.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained 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.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
ServiceRequest.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:sourceOfServiceRequest
DefinitionThis represents the source of referral.
Cardinality0...1
TypeExtension(CodeableConcept)
Aliasextensions, user content
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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:additionalContact
DefinitionDetails of an additional contact, who should be contacted regarding questions arising from the service request.
Cardinality0...*
TypeExtension(Reference(Organization | Practitioner | PractitionerRole))
Aliasextensions, user content
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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.extension:coverage
DefinitionThe funding category for the Service Request.
Cardinality0...1
TypeExtension(CodeableConcept)
Aliasextensions, user content
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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
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.

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.identifier
DefinitionIdentifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.
Cardinality0...*
TypeIdentifier
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • w5: FiveWs.identifier
  • v2: ORC.2, ORC.3, RF1-6 / RF1-11,
  • rim: .identifier
  • quick: ClinicalStatement.identifier
ServiceRequest.instantiatesCanonical
DefinitionThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.
Cardinality0...*
Typecanonical(ActivityDefinition | PlanDefinition)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesCanonical
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
ServiceRequest.instantiatesUri
DefinitionThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.
Cardinality0...*
Typeuri
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesUri
  • v2: Varies by domain
  • rim: .outboundRelationship[typeCode=DEFN].target
ServiceRequest.basedOn
DefinitionPlan/proposal/order fulfilled by this request.
Cardinality0...*
TypeReference(CarePlan | ServiceRequest | MedicationRequest)
SummaryTrue
Aliasfulfills
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.basedOn
  • v2: ORC.8 (plus others)
  • rim: .outboundRelationship[typeCode=FLFS].target
ServiceRequest.replaces
DefinitionThe request takes the place of the referenced completed or terminated request(s).
Cardinality0...*
TypeReference(ServiceRequest)
SummaryTrue
Aliassupersedes, prior, renewed order
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.replaces
  • v2: Handled by message location of ORC (ORC.1=RO or RU)
  • rim: .outboundRelationship[typeCode=RPLC].target
ServiceRequest.requisition
DefinitionA shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.
Cardinality0...1
TypeIdentifier
SummaryTrue
AliasgrouperId, groupIdentifier
Requirements

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

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.groupIdentifier
  • v2: ORC.4
  • rim: .inboundRelationship(typeCode=COMP].source[moodCode=INT].identifier
ServiceRequest.status
DefinitionThe status of the order.
Cardinality1...1
Typecode
Binding

The status of a service order.

RequestStatus (required)
Must SupportTrue
ModifierTrue
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.status
  • w5: FiveWs.status
  • v2: ORC.5,RF1-1
  • rim: .status
  • quick: Action.currentStatus
ServiceRequest.intent
DefinitionWhether the request is a proposal, plan, an original order or a reflex order.
Cardinality1...1
Typecode
Binding

The kind of service request.

RequestIntent (required)
Must SupportTrue
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.intent
  • w5: FiveWs.class
  • v2: N/A
  • rim: .moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
ServiceRequest.category
DefinitionA code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").
Cardinality0...*
TypeCodeableConcept
Binding

Classification of the requested service.

ServiceRequestCategoryCodes (example)
SummaryTrue
Requirements

Used for filtering what service request are retrieved and displayed.

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.

SlicingUnordered, Open, by coding.system(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: RF1-5
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
ServiceRequest.category:genomicsWholeCaseSequencing
DefinitionA code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases
Cardinality0...*
TypeCodeableConcept
Binding

Classification of the requested service.

UKCoreGenomeSequencingCategory (extensible)
SummaryTrue
Requirements

Used for filtering what service request are retrieved and displayed.

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
  • v2: RF1-5
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
ServiceRequest.category:genomicsWholeCaseSequencing.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
ServiceRequest.category:genomicsWholeCaseSequencing.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.category:genomicsWholeCaseSequencing.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

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

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ServiceRequest.category:genomicsWholeCaseSequencing.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
ServiceRequest.category:genomicsWholeCaseSequencing.coding.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.category:genomicsWholeCaseSequencing.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory

Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
ServiceRequest.category:genomicsWholeCaseSequencing.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
ServiceRequest.category:genomicsWholeCaseSequencing.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
ServiceRequest.category:genomicsWholeCaseSequencing.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
ServiceRequest.category:genomicsWholeCaseSequencing.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
ServiceRequest.category:genomicsWholeCaseSequencing.text
DefinitionA 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.
Cardinality0...1
Typestring
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.

Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
ServiceRequest.priority
DefinitionIndicates how quickly the ServiceRequest should be addressed with respect to other requests.
Cardinality0...1
Typecode
Binding

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

RequestPriority (required)
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.priority
  • w5: FiveWs.grade
  • v2: TQ1.9, RF1-2
  • rim: .priorityCode
ServiceRequest.priority.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
ServiceRequest.priority.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.priority.extension:priorityReason
DefinitionA SNOMED CT concept representing the reason a Service Request is urgent
Cardinality0...*
TypeExtension(CodeableConcept)
Aliasextensions, user content
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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • rim: N/A
ServiceRequest.priority.value
DefinitionPrimitive value for code
Cardinality0...1
TypeSystem.String
ServiceRequest.doNotPerform
DefinitionSet this to true if the record is saying that the service/procedure should NOT be performed.
Cardinality0...1
Typeboolean
ModifierTrue
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.

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.doNotPerform
  • rim: .actionNegationInd
ServiceRequest.code
DefinitionA set of codes from the SNOMED Clinical Terminology UK coding system regarding laboratory medicine test requests.
Cardinality0...1
TypeCodeableConcept
Binding

A set of codes that define laboratory medicine test requests. Selected from the SNOMED CT UK coding system.

UKCorePathologyAndLaboratoryMedicineProcedures (preferred)
SummaryTrue
Aliasservice requested
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.code
  • w5: FiveWs.what[x]
  • v2: PR1-3 / OBR-4 (varies by domain)
  • rim: .code
  • quick: Procedure.procedureCode
ServiceRequest.orderDetail
DefinitionAdditional 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.
Cardinality0...*
TypeCodeableConcept
Binding

Codified order entry details which are based on order context.

UKCoreProcedureCode (preferred)
SummaryTrue
Aliasdetailed instructions
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: NTE
  • rim: .code
  • quick: Procedure.procedureCode
ServiceRequest.quantity[x]
DefinitionAn 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).
Cardinality0...1
TypeQuantity
SummaryTrue
Requirements

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NTE
  • rim: .quantity
ServiceRequest.subject
DefinitionOn 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).
Cardinality1...1
TypeReference(Patient | Group | Location | Device)
Must SupportTrue
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • w5: FiveWs.subject[x]
  • v2: PID
  • rim: .participation[typeCode=SBJ].role
  • quick: ClinicalStatement.subject
  • w5: FiveWs.subject
ServiceRequest.encounter
DefinitionAn encounter that provides additional information about the healthcare context in which this request is made.
Cardinality0...1
TypeReference(Encounter)
SummaryTrue
Aliascontext
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.encounter
  • w5: FiveWs.context
  • v2: PV1
  • rim: .inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
  • quick: ClinicalStatement.encounter
ServiceRequest.occurrence[x]
DefinitionThe date/time at which the requested service should occur.
Cardinality0...1
TypedateTime
SummaryTrue
Aliasschedule
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.occurrence[x]
  • w5: FiveWs.planned
  • v2: TQ1/TQ2, OBR-7/OBR-8
  • rim: .effectiveTime
  • quick: Procedure.procedureSchedule
ServiceRequest.asNeeded[x]
DefinitionIf a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.
Cardinality0...1
Typeboolean
Binding

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

SNOMEDCTMedicationAsNeededReasonCodes (example)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value
  • quick: Proposal.prnReason.reason
ServiceRequest.authoredOn
DefinitionWhen the request transitioned to being actionable.
Cardinality0...1
TypedateTime
SummaryTrue
AliasorderedOn
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • w5: FiveWs.recorded
  • v2: ORC.9, RF1-7 / RF1-9
  • rim: .participation[typeCode=AUT].time
  • quick: Proposal.proposedAtTime
ServiceRequest.requester
DefinitionThe individual who initiated the request and has responsibility for its activation.
Cardinality0...1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)
Must SupportTrue
SummaryTrue
Aliasauthor, orderer
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.requester
  • w5: FiveWs.author
  • v2: ORC.12, PRT
  • rim: .participation[typeCode=AUT].role
  • quick: ClinicalStatement.statementAuthor
ServiceRequest.performerType
DefinitionDesired type of performer for doing the requested service.
Cardinality0...1
TypeCodeableConcept
Binding

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

ParticipantRoles (example)
SummaryTrue
Aliasspecialty
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”.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.performerType
  • w5: FiveWs.actor
  • v2: PRT, RF!-3
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=KIND].code
ServiceRequest.performer
DefinitionThe desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.
Cardinality0...*
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)
SummaryTrue
Aliasrequest recipient
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.performer
  • w5: FiveWs.actor
  • v2: PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
  • rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
ServiceRequest.locationCode
DefinitionThe preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.
Cardinality0...*
TypeCodeableConcept
Binding

A location type where services are delivered.

v3.ServiceDeliveryLocationRoleType (example)
SummaryTrue
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=KIND].code
ServiceRequest.locationReference
DefinitionA reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.
Cardinality0...*
TypeReference(Location)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.actor
  • rim: .participation[typeCode=LOC].role[scoper.determinerCode=INSTANCE]
ServiceRequest.reasonCode
DefinitionAn 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`.
Cardinality0...*
TypeCodeableConcept
Binding

A set of codes that define a reason for a service request.

UKCoreServiceRequestReasonCode (preferred)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • workflow: Request.reasonCode
  • w5: FiveWs.why[x]
  • v2: ORC.16, RF1-10
  • rim: .reasonCode
ServiceRequest.reasonReference
DefinitionIndicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in `supportingInfo`.
Cardinality0...*
TypeReference(Condition | Observation | DiagnosticReport | DocumentReference)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.reasonReference
  • w5: FiveWs.why[x]
  • v2: ORC.16
  • rim: .outboundRelationship[typeCode=RSON].target
ServiceRequest.insurance
DefinitionInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.
Cardinality0...*
TypeReference(Coverage | ClaimResponse)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.insurance
  • v2: IN1/IN2
  • rim: .outboundRelationship[typeCode=COVBY].target
ServiceRequest.supportingInfo
DefinitionAdditional 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.
Cardinality0...*
TypeReference(Resource)
AliasAsk at order entry question, AOE
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
  • v2: Accompanying segments
  • rim: .outboundRelationship[typeCode=PERT].target
ServiceRequest.specimen
DefinitionOne or more specimens that the laboratory procedure will use.
Cardinality0...*
TypeReference(Specimen)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SPM
  • rim: .participation[typeCode=SPC].role
ServiceRequest.bodySite
DefinitionAnatomic location where the procedure should be performed. This is the target site.
Cardinality0...*
TypeCodeableConcept
Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (preferred)
SummaryTrue
Aliaslocation
Requirements

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

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: SPM
  • rim: targetSiteCode
  • quick: Procedure.targetBodySite
ServiceRequest.note
DefinitionAny other notes and comments made about the service request. For example, internal billing notes.
Cardinality0...*
TypeAnnotation
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • v2: NTE
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]
  • quick: ClinicalStatement.additionalText
ServiceRequest.patientInstruction
DefinitionInstructions in terms that are understood by the patient or consumer.
Cardinality0...1
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: NTE
  • rim: .text
ServiceRequest.relevantHistory
DefinitionKey events in the history of the request.
Cardinality0...*
TypeReference(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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.relevantHistory
  • v2: N/A
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Table View

ServiceRequest..
ServiceRequest.extensionExtension..1
ServiceRequest.extensionExtension..
ServiceRequest.extensionExtension..1
ServiceRequest.status..
ServiceRequest.intent..
ServiceRequest.category..
ServiceRequest.category..
ServiceRequest.category.coding..
ServiceRequest.category.coding.system..
ServiceRequest.priority..
ServiceRequest.priority.extensionExtension..
ServiceRequest.code..
ServiceRequest.orderDetail..
ServiceRequest.subject..
ServiceRequest.requester..
ServiceRequest.reasonCode..
ServiceRequest.bodySite..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-ServiceRequest-Lab" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Lab" />
    <version value="2.0.0" />
    <name value="UKCoreServiceRequestLab" />
    <title value="UK Core Service Request Lab" />
    <status value="active" />
    <date value="2024-07-11" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the specific UK constraints and extensions on the International FHIR resource [ServiceRequest](https://hl7.org/fhir/R4/ServiceRequest.html), in order to support requesting laboratory services." />
    <purpose value="To provide implementers additional support for requesting a procedure or diagnostic or other service to be planned, proposed, or performed, with regards to a laboratory observation or a laboratory diagnostic report." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="ServiceRequest" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
    <derivation value="constraint" />
    <differential>
        <element id="ServiceRequest.extension:sourceOfServiceRequest">
            <path value="ServiceRequest.extension" />
            <sliceName value="sourceOfServiceRequest" />
            <short value="Describes the source of the Service Request." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SourceOfServiceRequest" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="ServiceRequest.extension:additionalContact">
            <path value="ServiceRequest.extension" />
            <sliceName value="additionalContact" />
            <short value="Supports recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="ServiceRequest.extension:coverage">
            <path value="ServiceRequest.extension" />
            <sliceName value="coverage" />
            <short value="Supports the exchange of information describing the method of funding for the Service Request." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="ServiceRequest.status">
            <path value="ServiceRequest.status" />
            <short value="The status of the order." />
            <mustSupport value="true" />
        </element>
        <element id="ServiceRequest.intent">
            <path value="ServiceRequest.intent" />
            <short value="Whether the request is a proposal, plan, an original order or a reflex order." />
            <mustSupport value="true" />
        </element>
        <element id="ServiceRequest.category">
            <path value="ServiceRequest.category" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="coding.system" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="ServiceRequest.category:genomicsWholeCaseSequencing">
            <path value="ServiceRequest.category" />
            <sliceName value="genomicsWholeCaseSequencing" />
            <short value="Classification of Genomics service" />
            <definition value="A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory" />
            </binding>
        </element>
        <element id="ServiceRequest.category:genomicsWholeCaseSequencing.coding.system">
            <path value="ServiceRequest.category.coding.system" />
            <fixedUri value="https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory" />
        </element>
        <element id="ServiceRequest.priority.extension:priorityReason">
            <path value="ServiceRequest.priority.extension" />
            <sliceName value="priorityReason" />
            <short value="Supports the underlying reason why a Service Request is urgent." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="ServiceRequest.code">
            <path value="ServiceRequest.code" />
            <definition value="A set of codes from the SNOMED Clinical Terminology UK coding system regarding laboratory medicine test requests." />
            <binding>
                <strength value="preferred" />
                <description value="A set of codes that define laboratory medicine test requests. Selected from the SNOMED CT UK coding system." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-PathologyAndLaboratoryMedicineProcedures" />
            </binding>
        </element>
        <element id="ServiceRequest.orderDetail">
            <path value="ServiceRequest.orderDetail" />
            <binding>
                <strength value="preferred" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode" />
            </binding>
        </element>
        <element id="ServiceRequest.subject">
            <path value="ServiceRequest.subject" />
            <short value="The individual or entity the service is ordered for." />
            <mustSupport value="true" />
        </element>
        <element id="ServiceRequest.requester">
            <path value="ServiceRequest.requester" />
            <short value="Who / what is requesting the service" />
            <mustSupport value="true" />
        </element>
        <element id="ServiceRequest.reasonCode">
            <path value="ServiceRequest.reasonCode" />
            <binding>
                <strength value="preferred" />
                <description value="A set of codes that define a reason for a service request." />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode" />
            </binding>
        </element>
        <element id="ServiceRequest.bodySite">
            <path value="ServiceRequest.bodySite" />
            <binding>
                <strength value="preferred" />
            </binding>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-ServiceRequest-Lab",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest-Lab",
    "version": "2.0.0",
    "name": "UKCoreServiceRequestLab",
    "title": "UK Core Service Request Lab",
    "status": "active",
    "date": "2024-07-11",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the specific UK constraints and extensions on the International FHIR resource [ServiceRequest](https://hl7.org/fhir/R4/ServiceRequest.html), in order to support requesting laboratory services.",
    "purpose": "To provide implementers additional support for requesting a procedure or diagnostic or other service to be planned, proposed, or performed, with regards to a laboratory observation or a laboratory diagnostic report.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "ServiceRequest",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ServiceRequest",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "ServiceRequest.extension:sourceOfServiceRequest",
                "path": "ServiceRequest.extension",
                "sliceName": "sourceOfServiceRequest",
                "short": "Describes the source of the Service Request.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SourceOfServiceRequest"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "ServiceRequest.extension:additionalContact",
                "path": "ServiceRequest.extension",
                "sliceName": "additionalContact",
                "short": "Supports recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContact"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "ServiceRequest.extension:coverage",
                "path": "ServiceRequest.extension",
                "sliceName": "coverage",
                "short": "Supports the exchange of information describing the method of funding for the Service Request.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Coverage"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "ServiceRequest.status",
                "path": "ServiceRequest.status",
                "short": "The status of the order.",
                "mustSupport": true
            },
            {
                "id": "ServiceRequest.intent",
                "path": "ServiceRequest.intent",
                "short": "Whether the request is a proposal, plan, an original order or a reflex order.",
                "mustSupport": true
            },
            {
                "id": "ServiceRequest.category",
                "path": "ServiceRequest.category",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "coding.system"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "ServiceRequest.category:genomicsWholeCaseSequencing",
                "path": "ServiceRequest.category",
                "sliceName": "genomicsWholeCaseSequencing",
                "short": "Classification of Genomics service",
                "definition": "A code that classifies the service for Genomics, whether it is a Whole Case Genome Sequencing or non-Whole Genome Sequencing for cancer or rare diseases",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory"
                }
            },
            {
                "id": "ServiceRequest.category:genomicsWholeCaseSequencing.coding.system",
                "path": "ServiceRequest.category.coding.system",
                "fixedUri": "https://fhir.hl7.org.uk/CodeSystem/UKCore-GenomeSequencingCategory"
            },
            {
                "id": "ServiceRequest.priority.extension:priorityReason",
                "path": "ServiceRequest.priority.extension",
                "sliceName": "priorityReason",
                "short": "Supports the underlying reason why a Service Request is urgent.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReason"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "ServiceRequest.code",
                "path": "ServiceRequest.code",
                "definition": "A set of codes from the SNOMED Clinical Terminology UK coding system regarding laboratory medicine test requests.",
                "binding": {
                    "strength": "preferred",
                    "description": "A set of codes that define laboratory medicine test requests. Selected from the SNOMED CT UK coding system.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-PathologyAndLaboratoryMedicineProcedures"
                }
            },
            {
                "id": "ServiceRequest.orderDetail",
                "path": "ServiceRequest.orderDetail",
                "binding": {
                    "strength": "preferred",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode"
                }
            },
            {
                "id": "ServiceRequest.subject",
                "path": "ServiceRequest.subject",
                "short": "The individual or entity the service is ordered for.",
                "mustSupport": true
            },
            {
                "id": "ServiceRequest.requester",
                "path": "ServiceRequest.requester",
                "short": "Who / what is requesting the service",
                "mustSupport": true
            },
            {
                "id": "ServiceRequest.reasonCode",
                "path": "ServiceRequest.reasonCode",
                "binding": {
                    "strength": "preferred",
                    "description": "A set of codes that define a reason for a service request.",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode"
                }
            },
            {
                "id": "ServiceRequest.bodySite",
                "path": "ServiceRequest.bodySite",
                "binding": {
                    "strength": "preferred"
                }
            }
        ]
    }
}

Feedback

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Report issue for UKCore-ServiceRequest-Lab, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Examples

C Reactive Protein Request - An example to illustrate a request for a C Reactive Protein test based on an inflammed finger joint observation.
Example UKCore-ServiceRequest-Lab-CReactiveProtein

Example Usage Scenarios

The following are example usage scenarios for the UK Core ServiceRequest-Lab profile:

  • Query for ServiceRequest-Lab information
  • Exchange ServiceRequest-Lab information used in Observations and DiagnosticReport

Profile Specific Implementation Guidance:

Mandatory and Must Support Data Elements

The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.

ElementReason
ServiceRequest.statusThe status of the order.
ServiceRequest.intentWhether the request is a proposal, plan, an original order or a reflex order.
ServiceRequest.subjectThe individual or entity the service is ordered for.
ServiceRequest.requesterWho / what is requesting the service


Extensions

More information about the extensions on the UKCore-ServiceRequest-Lab profile can be found using the links below.

ExtensionContextLinkComment
sourceOfServiceRequestServiceRequest.extensionhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SourceOfServiceRequestDescribes the source of the Service Request.
additionalContactServiceRequest.extensionhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdditionalContactSupports recording of additional contacts, who should be contacted regarding questions arising from the service request. This differs from the requester and responsibleClinician.
coverageServiceRequest.extensionhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CoverageSupports the exchange of information describing the method of funding for the Service Request.
priorityReasonServiceRequest.priority.extensionhttps://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PriorityReasonSupports the underlying reason why a Service Request is urgent.


Bindings (differential)

More information about the bindings to UK Core ValueSets can be found below.

ContextStrengthLink
ServiceRequest.categoryextensiblehttps://fhir.hl7.org.uk/ValueSet/UKCore-GenomeSequencingCategory
ServiceRequest.codepreferredhttps://fhir.hl7.org.uk/ValueSet/UKCore-PathologyAndLaboratoryMedicineProcedures
ServiceRequest.orderDetailpreferredhttps://fhir.hl7.org.uk/ValueSet/UKCore-ProcedureCode
ServiceRequest.reasonCodepreferredhttps://fhir.hl7.org.uk/ValueSet/UKCore-ServiceRequestReasonCode

ServiceRequest.extension:coverage extensible ValueSet UKCore-FundingCategory
ServiceRequest.extension:sourceOfServiceRequest preferred ValueSet UKCore-SourceOfServiceRequest
ServiceRequest.category:genomicsWholeCaseSequencing extensible ValueSet UKCore-GenomeSequencingCategory
ServiceRequest.priority.extension:priorityReason preferred ValueSet UKCore-ServiceRequestReasonCode

basedOn

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


replaces

The resource being referenced SHALL conform to the following:


category

The slice ServiceRequest.category:genomicsWholeCaseSequencing has been added to aid in identifying the category of service request for Genomics use cases.


priority

ServiceRequest.priority has the UKCore extension Extension UKCore-PriorityReason.


code

This SHOULD be from ValueSet UKCore-PathologyAndLaboratoryMedicineProcedures if possible.


orderDetail

This SHOULD be from ValueSet UKCore-ProcedureCode if possible.

The use of text might be considered more appropriate for the type of data that the definition describes. Therefore this element SHOULD be used with caution as there is no specific UK use case identified for it.


subject

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


encounter

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Encounter.


requester

Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:


locationReference

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Location.


supportingInfo

Where a UK Core profile exists the resource being referenced SHOULD conform to the profile.


specimen

Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Specimen.


relevantHistory

Where possible, it is expected that the resource being referenced SHOULD conform to